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Tessarin GWL, Toro LF, Pereira RF, Dos Santos RM, Azevedo RG. Peri-implantitis with a potential axis to brain inflammation: an inferential review. Odontology 2024; 112:1033-1046. [PMID: 38630323 DOI: 10.1007/s10266-024-00936-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/26/2024] [Indexed: 09/21/2024]
Abstract
Peri-implantitis (PI) is a chronic, inflammatory, and infectious disease which affects dental implants and has certain similarities to periodontitis (PD). Evidence has shown that PD may be related to several types of systemic disorders, such as diabetes and insulin resistance, cardiovascular diseases, respiratory tract infections, adverse pregnancy outcomes, and neurological disorders. Furthermore, some types of bacteria in PD can also be found in PI, leading to certain similarities in the immunoinflammatory responses in the host. This review aims to discuss the possible connection between PI and neuroinflammation, using information based on studies about periodontal disorders, a topic whose connection with systemic alterations has been gaining the interest of the scientific community. Literature concerning PI, PD, and systemic disorders, such as neuroinflammation, brain inflammation, and neurological disorder, was searched in the PubMed database using different keyword combinations. All studies found were included in this narrative review. No filters were used. Eligible studies were analyzed and reviewed carefully. This study found similarities between PI and PD development, maintenance, and in the bacterial agents located around the teeth (periodontitis) or dental implants (peri-implantitis). Through the cardiovascular system, these pathologies may also affect blood-brain barrier permeability. Furthermore, scientific evidence has suggested that microorganisms from PI (as in PD) can be recognized by trigeminal fiber endings and start inflammatory responses into the trigeminal ganglion. In addition, bacteria can traverse from the mouth to the brain through the lymphatic system. Consequently, the immune system increases inflammatory mediators in the brain, affecting the homeostasis of the nervous tissue and vice-versa. Based on the interrelation of microbiological, inflammatory, and immunological findings between PD and PI, it is possible to infer that immunoinflammatory changes observed in PD can imply systemic changes in PI. This, as discussed, could lead to the development or intensification of neuroinflammatory changes, contributing to neurodegenerative diseases.
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Affiliation(s)
- Gestter Willian Lattari Tessarin
- University Center in the North of São Paulo (UNORTE), São José Do Rio Preto, SP, 15020-040, Brazil.
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
| | - Luan Felipe Toro
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Marilia Medical School (FAMEMA), Marília, São Paulo, Brazil
| | - Renato Felipe Pereira
- Union of Colleges of the Great Lakes (UNILAGO), São José Do Rio Preto, São Paulo, Brazil
| | - Rodrigo Martins Dos Santos
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Renato Gomes Azevedo
- University Center in the North of São Paulo (UNORTE), São José Do Rio Preto, SP, 15020-040, Brazil
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Wang S, Chen X, Ling Z, Xie Y, Chen C, Shen X, He F. Clinical and radiographic outcomes of implant-supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study. Clin Oral Implants Res 2024; 35:1180-1192. [PMID: 38860608 DOI: 10.1111/clr.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The objective of this study is to analyze the clinical and radiographic outcomes of implant-supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible. MATERIALS AND METHODS Patients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single-unit crowns (ISSCs), ISFPCs, implant-supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three-unit ISFPN, ISFPC+ISFPC, or four-unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri-implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM). RESULTS The study included 87 patients and 152 implants. No implant loss occurred during an average follow-up of 3.48 ± 1.85 years (range: 1-7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow-up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four-unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p < .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6). CONCLUSION ISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri-implant bone stability and esthetics to adjacent ISSCs or ISFPNs.
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Affiliation(s)
- Siyuan Wang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhaoting Ling
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yiwen Xie
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Cong Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoting Shen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
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Monje A, Salvi GE. Diagnostic methods/parameters to monitor peri-implant conditions. Periodontol 2000 2024; 95:20-39. [PMID: 38923148 DOI: 10.1111/prd.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/18/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
The diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri-implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary diagnostic tools (chairside) seem to be highly specific, while their sensitivity is lower compared with their use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth and implant sites and the aerobic/anaerobic nature of the microbiome, it seems plausible for pocket probing depth to be indicative of disease progression or tissue stability. In addition, understanding the inflammatory nature of peri-implant diseases, it seems reasonable to advocate that bleeding, erythema, ulceration, and suppuration might be reliable indicators of pathology. Nevertheless, single spots of bleeding on probing may not reflect peri-implant disease, since implants are prone to exhibit bleeding related to probing force. On the other side, bleeding in smokers lacks sensitivity owing to the decreased angiogenic activity. Hence, the use of dichotomous scales on bleeding in the general population, in contrast to indices that feature profuseness and time after probing, might lead to false positive diagnoses. The definitive distinction between peri-implant mucositis and peri-implantitis, though, relies upon the radiographic evidence of progressive bone loss that can be assessed by means of two- and three-dimensional methods. Accordingly, the objective of this review is to evaluate the existing clinical and radiographic parameters/methods to monitor peri-implant conditions.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, University of Bern, Bern, Switzerland
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Manfredini M, Poli PP, Beretta M, Rossi F, Rigoni M, Veronesi V, Maiorana C. Radiographic evaluation of marginal bone levels around implants supporting splinted fixed bridges: A retrospective study on 412 implants. Clin Oral Implants Res 2024; 35:547-559. [PMID: 38372478 DOI: 10.1111/clr.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES The effect of the implant position within the prosthesis on bone remodeling is scarcely documented so far. Thus, the aim of the present study was to investigate whether central implants may suffer higher peri-implant marginal bone levels (MBL) compared to laterals in case of fixed splinted bridges supported by ≥ three implants. MATERIALS AND METHODS Partially edentulous subjects rehabilitated with at least one fixed bridge supported by ≥ three dental implants were enrolled. MBL was assessed radiographically by means of intraoral radiographs acquired with phosphor plates and imported in a dedicated software. MBL was calculated as the distance between the implant platform level and the most coronal visible bone-to-implant contact. A three-level linear mixed effects model was used for investigating the fixed effect of patient-, prosthesis-, and implant-level variables on the MBL. RESULTS Overall, 90 patients rehabilitated with 130 splinted fixed bridges supported by 412 implants were included. The median follow-up was 136 months. The mean peri-implant MBL resulted statistically significantly higher at central implants if compared to lateral implants (p < .01). The estimated MBL averages for central and external implants were 1.68 and 1.18 mm, respectively. The prosthesis-level variables suggested that a cement-retained bridge was prone to a significant 0.82 mm higher MBL than a screw-retained one. Implant surface showed an association with MBL changes, although less pronounced than implant retention. CONCLUSIONS In case of ≥3 adjacent implants supporting splinted bridges, central implants were more predisposed to MBL compared to laterals. At the prosthesis level, implants supporting cement-retained bridges were statistically more susceptible to MBL compared to screw-retained ones. Surface characteristics can also influence MBL stability at the implant level.
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Affiliation(s)
- Mattia Manfredini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Pier Paolo Poli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Mario Beretta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Federico Rossi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Veronesi
- Bicocca Bioinformatics Biostatistics and Bioimaging Center - B4, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Maiorana
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Roccuzzo A, Morandini M, Stähli A, Imber JC, Sculean A, Salvi GE. Clinical and radiographic outcomes of implant-supported zirconia fixed dental prostheses with cantilever extension: A proof-of-principle study with a follow-up of at least 1 year. Clin Oral Implants Res 2023; 34:1073-1082. [PMID: 37485971 DOI: 10.1111/clr.14138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES To test the reliability of full zirconia implant-supported fixed dental prostheses with cantilever extension (FDPCs) after at least 1 year of function. MATERIALS AND METHODS Thirty-five patients in need of implant-supported single unit crowns (SUC) and FDPCs in posterior areas were enrolled. After implant placement, patients were rehabilitated with screw-retained full-zirconia FDPCs. Implant survival rate, pocket probing depth (PPD), presence/absence of bleeding on probing (BoP), and presence/absence of mechanical/technical complications were recorded. Mesial and distal radiographic marginal bone levels (mBLs) from baseline (i.e., recall appointment 3-6 months after implant loading [T0]) to the follow-up examination (i.e., latest recall appointment after at least 12 months after T0 [T1]), were calculated. RESULTS Thirty patients with 34 FDPCs (31 SUCs and 3 FDPs) supported by 37 implants were available for analysis after a mean loading time of 2.6 ± 1.5 years (range: 13-87 months). No implants were lost. MBLs and mean PPD values did not change statistically significantly from T0 to T1 from 0.92 mm ± 0.42 to 0.96 mm ± 0.38 (95% CI: -0.07/0.17; p = .418) and from 2.99 mm ± 0.70 to 3.27 mm ± 0.71 (95% CI: -0.11/0.68; p = .25) respectively. Peri-implant mucositis was diagnosed in 22 cases. Screw-loosening and zirconia chipping occurred 1× in 4 patients. CONCLUSION Within the limitations of the present proof-of-principle study, the use of full-zirconia FDPCs in posterior areas seems a valid and safe short-term treatment option.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michele Morandini
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Bredberg C, Vu C, Häggman-Henrikson B, Chrcanovic BR. Marginal bone loss around dental implants: comparison between matched groups of bruxer and non-bruxer patients: A retrospective case-control study. Clin Implant Dent Relat Res 2023; 25:124-132. [PMID: 36411179 PMCID: PMC10099792 DOI: 10.1111/cid.13161] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare marginal bone loss (MBL) around dental implants in a group of bruxers in relation to a matched group of non-bruxers. METHODS The present record-based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö. Only implants not lost and with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up were considered for inclusion. Univariate linear regression models and a linear mixed-effects model were performed. RESULTS Two hundred and four patients (104 bruxers, 100 non-bruxers), with a total of 811 implants (416 in bruxers, 395 in non-bruxers) were included in the study. The results of the linear mixed-effects model suggested that bruxism, smoking, age, region of the jaws, implant diameter, and prosthesis type had a statistically significant influence on MBL over time. Individuals who are both bruxers and smokers showed greater MBL when compared to individuals who are either a bruxer or smoker, or neither (p < 0.001). CONCLUSIONS Bruxism is suggested to increase the risk of MBL over time, as well as higher age, smoking, and the combination of bruxism and smoking. Other factors that showed a correlation with increased MBL were implant diameter, region of the jaws, and prosthesis type, but it is not possible to draw robust conclusions for these factors, as the categories of these variables were very unbalanced.
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Affiliation(s)
| | - Camila Vu
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Salvi GE, Stähli A, Imber JC, Sculean A, Roccuzzo A. Physiopathology of peri-implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36515007 DOI: 10.1111/cid.13167] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Peri-implant health is characterized by the absence of clinical signs of soft tissue inflammation. Peri-implant diseases are initiated by the presence of bacterial biofilms and share a similar etiology as that involved in the onset of periodontal diseases. PURPOSE To summarize available evidence on the physiopathology of peri-implant diseases with emphasis on similarities and differences with periodontal diseases. MATERIALS AND METHODS Evidence on the biologic mechanisms involved in the pathogenesis of peri-implant mucositis and peri-implantitis were explored in the recent scientific literature. RESULTS Findings of studies in animals and in humans indicate that experimental peri-implant mucositis leads to a larger inflammatory connective tissue infiltrate and to a higher frequency of bleeding sites around implants compared with teeth. Tissue destruction at experimental peri-implantitis sites is more pronounced compared with that at experimental periodontitis sites. Although human periodontitis and peri-implantitis lesions share similarities with respect to etiology and clinical features, they represent distinct entities from a physiopathologic point of view. CONCLUSIONS Diagnosis of peri-implant health requires a clinical examination to confirm absence of peri-implant soft tissue inflammation. In order to make a correct diagnosis and select the appropriate therapeutic steps to manage peri-implant diseases, knowledge of their pathogenetic mechanisms is required.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Gil A, Strauss FJ, Hämmerle CHF, Wolleb K, Schellenberg R, Jung R, Thoma DS. Radiographic density changes may be associated with overloading and implant loss on short implants: A 5-year analysis of a randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:766-775. [PMID: 36190145 DOI: 10.1111/cid.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To analyze changes in radiographic bone density around short implants with and without cantilevers at 5 years post-loading. MATERIALS AND METHODS Thirty-six patients with two adjacent posterior missing teeth participated in this randomized controlled clinical trial. All patients were randomly allocated to receive either two short implants (6 mm) with single-unit restorations (group TWO) or one single short implant (6 mm) with a cantilever restoration (group ONE-C). Patients were followed up at 6 months, 1, 3, and 5 years. Radiographic analysis was performed, through an arbitrary gray scale value (GSV) of the peri-implant bone, assessing the changes in radiographic density between groups and between time points. Differences in GSV between groups and over time were calculated using a generalized estimating equation to allow for adjustments for the correlation within individuals and between time points. RESULTS At 5 years, 26 patients remained in the study (15 in group ONE-C; 11 in group TWO). Implant survival rates were 80.4% in group TWO and 84.2% in group ONE-C (p = 0.894). The radiographic analysis revealed that GSVs increased in both groups over time (p < 0.001). The overall radiographic density was higher in group ONE-C than in group TWO in the maxilla (p = 0.030). Conversely, in the mandible, these significant differences between the groups were not found (p > 0.05). Compared to the implants that survived, the implants that failed demonstrated a distinct radiographic density pattern (p < 0.05). CONCLUSION Within the limitations of the present study, the radiographic bone density in the maxilla appears to increase distinctly around short implants when cantilevers are used. In contrast, the radiographic density in the mandible appears to be unaffected by the use of a cantilever, suggesting a lower threshold of adaptation to occlusal forces and thus a higher susceptibility to overload and implant loss at earlier time points.
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Affiliation(s)
- Alfonso Gil
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
| | | | - Karin Wolleb
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
| | - Roman Schellenberg
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zürich, Switzerland
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Di Fiore A, Montagner M, Sivolella S, Stellini E, Yilmaz B, Brunello G. Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J Clin Med 2022; 11:jcm11164812. [PMID: 36013048 PMCID: PMC9409652 DOI: 10.3390/jcm11164812] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | | | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Department of Oral Surgery, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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Tosta M, Fahl N, Chambrone L, Duarte W. The beyond the gap filling approach: Modeling facial and interproximal tissues and improving esthetics for anterior flapless immediate implant placement. J ESTHET RESTOR DENT 2022; 34:592-603. [PMID: 35261141 DOI: 10.1111/jerd.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Maintenance of adequate interproximal tissue height between an implant and a natural tooth or between adjacent implants represents an esthetic challenge in implant dentistry. The aim of this case report is to describe a modified technique referred to as the beyond the gap filling (BGF) approach designed to improve the horizontal and vertical components of the facial aspect and particularly the height of interproximal bone peaks around immediately placed implants into fresh extraction sockets. CLINICAL CONSIDERATIONS Four patients (five teeth) requiring anterior tooth extraction were treated with the BGF approach that included: (a) minimally traumatic tooth extraction; (b) immediate implant placement without flap elevation; (c) installation of a narrow profile healing abutment to protect the implant during grafting; (d) grafting with a construct with 90% bovine bone granules and 10% porcine collagen packed coronally to the facial and interproximal bone walls above the level of the bone crest; and (e) delivery of an immediate restoration. CONCLUSIONS The current report suggests that the level/height of the interproximal bone crests between an implant and a natural tooth or between two adjacent implants can be improved by the BGF approach and, consequently, papilla height can be maintained in cases with a high risk of papilla height collapse and, consequently, esthetic outcomes can be maximized. CLINICAL SIGNIFICANCE The BGF is a simple technique to be used by clinicians to prevent significant papilla collapse in anterior immediate implants and consequently achieve maximum esthetic outcomes in implant dentistry.
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Affiliation(s)
| | - Newton Fahl
- Private Practice & Clinical and Scientific Director, Fahl Center, Curitiba, Brazil
| | - Leandro Chambrone
- School of Dentistry, Ibirapuera University (UNIB), São Paulo, Brazil.,Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Bogota, Colombia
| | - Wagner Duarte
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, USA
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12
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Occlusal change in posterior implant-supported single crowns and its association with peri-implant bone level: a 5-year prospective study. Clin Oral Investig 2022; 26:4217-4227. [PMID: 35129663 DOI: 10.1007/s00784-022-04394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aims to analyze the 5-year occlusal change in posterior implant-supported single crowns and the association between the relative occlusal force (ROF) and peri-implant bone level. MATERIALS AND METHODS Partially edentulous patients who had received implant-supported single crowns in the posterior region were included. Occlusal examinations with a computerized occlusion analysis system were conducted at 0.5, 3, 6, 12, 24, 36, 48, and 60 months after delivery of the implant-supported single crown. The ROFs of implant-supported single crowns, mesial adjacent teeth, and control natural teeth were recorded. Intraoral periapical radiographs were taken at each follow-up time to evaluate marginal bone level (MBL). Ordinary least square regression was used to analyze the association between ROF and MBL. RESULTS Thirty-seven posterior implant-supported single crowns in 33 participants (23.9 to 70.0 years) were followed up for 0.5 to 60 months [(42.4 ± 26.0) months]. The ROF of implant-supported single crowns increased from 2 weeks to 3 months (P < 0.01) and increased continuously between all two sequential time points from 6 to 36 months, with significant differences (P < 0.05). Then ROFs of implant-supported single crowns were significantly higher than those of control teeth at 48 and 60 months (P < 0.05). Regression analysis showed that ROF was significantly associated with MBL with a coefficient of 0.008 (P < 0.05). CONCLUSION The ROFs of posterior implant-supported single crown have significant change during 5 years' follow-up. The association between ROF and MBL has limited clinical significance. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-ROC-17012240. CLINICAL RELEVANCE The occlusion of implant-supported single crowns should be carefully monitored during follow-up examinations, and occlusal adjustment should be considered to prevent overloading.
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13
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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Thoma DS, Wolleb K, Schellenberg R, Strauss FJ, Hämmerle CHF, Jung RE. Two short implants versus one short implant with a cantilever: 5-Year results of a randomized clinical trial. J Clin Periodontol 2021; 48:1480-1490. [PMID: 34448219 PMCID: PMC9292666 DOI: 10.1111/jcpe.13541] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023]
Abstract
Aim To test whether or not the use of a short implant with a cantilever results in similar clinical and radiographic outcomes compared to two adjacent short implants with single tooth reconstructions. Materials and methods Thirty‐six patients with two adjacent missing teeth in the posterior region were randomly assigned to receive either a single 6‐mm implant with a cantilever (ONE‐C) or two 6‐mm implants (TWO). Fixed reconstructions were inserted 3–6 months after implant placement and patients were re‐examined up to 5 years (FU‐5). Results A total of 26 patients were available for re‐examination at FU‐5. The survival rate amounted to 84.2% in ONE‐C and to 80.4% in TWO (inter‐group: p = .894). Technical complication rates amounted to 64.2% (ONE‐C) and to 54.4% (TWO) (inter‐group: p = 1.000). From baseline to FU‐5, the median changes of the marginal bone levels were 0.13 mm in ONE‐C and 0.05 mm in TWO (inter‐group: p = .775). Probing depth, bleeding on probing, and plaque control record values showed no significant differences between the two treatment modalities (p > .05). Conclusions Short implants with a cantilever render similar clinical and radiographic outcomes compared to two adjacent short implants at 5 years, however, they tend to fail at earlier time points suggesting an overload of the implants. Considering the modest survival rates, the clinical indication of either treatment option needs to be carefully evaluated. ClinicalTrials.gov (NCT01649531).
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Roman Schellenberg
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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15
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Schmid E, Roccuzzo A, Morandini M, Ramseier CA, Sculean A, Salvi GE. Clinical and radiographic evaluation of implant-supported single-unit crowns with cantilever extension in posterior areas: A retrospective study with a follow-up of at least 10 years. Clin Implant Dent Relat Res 2021; 23:189-196. [PMID: 33448601 DOI: 10.1111/cid.12973] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Implant-supported restorations with cantilever extension may display high rates of biological and technical complications. PURPOSE To report the outcomes of single-unit crowns with cantilever extension (SCCs). MATERIALS AND METHODS Patients with SCCs were reevaluated after ≥10 years of loading. Radiographic marginal bone levels (mBLs) at baseline (ie, delivery of SCCs) and follow-up were calculated and compared between implant surfaces adjacent to and distant from the cantilever extension. Implant survival and success rates were calculated. RESULTS Twenty-one patients with 25 SCs supported by 25 implants were reevaluated after a mean of 13.6 ± 3.8 years (range: 10-19 years). No implants were lost. The mean overall mBLs changed from 0.99 mm ± 0.95 at baseline to 0.95 mm ± 0.99 at follow-up (p = 0.853). The mean pocket probing depths changed from 3.39 mm ± 0.62 at baseline to 3.34 mm ± 0.54 at follow-up (p = 0.635). Loss of retention occurred 3× in 2 patients (14.3%). At follow-up, peri-implant health was diagnosed in 10 (48%) and peri-implant mucositis in 11 (52%) patients, respectively. CONCLUSIONS Within the limitations of the present study, the use of implant-supported SCs with cantilever extension in posterior areas represents a reliable long-term treatment option with a 100% implant survival rate and minimal marginal bone level changes.
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Affiliation(s)
- Eric Schmid
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Michele Morandini
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Yin S, Zhang W, Tang Y, Yang G, Wu X, Lin S, Liu X, Cao H, Jiang X. Preservation of alveolar ridge height through mechanical memory: A novel dental implant design. Bioact Mater 2021; 6:75-83. [PMID: 32817915 PMCID: PMC7419257 DOI: 10.1016/j.bioactmat.2020.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 11/26/2022] Open
Abstract
Irreversible marginal bone loss can hinder recovery around dental implants. Insufficient alveolar osteogenesis and stress concentration during chewing contribute to marginal bone resorption and can result in implant failure. A biomaterial with a micropore-channel structure was developed using 3D printing technology. This design facilitated bony ingrowth and provided similar mechanical stimulation at the implant neck during mastication to a natural tooth. The micropore channels provided a guiding structure for bone mesenchymal stem cell proliferation and differentiation without the need for growth factors. Specifically, this was achieved through mechanical transduction by F-actin remodeling and the activation of Yes-associated protein (YAP). The implants were verified in a canine dental implant surgery model, which demonstrated the promising use of biomaterial-based dental implants in future clinical applications.
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Affiliation(s)
- Shi Yin
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Wenjie Zhang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yanmei Tang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Guangzheng Yang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xiaolin Wu
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Sihan Lin
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Science, Beijing, 100049, China
| | - Huiliang Cao
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, 200050, China
| | - Xinquan Jiang
- Department of Prosthodontics, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China
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Lateral static overload on immediately restored implants decreases the osteocyte index in peri-implant bone: a secondary analysis of a pre-clinical study in dogs. Clin Oral Investig 2020; 25:3297-3303. [PMID: 33150510 DOI: 10.1007/s00784-020-03662-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/27/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES This animal study was conducted to evaluate the osteocyte index in the peri-implant bone around immediately restored implants under static lateral overload. MATERIAL AND METHODS Seven mongrel dogs received three implants on each side of the mandible. Forty-two implants were distributed into three groups (14 implants per group); each animal received two implants connected to a 4.5-mm opened expansion device (experimental group); in the other mandible side, two implants were connected into an expansion device without activation (control group); one implant each side of the mandible was left submerged (unload group). After 4 months under daily mechanical and chemical plaque control, the animals were euthanized; dental implants and surrounding bone were removed and processed to obtain thin ground sections. Histomorphometry was used to evaluate the osteocyte index in the peri-implant bone contact to implant. RESULTS A higher, statistically significant mean number of osteocytes × 10-5 μm2 (54.74 ± 23.91) was found in the control group compared with the test group (22.57 ± 22.55) (p = 0.0221). The correlation between percentage of bone-implant contact and osteocyte index for submerged implants was not statistically significant (p = 0.2667), whereas the value for immediately loaded implants was statistically significant (p = 0.0480). CONCLUSION The lower number of osteocytes in the peri-implant bone around overloaded implants could be related to the need for functional adaptation of the bone tissue to overloading and to the hypothesized involvement of the osteocytes in the maintenance of the bone matrix in the control group. CLINICAL RELEVANCE Osteocytes play a pivotal role in bone adaptation to mechanical loading, and the osteocyte network has been regarded as being the main mechanosensory mechanism.
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