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West N, Chapple I, Culshaw S, Donos N, Needleman I, Suvan J, Nibali L, Patel A, Preshaw PM, Kebschull M. BSP Implementation of prevention and treatment of peri-implant diseases - The EFP S3 level clinical practice guideline. J Dent 2024; 149:104980. [PMID: 38697506 DOI: 10.1016/j.jdent.2024.104980] [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: 03/11/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES to adapt the supranational European Federation of Periodontology (EFP) Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline for UK healthcare environment, taking into account a broad range of views from stakeholders and patients. SOURCES This UK version, based on the supranational EFP guideline [1] published in the Journal of Clinical Periodontology, was developed using S3-level methodology, combining assessment of formal evidence from 13 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 55 clinical recommendations for the Prevention and Treatment of Peri-implant Diseases, based on the classification for periodontal and peri‑implant diseases and conditions [2]. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework, following the S3-process, the underlying evidence was updated and a representative guideline group of 111 delegates from 26 stakeholder organisations was assembled into four working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline for the Prevention and Treatment of Peri-implant Diseases was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the UK healthcare community including the public. CLINICAL SIGNIFICANCE The S3-level-guidelines combine evaluation of formal evidence, grading of recommendations and synthesis with clinical expertise of a broad range of stakeholders. The international S3-level-guideline was implemented for direct clinical applicability in the UK healthcare system, facilitating a consistent, interdisciplinary, evidence-based approach with public involvement for the prevention and treatment of peri‑implant diseases.
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Affiliation(s)
- Nicola West
- Restorative Dentistry, Bristol Dental School, University of Bristol, Bristol BS1 2LY, UK; Restorative Dentistry, Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough Street, Bristol BS1 3NU, UK; Secretary General, European Federation of Periodontology, 4 rue de la Presse, 1000, Brussels, Belgium.
| | - Iain Chapple
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Shauna Culshaw
- University of Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (AMUL), Turner Street, London, E1 2AD, UK
| | - Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Jeanie Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Amit Patel
- Birmingham Dental Specialists, President of the Association of Dental Implantology, University of Birmingham, Birmingham, UK
| | - Philip M Preshaw
- School of Dentistry, University of Dundee, Dundee UK; School of Dental Sciences, University of Newcastle, Newcastle upon Tyne, UK
| | - Moritz Kebschull
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA; School of Dentistry, University of Birmingham, President-Elect of the European Federation of Periodontology, Birmingham B5 7EG, UK.
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Pedrinaci I, Hamilton A, Lanis A, Sanz M, Gallucci GO. The Bio-Restorative Concept for Implant-Supported Restorations. J ESTHET RESTOR DENT 2024. [PMID: 39210698 DOI: 10.1111/jerd.13306] [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: 06/03/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study aims to present the bio-restorative approach in implant dentistry, which combines biological and restorative concepts through digital planning. This concept combines periodontal, surgical, and prosthetic variables, aiming to reduce patient morbidity while achieving satisfactory esthetic and functional outcomes in implant-supported restorations in the long term. OVERVIEW Implant dentistry evolved from a primarily surgical to a recent prosthetically driven approach. This evolution was partly due to advancements in bone reconstructive techniques and an increased demand for esthetic outcomes. Recently, digital planning has introduced a new paradigm that allows for the full integration of both approaches. The bio-restorative concept considers functional, esthetic, and biological variables in a virtual planning environment. This is achieved through the simultaneous digital assessment of (A) anatomical site characteristics and (B) implant restorative variables. These variables include digital tooth arrangement, soft-hard tissue conditions, implant variables, supra-platform components, and a surgical plan that respects or modifies peri-implant phenotype. CONCLUSIONS The bio-restorative concept is intended to improve contemporary implant dentistry by integrating updated biological and prosthetic notions through digital planning. Adopting this paradigm has the potential to redefine the standards in implant dentistry, fostering a holistic and patient-centered approach. CLINICAL CONSIDERATIONS It enhances patient and clinician satisfaction through more efficient and less invasive procedures. Significantly, it improves predictability, leading to successful implant-supported restorations in the long term.
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Affiliation(s)
- Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Australia
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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Chou YH, Hsiao WL, Chen CJ, Lin YC, Liu PF, Hu KF, Cheng CW. Association between prosthesis contour and peri-implantitis in patients compliant with supportive periodontal therapy: A retrospective cohort study. J Prosthodont Res 2024:JPR_D_23_00236. [PMID: 39198202 DOI: 10.2186/jpr.jpr_d_23_00236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2024]
Abstract
PURPOSE Poor contour of the implant restoration causes plaque accumulation and increases the risk of peri-implantitis. This study aimed to investigate whether the prosthodontic components of dental implants were associated with the prevalence of peri-implantitis. METHODS We enrolled 185 patients with 348 implants who underwent at least 1-year follow-up after the delivery of the prosthesis from February 2010 to January 2021. Demographic data of the patients and implants and the follow-up period were recorded. The emergence angle, type of cervical crown contour, and contour angle were analyzed using annual bite-wing radiographs. Peri-implantitis in this study was diagnosed if the peri-implant bone loss was greater than 2 mm between the bite-wing radiographs taken at baseline and the latest. Chi-square test, two-sample t-test, and multivariate logistic regression were used to investigate the differences and odds ratios between the peri-implantitis and non-peri-implantitis groups. RESULTS The incidence of peri-implantitis was 14.9% during a follow-up period of 1509 days after the delivery of the prosthesis for at least 1-year. Based on the prevalence of non-peri-implantitis and after adjusting for confounding factors, the risk factors identified were bone types for implants (native bone vs. alveolar ridge preservation: adjusted odds ratio = 2.43, P = 0.04). Sex, arch, and guided bone regeneration vs. alveolar ridge preservation have the potential for a statistical difference. CONCLUSIONS Compared with implants at alveolar ridge preservation sites, implants in the native bone were more prone to peri-implantitis. Further randomized controlled trials are required to determine these associations.
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Affiliation(s)
- Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Lin Hsiao
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jung Chen
- Division of Periodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Kai-Fang Hu
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Wen Cheng
- Division of Family Dentistry, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
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Pimkhaokham A, Chow J, Pozzi A, Arunjaroensuk S, Subbalehka K, Mattheos N. Computer-assisted and robotic implant surgery: Assessing the outcome measures of accuracy and educational implications. Clin Oral Implants Res 2024; 35:939-953. [PMID: 37994685 DOI: 10.1111/clr.14213] [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: 08/14/2023] [Revised: 09/30/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE This scoping review aimed to (1) critically evaluate the outcomes measures used to assess the accuracy of implant placement with Computer Assisted Implant Surgery (CAIS) and (2) review the evidence supporting the efficient implementation of CAIS in training and education of clinicians. METHODS A scoping literature review was conducted aiming to identify (a) clinical trials assessing accuracy of implant placement with CAIS, and (b) clinical trials or simulation/cadaver studies where CAIS was utilised and assessed for the training/education of clinicians. Studies since 1995 were assessed for suitability and data related to the outcomes measures of accuracy and educational efficacy were extracted and synthesised. RESULTS Accuracy of CAIS has been mainly assessed through surrogate measures. Individual clinical trials have not shown any difference between static and dynamic CAIS, but recent meta-analyses suggest an advantage of dynamic CAIS in reducing angular deviation. The combination of static and dynamic CAIS might offer higher accuracy than each of the two used alone. Dynamic CAIS is suitable for novice surgeons and might even have added value as an education tool for implant surgery, although mastering the technique requires longer training than static. CONCLUSION Meta-analyses of large samples, new and diverse outcomes measures, as well as benchmarking of levels of accuracy with specific clinical outcomes will help to better understand the potential and limitations of CAIS. Dynamic CAIS is suitable for novice operators, but educational interventions distributed over longer periods of time will be required for mastery of the process.
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Affiliation(s)
- Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - James Chow
- Brånnemark Osseointegration Centre, Hong Kong SAR, China
| | - Alessandro Pozzi
- Goldstein Center for Esthetic and Implant Dentistry, Augusta University, Dental College of Georgia, Augusta, Georgia, USA
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalehka
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Strasding M, Marchand L, Merino E, Zarauz C, Pitta J. Material and abutment selection for CAD/CAM implant-supported fixed dental prostheses in partially edentulous patients - A narrative review. Clin Oral Implants Res 2024; 35:984-999. [PMID: 38864592 DOI: 10.1111/clr.14315] [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: 08/31/2023] [Revised: 05/15/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024]
Abstract
Restorative material selection has become increasingly challenging due to the speed of new developments in the field of dental material science. The present narrative review gives an overview of the current indications for implant abutments and restoration materials for provisional and definitive implant-supported fixed dental prostheses in partially edentulous patients. For single implant restorations, titanium base abutments for crowns are suggested as an alternative to the conventional stock- and customized abutments made out of metal or zirconia. They combine the mechanical stability of a metallic connection with the esthetic potential of ceramics. For multiple-unit restorations, conical titanium bases especially designed for bridges are recommended, to compensate for deviating implant insertion axes and angulations. Even though titanium base abutments with different geometries and heights are available, certain clinical scenarios still benefit from customized titanium abutments. Indications for the definitive material in fixed implant restorations depend on the region of tooth replacement. In the posterior (not esthetically critical) zone, ceramics such as zirconia (3-5-Ymol%) and lithium-disilicate are recommended to be used in a monolithic fashion. In the anterior sector, ceramic restorations may be buccally micro-veneered for an optimal esthetic appearance. Lithium-disilicate is only recommended for single-crowns, while zirconia (3-5-Ymol%) is also recommended for multiple-unit and cantilever restorations. Attention must be given to the specific mechanical properties of different types of zirconia, as some feature reduced mechanical strengths and are therefore not indicated for all regions and restoration span lengths. Metal-ceramics remain an option, especially for cantilever restorations.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Marchand
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Elizabeth Merino
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Cristina Zarauz
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Rungtanakiat P, Thitaphanich N, Janda M, Strauss FJ, Arksornnukit M, Mattheos N. Association of Peri-Implant Mucosa Dimensions With Emergence Profile Angles of the Implant Prosthesis. Clin Exp Dent Res 2024; 10:e939. [PMID: 39039934 PMCID: PMC11263758 DOI: 10.1002/cre2.939] [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: 03/31/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES The primary aim of this cross-sectional study was to investigate the association between prosthesis design and peri-implant mucosa dimensions and morphology. The secondary aim was to investigate associations between mucosal dimensions and the presence of mucositis. MATERIALS AND METHODS Forty-seven patients with 103 posterior bone level implants underwent clinical and radiographic examination, including cone beam computer tomography and intraoral optical scanning. Three-dimensional models for each implant and peri-implant mucosa were constructed. Vertical mucosa height (TH), horizontal mucosa width at implant platform (TW), and 1.5 mm coronal of the platform (TW1.5), as well as mucosal emergence angle (MEA), deep angle (DA), and total contour angle (TA) were measured at six sites for each implant. RESULTS There was a consistent correlation between peri-implant mucosa width and height (β = 0.217, p < 0.001), with the width consistently surpassing height by a factor of 1.4-2.1. All three angles (MEA, DA, TA) were negatively associated with mucosa height (p < 0.001), while DA was negatively associated with mucosa width (TW1.5) (p < 0.001, β = -0.02, 95% CI: -0.03, -0.01). There was a significant negative association between bleeding on probing (BoP) and mucosa width at platform (OR 0.903, 95% CI: 0.818-0.997, p = 0.043) and 1.5 coronal (OR 0.877, 95% CI: 0.778-0.989, p = 0.033). Implants with less than half sites positive for BoP (0-2/6) had significantly higher mucosa height (OR 3.51, 95% CI: 1.72-7.14, p = 0.001). CONCLUSIONS Prosthesis design can influence the dimensions of the peri-implant mucosa, with wider emergence profile angles associated with reduced peri-implant mucosa height. In particular, a wider deep angle is associated with reduced mucosa width in posterior sites. Reduced peri-implant mucosa height and width are associated with more signs of inflammation. TRIAL REGISTRATION Registered in Thai Clinical Trials Registry: http://www.thaiclinicaltrials.org/show/TCTR20220204002.
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Affiliation(s)
- Piboon Rungtanakiat
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Natchaya Thitaphanich
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Martin Janda
- Department of Prosthodontics, Faculty of OdontologyMalmoe UniversityMalmöSweden
| | - Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
- Faculty of DentistryUniversidad Finis TerraeSantiagoChile
| | - Mansuang Arksornnukit
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
- Department of Dental MedicineKarolinska InstituteStockholmSweden
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Târtea DA, Manolea HO, Ionescu M, Gîngu O, Amărăscu MO, Popescu AM, Mercuţ V, Popescu SM. A Microscopy Evaluation of Emergence Profile Surfaces of Dental Custom CAD-CAM Implant Abutments and Dental Implant Stock Abutments. J Pers Med 2024; 14:699. [PMID: 39063952 PMCID: PMC11278322 DOI: 10.3390/jpm14070699] [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: 05/29/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Recently, due to the high demand for dental implants, the use of dental implant stock abutments has increased significantly, especially dental custom CAD/CAM implant abutments milled by dental technicians in their laboratories. The purpose of this study is to analyze the surface quality of the emergence profile of dental custom CAD/CAM implant abutments made by a non-industrial milling machine, compared to original and compatible dental implant stock abutments made by industrial machines. Thirty dental implant abutments were divided into six study lots. Lot 1 (control group): original dental implant stock abutments-industrial machined; lot 2 (study group): compatible dental implant stock abutments-industrial machined; lots 3, 4, 5, and 6 (study groups): compatible custom CAD/CAM dental implant abutments-non-industrial milled with hyperDENT CAM software and Paragon Tools. The Nikon SMZ745T stereomicroscope was used to analyze the emergence profile surface of each dental implant abutment. The structure of the analyzed surfaces did not show significant differences between original and compatible abutments that were industrially machined. As for the customized dental implant abutments, the greatest similarity with the original was obtained for lot 6, and a significant statistical difference was obtained for lot 4. Stepover and Feed Rate parameters of the milling process influenced the surface roughness of the emergence profile for the customized dental implant abutments. The digital technology of non-industrial milling compatible custom CAD/CAM dental implant abutments is reliable and within the correct milling parameters.
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Affiliation(s)
- Daniel Adrian Târtea
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania (S.M.P.)
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Oana Gîngu
- Department of Engineering and Management of Technological Systems, Faculty of Mechanics, University of Craiova, 200512 Craiova, Romania;
| | - Marina Olimpia Amărăscu
- Department of Dental Morphology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adrian Marcel Popescu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.M.P.); (V.M.)
| | - Veronica Mercuţ
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.M.P.); (V.M.)
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania (S.M.P.)
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Sanz-Sánchez I, Molina A, Martin C, Bollain J, Calatrava J, Sanz M. The effect of one-time abutment placement on clinical and radiographic outcomes: A 5-year randomized clinical trial. Clin Oral Implants Res 2024; 35:609-620. [PMID: 38506392 DOI: 10.1111/clr.14256] [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: 01/05/2024] [Revised: 02/22/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-term (5 years) clinical efficacy of the one-abutment one-time protocol (test) versus the standard of care by placing the definitive abutment on the day of the prosthetic delivery (control). MATERIALS AND METHODS In this study, 39 subjects with 60 implants were randomly allocated to either the test or the control group. Changes in the radiographic interproximal bone levels (DIB), modified sulcus bleeding index, probing depth, modified plaque index, papilla fill (Jemt score), incidence of peri-implantitis and peri-implant mucositis as well as patient-reported outcomes measures (PROMs) were collected and compared at 1, 3 and 5 years. RESULTS At 5 years, the control group showed a greater, although not statistically significant, change in mean DIB values (0.97 mm vs. 0.53 mm). Regarding the other clinical parameters evaluated, no statistically significant differences were observed between groups at any time point. At 5 years, 51% of the implants presented peri-implant mucositis (25.5% in the control and 23.5% in the test), and only one implant in the test group developed peri-implantitis. CONCLUSIONS The connection and disconnection of healing abutments during the healing period was not associated with higher long-term bone loss. Clinical outcomes and PROMs were similar between groups.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Conchita Martin
- BIOCRAN (Craniofacial Biology: Orthodontics and Dentofacial Orthopedics) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Juan Bollain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Javier Calatrava
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
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Janda M, Mattheos N. Prosthetic design and choice of components for maintenance of optimal peri-implant health: a comprehensive review. Br Dent J 2024; 236:765-771. [PMID: 38789753 DOI: 10.1038/s41415-024-7357-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 05/26/2024]
Abstract
Current research has identified features of the prosthetic design with potential to significantly impact the long-term health of peri-implant tissues, while the choice of prosthetic components is also shown to be critical in an effort to reduce long-term complications of implant therapy. Overcontouring of the prosthesis emergence profile has been associated with marginal bone loss, recession and peri-implantitis, while the mucosal emergence angle is shown to have a strong association with peri-implant tissue inflammation. Further elements of interest include convexity/concavity of the restoration, the prosthetic connection and the different geometric configurations of junctions, as well as the peri-implant tissue dimensions. With regards to implant components, the choice between original and third-party-manufactured components might come with implications, as differences in material and microgeometry might impact precision of fit and overall performance, potentially leading to complications. Scrutiny of the specifications and manufacturing is essential when third-party-manufactured components are considered.The aim of this narrative review was to summarise the current evidence with regards to the restorative features of the implant prosthesis and also the selection of prosthetic components which can have implications for the long-term success of the implant therapy. Furthermore, the review aimed at interpretating current scientific evidence into meaningful strategies and recommendations to implement in clinical practice of implant dentistry.
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Affiliation(s)
- Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Sweden.
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Ruiz-Romero V, Figueiredo R, Toledano-Serrabona J, Abdelazim Y, Camps-Font O, Salazar-Salazar Y, Plana-Soler A, Subirà-Pifarré C, Valmaseda-Castellón E. Peri-implantitis in patients without regular supportive therapy: Prevalence and risk indicators. Clin Oral Investig 2024; 28:278. [PMID: 38671152 PMCID: PMC11052890 DOI: 10.1007/s00784-024-05673-8] [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: 10/10/2023] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To determine the prevalence of peri-implant diseases in patients treated in a university setting without a regular peri-implant supportive therapy schedule, and to identify the risk indicators associated with peri-implantitis. MATERIAL AND METHODS A retrospective cohort study was made of patients with dental implants with at least 12 months of functional loading who did not receive regular peri-implant supportive therapy. Patient- and implant-related variables were retrieved, and clinical and radiological examinations were performed. Descriptive and bivariate analyses and multilevel logistic regression analyses were performed to identify factors associated with peri-implantitis. RESULTS A total of 213 implants in 88 patients were analyzed. The patient-level prevalence of peri-implantitis and peri-implant mucositis was 26.1% (95%CI: 16.7%-35.5%) and 44.3% (95%CI: 34.0%-54.6%), respectively. Peri-implant diseases were significantly more frequent when the width of the keratinized mucosa was < 2 mm (OR = 5.26; 95%CI: 1.24-22.26; p = 0.024), and when there was 12 month post-loading bone loss (OR = 2.96; 95%CI: 1.35-6.52; p = 0.007). CONCLUSIONS Peri-implantitis is a common finding in patients without regular peri-implant supportive therapy (prevalence 16.7-35.5%). A thin peri-implant keratinized mucosa (< 2 mm) and a higher degree of bone remodeling after loading seem to be the main risk factors for peri-implantitis in this patient profile. CLINICAL RELEVANCE Patients who do not engage in supportive peri-implant maintenance have a higher risk of peri-implantitis. A thin keratinized mucosa and bone loss during the first year of loading are predisposing factors for peri-implantitis.
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Affiliation(s)
- Víctor Ruiz-Romero
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Rui Figueiredo
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
| | - Jorge Toledano-Serrabona
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
| | - Yehia Abdelazim
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Octavi Camps-Font
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain.
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain.
| | - Yamil Salazar-Salazar
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Aina Plana-Soler
- Master of Adult Dental Comprehensive Dentistry, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Carles Subirà-Pifarré
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
- Master of Adult Dental Comprehensive Dentistry, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences of the University of Barcelona, Barcelona, Spain
- Dental and Maxillofacial Pathology and Therapeutics Research Group, IDIBELL Research Institute, Barcelona, Spain
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11
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Neckel N, Pohl J, Preissner S, Wagendorf O, Sachse C, Vach K, Heiland M, Nahles S. Cross-sectional analysis comparing prefabricated titanium to individualized hybrid zirconia abutments for cemented zirconia based fixed dental prostheses: a critical concept assessment. Int J Implant Dent 2024; 10:13. [PMID: 38498247 PMCID: PMC10948712 DOI: 10.1186/s40729-024-00529-y] [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: 10/19/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Despite the differences in material properties and shapes among the different types of prefabricated titanium (pTiA) and individualized hybrid zirconia abutments (ihZiA), the biological and clinical relevance of materials and construction features remains vague. Yet, individualized ihZiA are increasingly implemented into daily routine aiming to satisfy rising expectations. The objective was to compare these two types of abutments in fixed dental prostheses (FDP). METHODS This cross-sectional study examined 462 implants in 102 patients comparing pTiA (52 patients) to ihZiA (50 patients) for FDP. These different treatment regimens were evaluated in terms of peri-implant health, radiographic bone loss, and oral-health related quality of life (OH-QoL) with special consideration of abutment type and superstructure design. RESULTS ihZiA showed significantly different design features than prefabricated pTiA, but the annual bone loss in both groups did not. Visible titanium in the esthetic zone negatively impacted OHIP 14 scores. The combination of an emergence angle (EA) of < 30° and a concave emergence profile (EP) as well as gingiva thickness (p = 0.002) at the time of the prosthetic restoration significantly improved the annual peri-implant bone loss, independently of the abutment type. CONCLUSION ihZiA showed comparable results to pTiA. To optimize the long-term outcome, not just material alone but generating adequate soft tissue thickness, minimizing the EA, and applying a concave EP seem to be the most relevant factors. To improve OH-QoL, particular attention must be paid to the esthetic zone.
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Affiliation(s)
- Norbert Neckel
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Josephine Pohl
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Oliver Wagendorf
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Sachse
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kirstin Vach
- Faculty of Medicine and Medical Center, Institute of Medical Biometry and Medical Statistics, University of Freiburg, Freiburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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12
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [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: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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13
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Mittal S, Kaurani P, Goyal R. Comparison of accuracy between single posterior immediate and delayed implants placed using computer guided implant surgery and a digital laser printed surgical guide: A clinical investigation. J Prosthet Dent 2024:S0022-3913(23)00816-8. [PMID: 38218708 DOI: 10.1016/j.prosdent.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 01/15/2024]
Abstract
STATEMENT OF PROBLEM The congruence of surgical implant placement with the preplanned position is important for anatomic and prosthetic precision, minimal complications, and increased longevity. The influence of implant placement timing on the surgical deviations in single posterior implants is unclear. PURPOSE The purpose of this clinical study was to compare deviations between preplanned and single posterior immediate and delayed implants placed using computer-guided digital light processing (DLP) surgical guides fabricated using intraoral scanning and cone beam computed tomography (CBCT). MATERIAL AND METHODS Implant surgery was performed on 24 participants requiring single immediate or delayed implants in the posterior maxillary and mandibular regions, for which the surgical site data were obtained from CBCT and intraoral scanning. Subsequently, virtual implant planning and DLP surgical guides were fabricated. Preimplant and postimplant placement CBCT scans were overlapped, and mean deviations for the immediate and delayed implant groups were calculated. The groups were compared with unpaired t tests (α=.05). RESULTS A total of 24 implants were placed, 12 in each group. In participants who received immediate implant placement, the mean ±standard deviation angular deviation, linear deviation at shoulder, linear deviation at apex, and vertical deviation were 1.03 ±0.70 degrees, 0.26 ±0.30 mm, 0.23 ±0.24 mm, and 0.39 ± 0.34 mm, respectively. In participants who received delayed implant treatment, the deviations were 0.53 ±0.60 degrees, 0.15 ±0.18 mm, 0.25 ±0.33 mm, and 0.17 ±0.10 mm, respectively. Significant differences between the 2 groups were found in the vertical deviation (P<.05). CONCLUSIONS The timing of the single posterior placement was associated with different deviations in the vertical direction. All deviations obtained were below the recommended values. DLP surgical guides fabricated from intraoral and CBCT scans provided accurate implant placement in immediate and delayed single posterior implants.
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Affiliation(s)
- Sankalp Mittal
- Head of Department, Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Jaipur, India.
| | - Pragati Kaurani
- Professor, Department of Prosthodontics Crown and Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
| | - Ritika Goyal
- Postgraduate student, Department of Prosthodontics Crown and Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
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14
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Satpathy A, Grover V, Kumar A, Jain A, Gopalakrishnan D, Grover HS, Kolte A, Melath A, Khatri M, Dani N, Thakur R, Tiwari V, Yadav VS, Thomas B, Chahal GS, Bhasin MT, Pandit N, Lawande SA, Manjunath RGS, Sachdeva S, Bhardwaj A, Pradeep AR, Nichani AS, Singh B, Ganesh PR, Deshpande NC, Reddy SSP, Raj SC. Indian Society of Periodontology Good Clinical Practice Recommendations for Peri-implant Care. J Indian Soc Periodontol 2024; 28:6-31. [PMID: 38988964 PMCID: PMC11232813 DOI: 10.4103/jisp.jisp_124_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 07/12/2024] Open
Abstract
Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.
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Affiliation(s)
- Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Vishakha Grover
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Jain
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | | | - Abhay Kolte
- Department of Periodontology and Implantology, Ranjeet Deshmukh Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Puducherry, India
| | - Manish Khatri
- Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Nitin Dani
- Private Practitioner, Nashik, Maharashtra, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, Maharashtra, India
| | - Vaibhav Tiwari
- Department of Periodontology, Government Dental College, Raipur, Chhattisgarh, India
| | - Vikender Singh Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Biju Thomas
- Department of Periodontology, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be university), Mangalore, Karnataka, India
| | - Gurparkash Singh Chahal
- Department of Periodontology, Dr. HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, Manipur, India
| | - Meenu Taneja Bhasin
- Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Uttar Pradesh, India
| | - Nymphea Pandit
- Department of Periodontology, D.A.V Dental College and Hospital, Yamunanagar, Haryana, India
| | | | - R G Shiva Manjunath
- Department of Periodontology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Surinder Sachdeva
- Department of Periodontology, M.M. College of Dental Sciences and Research, MM Deemed to be University, Mullana, Punjab, India
| | - Amit Bhardwaj
- Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India
| | - Avni Raju Pradeep
- Department of Periodontology, Government Dental College, Bengaluru, Karnataka, India
| | - Ashish Sham Nichani
- Department of Periodontology, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Baljeet Singh
- Department of Periodontology and Implantology, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India
| | - P R Ganesh
- Department of Periodontology, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Neeraj Chandrahas Deshpande
- Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | | | - Subash Chandra Raj
- Department of Periodontology, S.C.B Dental College and Hospital, Cuttack, Odisha, India
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15
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Paolantoni G, Tatullo M, Miniello A, Sammartino G, Marenzi G. Influence of crestal and sub-crestal implant position on development of peri-implant diseases: a 5-year retrospective analysis. Clin Oral Investig 2023; 28:16. [PMID: 38135770 DOI: 10.1007/s00784-023-05413-4] [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: 08/04/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES The aim of the present study was to evaluate the influence of crestal and subcrestal implant position on development of peri-implant diseases. MATERIALS AND METHODS The study was designed as a retrospective clinical and radiographic analysis. Implant-supported fixed dental prostheses were allocated in two groups: with the shoulder (i) placed in sub-crestal level and (ii) placed at bone level. For each patient, the following clinical variables were assessed: FMPS, FMBS, PlI, BOP, and PD. After prothesis delivery, an intraoral radiograph was obtained; this exam was performed also at 5 years of observation period. RESULTS No statistically significant difference was found in terms of FMPS and FMBS at baseline and after 5 years follow-up (P < 0.05). A statistically significant difference was assessed between PD of control group and test group (P = 0.042). Patient-based analysis showed a 25.6% of peri-implant mucositis and 32.6% of peri-implantitis for implants placed with the shoulder in crestal position, while for implants inserted in sub-crestal position the percentage of peri-implant-mucositis and peri-implantitis were 19%; no statistically significant difference was found between groups after 5 years (P < 0.05). CONCLUSIONS Within the limitation of the present study, the clinical and radiographic outcomes showed that the percentage of peri-implant mucositis and peri-implantitis was not statistically significant for both groups after 5 years follow-up. CLINICAL RELEVANCE The outcomes of present study clinically demonstrated that a deep position of implant shoulder did not provide any benefits. On the contrary, it may be considered a possible risk indicator for implant diseases.
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Affiliation(s)
| | - Marco Tatullo
- Department of Traslational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Umberto I, 70121, Bari, Italy
| | - Alessandra Miniello
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Gaetano Marenzi
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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Han JW, Han JW, Pyo SW, Kim S. Impact of profile angle of CAD-CAM abutment on the marginal bone loss of implant-supported single-tooth posterior restorations. J Prosthet Dent 2023:S0022-3913(23)00780-1. [PMID: 38129258 DOI: 10.1016/j.prosdent.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
STATEMENT OF PROBLEM Although the emergence angle has been related to marginal bone loss, information regarding the relationship between the transmucosal configuration of a computer-aided design and computer-aided manufacturing (CAD-CAM) abutment at specific subgingival levels and the amount of marginal bone loss is lacking. PURPOSE The purpose of this retrospective clinical study was to evaluate the influence of CAD-CAM abutment profile angles, measured at different subgingival positions, on the marginal bone loss of posterior single-tooth implant-supported restorations. MATERIAL AND METHODS A total of 260 posterior single-tooth implant-supported restorations using CAD-CAM abutments were analyzed in 206 patients. All implants had internal conical seal connections with a platform-switched design. The following data were extracted using digital periapical radiography: emergence profile, profile angle at distance ranges of 0 to 1 mm, 1 to 2 mm, and 2 to 3 mm from the implant-abutment junction, and peri-implant marginal bone loss (MBL). The MBL was measured from the time of delivery of the restorations up to 7 years or more. A linear mixed model was applied to investigate whether there was a significant difference in MBL based on the emergence profile and time, followed by the Bonferroni correction post hoc test. A Pearson correlation analysis was used to analyze the correlation between the profile angle and MBL at each distance range. The cut-off points for each distance range were determined by using the c-index, and independent t tests were conducted based on these cut-off values to evaluate the statistical differences (α=.05 for all statistical analyses). RESULTS The convex emergence profile exhibited greater MBL than the concave and straight profiles at each follow-up visit (P<.001). A significant correlation was found between the profile angle and MBL in the 0 to 1 mm, 1 to 2 mm distance ranges. However, no significant correlation was found between the profile angle and MBL in the 2 to 3 mm distance range (P>.05). The cut-off points were 34 degrees at the mesial and 28 degrees at the distal in the 0 to 1 mm range, and 33 and 20 degrees at the mesial and distal in the 1 to 2 mm range. CONCLUSIONS The profile angle near the implant-abutment junction and the type of emergence profile of the CAD-CAM abutment were closely associated with MBL in implants with internal conical seal connection with a platform switch design.
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Affiliation(s)
- Jin-Won Han
- Former Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jin-Woo Han
- Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Se-Wook Pyo
- Clinical Assistant Professor, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sunjai Kim
- Professor and Chairman, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Yang H, Xu L, Jiang J, Xu Y, Li X, He F. Clinical effect of Nobel Biocare angulated screw channel crown compared with cement crown in the aesthetic area: A retrospective cohort study with a mean 32 months follow-up (range 12 to 70 months). Clin Implant Dent Relat Res 2023; 25:1178-1186. [PMID: 37605302 DOI: 10.1111/cid.13264] [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: 04/11/2023] [Revised: 07/17/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE The objective of this study is to compare the clinical efficacy of angulated screw channel abutment applied in the anterior area with regular cemented crowns. MATERIALS AND METHODS Forty-eight patients were included and divided into two groups: the angulated screw channel group (ASC) and regular cemented group (RC) in this retrospective cohort study. The evaluation criteria included implant/restoration survival rate, keratinized mucosa width (KMW), bleeding on probing rate (BOP%), probing depth (PD), pink aesthetic score (PES), mechanical/biological complications, emergence angle (EA), the site of implant axis penetrate (SA), marginal bone loss (MBL), and buccal bone thickness (BBT) at 0 mm, 1 mm, 3 mm, 5 mm below the implant shoulder were evaluated in immediate postoperative (T0) and follow-up period (T1). RESULTS This retrospective cohort study included a total of 48 patients, with a mean 32 months follow-up period range from 12 months to 70 months. The study did not find any cases of implant failure or restoration failure. EA was significantly wider in the RC group than ASC group (RC: 33.53° ± 8.36° vs ASC: 27.43° ± 8.08°, p = 0.016*). While the BOP% was statistically significant higher in the RC group than ASC group (RC: 28.35% ± 22.92% vs ASC: 13.18% ± 20.00%, p = 0.027*). No significant differences were observed in the other measurements of comparison. CONCLUSION Within the limitations of the study, angulated screw channel (Nobel Biocare) crowns might allow the implant axis aim at incisal edge to reduce the emergence angle in the anterior area and benefit the soft-tissue during the 12-70 months follow-up period.
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Affiliation(s)
- Hang Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Lehan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yuzi Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaojun Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Corbella S, Morandi B, Calciolari E, Alberti A, Francetti L, Donos N. The influence of implant position and of prosthetic characteristics on the occurrence of peri-implantitis: a retrospective study on periapical radiographs. Clin Oral Investig 2023; 27:7261-7271. [PMID: 37910236 PMCID: PMC10713669 DOI: 10.1007/s00784-023-05303-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The present retrospective study aimed to investigate the influence of malposition on the occurrence of peri-implantitis. MATERIALS AND METHODS The study included clinical records of systemically healthy patients with single and partial implant-supported rehabilitations and at least 1-year post-loading follow-up. The parameters collected included implant-related factors, patient-related factors, site-related factors, and prosthesis-related factors. The radiographic measurements were taken by using a dedicated software and the diagnosis of peri-implantitis was made based on all the available clinical and radiographic data. Descriptive statistics were provided for all variables. Following an exploratory approach, an implant-level analysis of factors influencing the occurrence of peri-implantitis was done through a multilevel multivariate logistic regression (mixed). RESULTS A total of 180 implants belonging to 90 subjects were randomly selected. Malposition showed no statistically significant association with the occurrence of peri-implantitis. According to the multi-level analysis, the parameters that were significantly associated with peri-implantitis included presence / history of periodontitis (OR = 5.945, 95% CI: 1.093 - 32.334, P = 0.039) and presence of an emergence profile angle ≥ 45° (OR = 9.094, 95% CI: 2.017 - 40.995, P = 0.005). CONCLUSIONS Implant malposition, as defined following Buser's criteria (2004), did not influence the occurrence of peri-implantitis in the selected cohort. Conversely, history of periodontitis and presence of a prosthetic emergence profile with an angle ≥ 45° were correlated to an increased risk of peri-implantitis.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Atieh MA, Shah M, Ameen M, Tawse-Smith A, Alsabeeha NHM. Influence of implant restorative emergence angle and contour on peri-implant marginal bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2023; 25:840-852. [PMID: 37183357 DOI: 10.1111/cid.13214] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Implant restorative emergence angle and profile may have a negative impact on peri-implant marginal bone level and may increase the risk of developing peri-implantitis. However, the role of these prosthetic features on peri-implant health is still unclear. The aim of this systematic review and meta-analyses was to evaluate the long-term outcomes of implant restorations with an emergence angle of >30° in comparison to those with ≤30° in terms of changes in peri-implant marginal bone level, periodontal parameters, and prevalence rate of peri-implantitis. METHODS Electronic databases were searched to identify observational studies that compared implant restorations with an emergence angle of >30° to those with ≤30°. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. RESULTS Four studies with 912 dental implants in 397 participants were included in the present review. Of these, 455 implants had restorations with an emergence angle of >30°, while the remaining implants had restorative emergence angle of ≤30°. The follow-up time varied between 3.8 and 10.9 years. Implant restorations with an emergence angle of ≤30° were associated with less changes in peri-implant marginal bone level compared to those with emergence angle of >30°. The difference, however, was not statistically significant (mean difference 0.80; 95% confidence interval (CI) -0.13 to 1.72; p = 0.09). In platform-matched implants, the difference between the two groups was statistically significant in favor of implant restorations with emergence angle of ≤30°. In terms of emergence profile, implant restorations with convex profile had significantly higher rate of peri-implantitis (57.8%) compared to implant restorations with concave or straight profile (21.3%) (risk ratio 2.32; 95% CI 1.12-4.82; p = 0.02). CONCLUSIONS Within the limitation of this review, implant restorations with an emergence angles of >30° or ≤30° seem to have no significant influence on peri-implant marginal bone level. Platform-matched implants with an emergence angle of ≤30° may have positive effects on the peri-implant marginal bone level changes, but the evidence support is of low to moderate certainty.
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Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Mohammed Ameen
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
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20
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Pelekos G, Chin B, Wu X, Fok MR, Shi J, Tonetti MS. Association of crown emergence angle and profile with dental plaque and inflammation at dental implants. Clin Oral Implants Res 2023; 34:1047-1057. [PMID: 37461128 DOI: 10.1111/clr.14134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/06/2023] [Accepted: 07/06/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The shape of implant restorations is critical for function and aesthetics. It may also be important in peri-implant tissue health preservation. This study aimed to associate the restorative contour of a single crown with marginal dental plaque accumulation, tissue inflammation and probing depths. METHODS Subjects with a single screw-retained implant restoration were clinically examined. The presence of dental biofilm, tissue inflammation and probing pocket depths were the dependent variables. The emergence angle, profile and depth of the mucosal tunnel were measured on superimposed digital scans of the crown soft-tissue complex, the removed crown mounted on an analogue and the soft tissue. RESULTS One hundred twenty two subjects (46.7% female, 68.9% never smokers, 77% with treated periodontitis and 52.5% participating in regular supportive peri-implant care) were examined. The emergence angles at the mucosal margin were 15.3 ± 9.4°, 12.7 ± 8.5°, 31.3 ± 11.8° and 19.2 ± 9.8° for the mesial, distal, vestibular and oral aspects of the crowns. The largest emergence profile angles were observed on the vestibular aspect (74.6% of cases), reaching a maximum of 61.7°, and profiles were convex in 59% of cases. Generalized estimating equations indicated that the site-specific platform-level emergence angle and profile and depth of the mucosal tunnel were significantly associated with the presence of detectable plaque accumulation (p < .01) and bleeding on probing (p < .02). CONCLUSIONS Subtle variations in the shape of the restorative crown are associated with biofilm accumulation and mucosal inflammation. These findings are important for 3D implant planning/positioning and preservation of peri-implant tissue health.
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Affiliation(s)
- George Pelekos
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Bonnie Chin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Xinyu Wu
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Melissa R Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Junyu Shi
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maurizio S Tonetti
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Shanghai PerioImplant Innovation Center, Department of Oral and Maxillofacial Implantology, National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- European Research Group on Periodontology, Genoa, Italy
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21
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Chantler JGM, Evans CDJ, Zitzmann NU, Derksen W. Clinical performance of single implant prostheses restored using titanium base abutments: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:64-85. [PMID: 37750524 DOI: 10.1111/clr.14128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The aim of this review was to evaluate the survival rates of restorations utilizing titanium base abutments (TBA) for restoring single-unit implant prostheses. MATERIALS AND METHODS This review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The focus question was: In patients who require the restoration of a single dental implant utilizing a titanium base abutment, what are the determining factors and outcomes relating to implant prosthesis prognosis and survival? A comprehensive search of databases (PubMed, EMBASE, and Cochrane Library) was conducted on 16 April 2023 and updated on 5 May 2023. Randomized clinical trials (RCT), retrospective studies and prospective studies, reporting on the use of TBA for single implant prostheses, were reviewed. A Cochrane collaboration risk of bias assessment analysis was performed for randomized clinical studies, and the Newcastle-Ottawa Scale tool was applied for non-randomized studies. A meta-analysis was performed on clinical trials reporting on survival rates of both TBA and other abutments. Other clinical studies, reporting on TBA only, were included for descriptive statistics. RESULTS The search provided 1159 titles after duplicates were removed. Six RCTs were included to perform a meta-analysis and compare the survival of the TBA to other abutments [OR 0.74; 95% CI: 0.21-2.63, heterogeneity; I2 0%; p = .99]. Twenty-three prospective and retrospective studies fulfilled the criteria and were included in the meta-analysis after 12 months of function. A total of 857 single implant-supported prostheses fabricated with a TBA were included. TBA abutments have an estimate 98.6% survival rate after 1 year in function (95% CI: 97.9%-99.4%). The mean follow-up period was 31.2 ± 16.9 months. CONCLUSIONS Single implant prosthesis restored with titanium base abutments showed favourable short-term survival rates.
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Affiliation(s)
| | | | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
| | - Wiebe Derksen
- Department of Oral Implantology and Prosthetic Dentistry, Amsterdam, Netherlands
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Covani U, Giammarinaro E, Di Pietro N, Boncompagni S, Rastelli G, Romasco T, Velasco-Ortega E, Jimenez-Guerra A, Iezzi G, Piattelli A, Marconcini S. Electron Microscopy (EM) Analysis of Collagen Fibers in the Peri-Implant Soft Tissues around Two Different Abutments. J Funct Biomater 2023; 14:445. [PMID: 37754859 PMCID: PMC10532031 DOI: 10.3390/jfb14090445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
The design of the implant prosthesis-abutment complex appears crucial for shaping healthy and stable peri-implant soft tissues. The aim of the present animal study was to compare two implants with different healing abutment geometries: a concave design (TEST) and a straight one (CTRL). Transmission electron microscopy (TEM) was used to quantify the three-dimensional topography and morphological properties of collagen at nanoscale resolution. 2 swine were included in the experiment and 6 implants per animal were randomly placed in the left or right hemimandible in either the physiologically mature bone present between the lower canine and first premolar or in the mandibular premolar area, within tooth extraction sites. Each CTRL implant was positioned across from its respective TEST implant on the other side of the jaw. After 12 weeks of healing, 8 specimens (4 CTRL and 4 TEST) were retrieved and prepared for histological and TEM analysis. The results showed a significantly higher percentage of area covered by collagen bundles and average bundle size in TEST implants, as well as a significant decrease in the number of longitudinally oriented bundles with respect to CTRL implants, which is potentially due to the larger size of TEST bundles. These data suggest that a concave transmucosal abutment design serves as a scaffold, favoring the deposition and growth of a well-organized peri-implant collagen structure over the implant platform in the early healing phase, also promoting the convergence of collagen fibers toward the abutment collar.
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Affiliation(s)
- Ugo Covani
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
| | - Enrica Giammarinaro
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
| | - Simona Boncompagni
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giorgia Rastelli
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
- Center for Advanced Studies and Technology—CAST, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.B.); (G.R.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain; (E.V.-O.); (A.J.-G.)
| | - Alvaro Jimenez-Guerra
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain; (E.V.-O.); (A.J.-G.)
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (T.R.); (G.I.)
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy;
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Simone Marconcini
- Department of Stomatology, Tuscan Dental Institute, 55041 Lido di Camaiore, Italy; (U.C.); (E.G.); (S.M.)
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23
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Laleman I, Lambert F. Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review. Clin Implant Dent Relat Res 2023; 25:723-733. [PMID: 36825512 DOI: 10.1111/cid.13185] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023]
Abstract
Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis. With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, higher implants (≥2mm) with an emergence angle below 30° seem more favourable. It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice. [Correction added on 13 March 2023, after first online publication: 'longer implants (≥2mm)' was changed to 'higher implants (≥2mm)' in this version.].
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Affiliation(s)
- Isabelle Laleman
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
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24
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Puisys A, Janda M, Auzbikaviciute V, Gallucci G, Mattheos N. Contour angle and peri-implant tissue height: Two interrelated features of the implant supracrestal complex. Clin Exp Dent Res 2023. [PMID: 36988518 DOI: 10.1002/cre2.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES Recent research has suggested the contour of the prosthesis and the vertical height of the peri-implant mucosa as important parameters that can influence the long term health and stability of the peri-implant tissue. In particular, overcontouring of the prosthesis has been correlated with an increased risk for peri-implantitis, while reduced soft tissue height has been associated with marginal bone loss, recession, and other soft tissue complications. Although these two parameters have been investigated as independent in the current literature, clinical experience points toward a close interrelation between transmucosal tissue height and prosthesis contour angle. It is often found that a reduced vertical height of the implant supracrestal complex is the main reason for overcontouring of the prosthesis. At the same time, achieving a favorable contour of 30o or less is not possible unless the clinician has ensured an adequate vertical height of the soft tissue. The purpose of this short communication is to establish the relation between tissue vertical height and prosthesis contour by utilizing a theoretical geometry equation based on the Pythagorean theorem. In doing so, one can use the dimensions of the implant as well as those of the prosthesis at the mucosal margin to calculate the essential vertical height for achieving a favorable prosthesis contour. CONCLUSIONS As the treatment plan of the implant supracrestal complex is "top-down," in case of deficient vertical height, subcrestal placement of the implant should be considered to achieve a proper prosthesis contour.
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Affiliation(s)
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmoe University, Malmö, Sweden
| | | | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, School of Dental Medicine Harvard University, Boston, Massachusetts, USA
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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25
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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26
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [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: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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27
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Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36533411 DOI: 10.1111/cid.13155] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders. PURPOSE The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis. METHODS The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases. RESULTS Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases. CONCLUSION Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.
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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, ZMK University of Bern Bern CH Switzerland
| | - Joseph Y. Kan
- Department of Implantology Loma Linda University Loma Linda California USA
| | - Wenche Borgnakke
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
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28
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Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
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Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
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Association between Peri-Implant Soft Tissue Health and Different Prosthetic Emergence Angles in Esthetic Areas: Digital Evaluation after 3 Years’ Function. J Clin Med 2022; 11:jcm11216243. [PMID: 36362471 PMCID: PMC9654584 DOI: 10.3390/jcm11216243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background: The aim of the present retrospective study was to assess peri-implant soft tissue health for implants restored with different prosthetic emergence profile angles. Methods: Patients were treated with implants supporting fixed dentures and were followed for 3 years. Buccal emergence angle (EA) measured at 3 years of follow-up visits (t1) were calculated for two different groups: Group 1 (153 implants) for restorations with angle between implant axis and prosthetic emergence angle from ≥30°, and Group 2 (67 implants) for those with angle ≤30°, respectively. Image J software was used for the measurements. Moreover, peri-implant soft tissue parameters such as pocket probing depth (PPD), plaque index (PI) and gingival index (GI) were assessed, respectively. Results: A total of 57 patients were included in the analysis and a total of 220 implants were examined. Mean (±SD) EA in Groups 1 and 2 was 46.4 ± 12.2 and 24.5 ± 4.7 degrees, respectively. After 3 years of follow-up, a PPD difference of 0.062 mm (CI95% −0.041 mm; 0.164 mm) was calculated between the two groups and was not statistically significant (p = 0.238). Similar results were found for PI (OR = 0.78, CI95% 0.31; 1.98, p = 0.599). Furthermore, GI scores of 2 and 3 were found for nine implants (5.9%) in Group 1, and for five implants in Group 2 (7.5%). A non-significant difference (p = 0.76) was found. Conclusions: Peri-implant soft-tissue health does not seem to be influenced by EA itself, when a proper emergence profile is provided for implant-supported reconstructions in anterior areas.
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Pérez‐Sayans M, Castelo‐Baz P, Penarrocha‐Oltra D, Seijas‐Naya F, Conde‐Amboage M, Somoza‐Martín JM. Impact of abutment geometry on early implant marginal bone loss. A double-blind, randomized, 6-month clinical trial. Clin Oral Implants Res 2022; 33:1038-1048. [PMID: 35869615 PMCID: PMC9796139 DOI: 10.1111/clr.13985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/09/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL). MATERIAL AND METHODS A balanced, randomized, double-blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were "cylindrical" abutment and "concave" abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months. RESULTS The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of -0.6 ± 0.7 mm in the cylindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was -0.4 ± 0.6 mm (p = .030). The estimated effect size (ES) was negative for the cylindrical abutment (ES = -1.3730, CI -2.5919 to -0.1327; t-value = -2.4893; p = .0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES = 2.8231; CI: 1.4379 to 4.2083; t-value = 4.0957; p = .0002), therefore implying an increase in the average bone level. CONCLUSIONS The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did.
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Affiliation(s)
- Mario Pérez‐Sayans
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain,Health Research Institute of Santiago de Compostela (IDIS)Santiago de CompostelaSpain
| | - Pablo Castelo‐Baz
- Department of Restorative Dentistry and Endodontics, Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | | | - Flavio Seijas‐Naya
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Mercedes Conde‐Amboage
- CITMAgaSantiago de CompostelaSpain,Department of Statistics, Mathematical Analysis and Optimization, Models of Optimization, Decision, Statistics and Applications Reseach Group (MODESTYA)Universidade de Santiago de CompostelaSantiago de CompostelaSpain
| | - José M. Somoza‐Martín
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain,Health Research Institute of Santiago de Compostela (IDIS)Santiago de CompostelaSpain
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31
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Pimkhaokham A, Jiaranuchart S, Kaboosaya B, Arunjaroensuk S, Subbalekha K, Mattheos N. Can computer-assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review. Periodontol 2000 2022; 90:197-223. [PMID: 35924457 PMCID: PMC9805105 DOI: 10.1111/prd.12458] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Computer-assisted implant surgery (CAIS), either static or dynamic, is well documented to significantly improve the accuracy of implant placement. Whether the increased accuracy leads to a corresponding improvement in clinical outcomes has not yet been systematically investigated. The aim of this critical review was to investigate whether the use of CAIS can lead to reduction of complications as well as improved clinical and patient-reported outcomes (PROs) when compared with conventional freehand implant surgery. A comprehensive online search was conducted to identify studies where implants were installed with static computer-assisted implant surgery (s-CAIS)or dynamic computer-assisted implant surgery(d-CAIS) or combinations of the two, either compared with conventional free-hand implant placement or not. Seventy-seven studies were finally included in qualitative analysis, while data from three studies assessing postsurgical pain were suitable for a meta-analysis. Only a small number of the available studies were comparative. The current evidence does not suggest any difference with regard to intraoperative complications, immediate postsurgical healing, osseointegration success, and survival of implants placed with CAIS or freehand protocols. Intraoperative and early healing events as reported by patients in randomized clinical trials (RCTs) did not differ significantly between CAIS used with flap elevation and conventional implant placement. There is limited evidence that increased accuracy of placement with CAIS is correlated with superior esthetic outcomes. Use of CAIS does not significantly reduce the length of surgeries in cases of single implants and partially edentulous patients, although there appears to be a more favorable impact in fully edentulous patients. Although CAIS alone does not seem to improve healing and the clinical and PRO, to the extent that it can increase the utilization of flapless surgery and predictability of immediacy protocols, its use may indirectly lead to substantial improvements in all of the above parameters.
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Affiliation(s)
- Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand,Department of Dental MedicineKarolinska InstituteStockholmSweden
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Sousa V, Mardas N, Spratt D, Hassan IA, Walters NJ, Beltrán V, Donos N. The Effect of Microcosm Biofilm Decontamination on Surface Topography, Chemistry, and Biocompatibility Dynamics of Implant Titanium Surfaces. Int J Mol Sci 2022; 23:ijms231710033. [PMID: 36077428 PMCID: PMC9456268 DOI: 10.3390/ijms231710033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Since the inception of dental implants, a steadily increasing prevalence of peri-implantitis has been documented. Irrespective of the treatment protocol applied for the management of peri-implantitis, this biofilm-associated pathology, continues to be a clinical challenge yielding unpredictable and variable levels of resolution, and in some cases resulting in implant loss. This paper investigated the effect of microcosm biofilm in vitro decontamination on surface topography, wettability, chemistry, and biocompatibility, following decontamination protocols applied to previously infected implant titanium (Ti) surfaces, both micro-rough -Sandblasted, Large-grit, Acid-etched (SLA)-and smooth surfaces -Machined (M). Microcosm biofilms were grown on SLA and M Ti discs. These were treated with TiBrushes (TiB), combination of TiB and photodynamic therapy (PDT), combination of TiB and 0.2%CHX/1%NaClO, plus or minus Ultraviolet-C (UV-C) radiation. Surface topography was evaluated by Scanning Electron Microscopy (SEM) and Laser Surface Profilometry. Surface function was analysed through wettability analysis. Surface chemistry evaluation of the discs was performed under SEM/Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS). Biocompatibility was tested with the cytocompatibility assay using human osteoblast-like osteosarcoma cell line (MG-63) cells. Elemental analysis of the discs disclosed chemical surface alterations resulting from the different treatment modalities. Titanium, carbon, oxygen, sodium, aluminium, silver, were identified by EDX as the main components of all the discs. Based on the data drawn from this study, we have shown that following the decontamination of Ti surfaces the biomaterial surface chemistry and topography was altered. The type of treatment and Ti surface had a significant effect on cytocompatibility (p = 0.0001). Although, no treatment modality hindered the titanium surface biocompatibility, parameters such as the use of chemical agents and micro-rough surfaces had a higher cytotoxic effect in MG-63 cells. The use of smooth surfaces, and photofunctionalisation of the TiO2 layer had a beneficial effect on cytocompatibility following decontamination.
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Affiliation(s)
- Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
- Correspondence:
| | - Nikos Mardas
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Dave Spratt
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Iman A. Hassan
- Materials Chemistry Centre, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - Nick J. Walters
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center, Dental School and Center for Translational Medicine, Universidad de La Frontera, Temuco 4780000, Chile
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
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Soulami S, Slot DE, van der Weijden F. Implant‐abutment emergence angle and profile in relation to peri‐implantitis: A systematic review. Clin Exp Dent Res 2022; 8:795-806. [PMID: 35713938 PMCID: PMC9382038 DOI: 10.1002/cre2.594] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Statement The aim of this systematic review is to analyze literature regarding the relationship between the implant‐abutment emergence angle (EA) and implant emergence profile (EP) and the prevalence of peri‐implantitis. Methods PubMed and the Cochrane Library were searched for studies from initiation up to April 2022. Studies describing the EA and EP in association with peri‐implantitis were considered eligible for this review and selected for inclusion in this review if implant groups with wide and narrow EA and different EP types were described. Results Searches in PubMed and the Cochrane Library led to 1116 unique titles and the inclusion of three studies. These concerned 168–349 implants. Two studies presented the mean prevalence of peri‐implantitis which was 16.7% and 24.8% at the implant level. Both studies showed a significant relationship between peri‐implantitis in bone‐level implant groups with an EA above 30° compared to implants with an EA below 30°. A third study presented marginal bone loss which tended to be smaller when the EA was around 20°–40°. In one of the three included studies, the prevalence of peri‐implantitis was significantly higher if implants had a convex EP compared to a concave or straight EP. Another study showed a significantly higher prevalence of peri‐implantitis in implants with a convex EP compared to other EP types, if combined with an EA above 30°. Conclusions Three eligible studies were found. Reported associations should therefore be considered with caution. Synthesis suggests an association between a larger EA (>30°) and a higher prevalence of peri‐implantitis or marginal bone loss compared to a smaller EA (<30°). A convex EP may also be associated with a higher prevalence of peri‐implantitis. However, causality remains a question.
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Affiliation(s)
- Sara Soulami
- Master of Science Program of Dental Sciences Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Fridus van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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Chanthasan S, Mattheos N, Pisarnturakit PP, Pimkhaokham A, Subbalekha K. Influence of interproximal peri-implant tissue and prosthesis contours on food impaction, tissue health, and patients' quality of life. Clin Oral Implants Res 2022; 33:768-781. [PMID: 35578787 DOI: 10.1111/clr.13958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE 1) To investigate tissue features and interproximal contour of posterior implant supported single crowns (ISSC), which correlate with food impaction. 2) To evaluate the influence of food impaction on the health of the adjacent peri-implant tissue and patients' oral health related quality of life (OHRQoL). MATERIALS AND METHODS Patients with posterior ISSC under maintenance between July 2019 and July 2020 were recruited. OHRQoL of patients who self-reported food impaction between ISSC and teeth was evaluated by Oral Impacts on Daily Performance questionnaire and reported at patient level. Interproximal prosthesis contours and periodontal/peri-implant tissue conditions were assessed by clinical and radiographic examination. Differences between food impaction (FI) and non-food impaction (NFI) sites were analysed. RESULTS Totally 178 patients (286 ISSC and 410 interproximal spaces) were included. Among 119 patients who self-reported food impaction, 84 (70.6%) reported their OHRQoL to be affected with minor to severe intensity. The most common affected daily performance was the ability to clean the teeth. Plaque accumulation at ISSC, deeper probing depth, complete interdental papilla fill, loose contact, longer contact length, lower contact point level, closer distance between ISSC and tooth, lesser embrasure surface area, tissue level implant and cement-retained restoration were found significantly more in the FI group than the NFI group (P<0.05). CONCLUSION Interproximal features of the implant prosthesis were associated with food impaction between the ISSC and the adjacent tooth, which might affect periodontal and/or peri-implant tissue health conditions. Patients' OHRQoL was commonly affected by food impaction, but the intensity was low.
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Affiliation(s)
- Souknilan Chanthasan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Sweden
| | | | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Schwarz F, Alcoforado G, Guerrero A, Jönsson D, Klinge B, Lang N, Mattheos N, Mertens B, Pitta J, Ramanauskaite A, Sayardoust S, Sanz-Martin I, Stavropoulos A, Heitz-Mayfield L. Peri-implantitis: Summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021; 32 Suppl 21:245-253. [PMID: 34642987 DOI: 10.1111/clr.13827] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the influence of implant and prosthetic components on peri-implant tissue health. A further aim was to evaluate peri-implant soft-tissue changes following surgical peri-implantitis treatment. MATERIALS AND METHODS Group discussions based on two systematic reviews (SR) and one critical review (CR) addressed (i) the influence of implant material and surface characteristics on the incidence and progression of peri-implantitis, (ii) implant and restorative design elements and the associated risk for peri-implant diseases, and (iii) peri-implant soft-tissue level changes and patient-reported outcomes following peri-implantitis treatment. Consensus statements, clinical recommendations, and implications for future research were discussed within the group and approved during plenary sessions. RESULTS Data from preclinical in vivo studies demonstrated significantly greater radiographic bone loss and increased area of inflammatory infiltrate at modified compared to non-modified surface implants. Limited clinical data did not show differences between modified and non-modified implant surfaces in incidence or progression of peri-implantitis (SR). There is some evidence that restricted accessibility for oral hygiene and an emergence angle of >30 combined with a convex emergence profile of the abutment/prosthesis are associated with an increased risk for peri-implantitis (CR). Reconstructive therapy for peri-implantitis resulted in significantly less soft-tissue recession, when compared with access flap. Implantoplasty or the adjunctive use of a barrier membrane had no influence on the extent of peri-implant mucosal recession following peri-implantitis treatment (SR). CONCLUSIONS Prosthesis overcontouring and impaired access to oral hygiene procedures increases risk for peri-implantitis. When indicated, reconstructive peri-implantitis treatment may facilitate the maintenance of post-operative peri-implant soft-tissue levels.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Gil Alcoforado
- Clinical Research Unit, Egas Moniz University, Almada, Portugal
| | | | - Daniel Jönsson
- Department of Clinical Sciences, Medical Faculty, Lund University, Malmö, Sweden.,Public Dental Service of Skåne, Lund, Sweden.,Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Dental Medicine, Division of Oral Diseases, Karolinska Institute, Stockholm, Sweden
| | - Niklaus Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Brenda Mertens
- Department of Periodontology, Oral and Implant Surgery, University of Liege, Liège, Belgium.,Private practice, Montpellier, France
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt, Germany
| | - Shariel Sayardoust
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
| | - Lisa Heitz-Mayfield
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Crawley, Perth, WA, Australia
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