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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [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: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Deng J, Van Duyn C, Cohen DJ, Schwartz Z, Boyan BD. Strategies for Improving Impaired Osseointegration in Compromised Animal Models. J Dent Res 2024; 103:467-476. [PMID: 38616679 PMCID: PMC11055505 DOI: 10.1177/00220345241231777] [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] [Indexed: 04/16/2024] Open
Abstract
Implant osseointegration is reduced in patients with systemic conditions that compromise bone quality, such as osteoporosis, disuse syndrome, and type 2 diabetes. Studies using rodent models designed to mimic these compromised conditions demonstrated reduced bone-to-implant contact (BIC) or a decline in bone mineral density. These adverse effects are a consequence of disrupted intercellular communication. A variety of approaches have been developed to compensate for the altered microenvironment inherent in compromised conditions, including the use of biologics and implant surface modification. Chemical and physical modification of surface properties at the microscale, mesoscale, and nanoscale levels to closely resemble the surface topography of osteoclast resorption pits found in bone has proven to be a highly effective strategy for improving implant osseointegration. The addition of hydrophilicity to the surface further enhances osteoblast response at the bone-implant interface. These surface modifications, applied either alone or in combination, improve osseointegration by increasing proliferation and osteoblastic differentiation of osteoprogenitor cells and enhancing angiogenesis while modulating osteoclast activity to achieve net new bone formation, although the specific effects vary with surface treatment. In addition to direct effects on surface-attached cells, the communication between bone marrow stromal cells and immunomodulatory cells is sensitive to these surface properties. This article reports on the advances in titanium surface modifications, alone and in combination with novel therapeutics in animal models of human disease affecting bone quality. It offers clinically translatable perspectives for clinicians to consider when using different surface modification strategies to improve long-term implant performance in compromised patients. This review supports the use of surface modifications, bioactive coatings, and localized therapeutics as pragmatic approaches to improve BIC and enhance osteogenic activity from both structural and molecular standpoints.
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Affiliation(s)
- J. Deng
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - C. Van Duyn
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - D. J. Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Z. Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - B. D. Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
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Cui B, Bai T, Wu Q, Hu Y, Liu Y. Pre-implantation teriparatide administration improves initial implant stability and accelerates the osseointegration process in osteoporotic rats. Int J Implant Dent 2024; 10:18. [PMID: 38625587 PMCID: PMC11021383 DOI: 10.1186/s40729-024-00536-z] [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: 01/09/2024] [Accepted: 03/27/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE Osteoporotic individuals who have dental implants usually require a prolonged healing time for osseointegration due to the shortage of bone mass and the lack of initial stability. Although studies have shown that intermittent teriparatide administration can promote osseointegration, there is little data to support the idea that pre-implantation administration is necessary and beneficial. METHODS Sixty-four titanium implants were placed in the bilateral proximal tibial metaphysis in 32 female SD rats. Bilateral ovariectomy (OVX) was used to induce osteoporosis. Four major groups (n = 8) were created: PRE (OVX + pre-implantation teriparatide administration), POST (OVX + post-implantation administration), OP (OVX + normal saline (NS)) and SHAM (sham rats + NS). Half of rats (n = 4) in each group were euthanized respectively at 4 weeks or 8 weeks after implantation surgery, and four major groups were divided into eight subgroups (PRE4 to SHAM8). Tibiae were collected for micro-CT morphometry, biomechanical test and undecalcified sections analysis. RESULTS Compared to OP group, rats in PRE and SHAM groups had a higher value of insertion torque (p < 0.05). The micro-CT analysis, biomechanical test, and histological data showed that peri-implant trabecular growth, implants fixation and bone-implant contact (BIC) were increased after 4 or 8 weeks of teriparatide treatment (p < 0.05). There was no statistically difference in those parameters between PRE4 and POST8 subgroups (p > 0.05). CONCLUSIONS In osteoporotic rats, post-implantation administration of teriparatide enhanced peri-implant bone formation and this effect was stronger as the medicine was taken longer. Pre-implantation teriparatide treatment improved primary implant stability and accelerated the osseointegration process.
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Affiliation(s)
- Boyu Cui
- Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Tianyi Bai
- Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Qiyou Wu
- Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yibo Hu
- Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yihong Liu
- Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
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Dhayanithi J, Rajasekar A. Comparison of Alveolar Bone Level around Osseointegrated Dental Implants among Premenopausal and Postmenopausal Women: A 2-Year Study. J Long Term Eff Med Implants 2024; 34:89-92. [PMID: 38305376 DOI: 10.1615/jlongtermeffmedimplants.2023047432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The success of dental implants is affected by bone quality and quantity at the dental implant site. The present study was done to assess the changes in alveolar bone level around osseointegrated dental implants over a period of 2 years among the premenopausal and postmenopausal women. This prospective clinical study was conducted among 50 female patients who reported between January 2020-June 2020 and had a single missing molar in maxillary or mandibular arch. Patients were categorized into 2 groups: premenopause patients (Group A; n = 25) and postmenopause patients (Group B; n = 25). Marginal bone loss (MBL) was recorded at baseline, 12 mo and 24 mo follow-up and compared between both the groups using independent t-test. ANOVA was done to compare MBL between different time periods. On intragroup comparison, a statistically significant difference was observed between different time periods in both Group A (P = 0.05) and Group B (P = 0.04). Also, on intergroup comparison, a statistically significant difference was observed in Group B from Group A at 12 mo and 24 mo (P < 0.05). Increase in marginal bone loss was observed among postmenopausal women. Therefore, clinicians should emphasize the need for oral hygiene maintenance among postmenopausal women for peri-implant health.
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Affiliation(s)
- J Dhayanithi
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Ting M, Huynh BH, Woldu HG, Gamal I, Suzuki JB. Clinical Impact on Dental Implant Survival in Patients Taking Antiresorptive Medications: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2023; 49:599-615. [PMID: 37905745 DOI: 10.1563/aaid-joi-d-21-00160] [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] [Indexed: 11/02/2023]
Abstract
Dental implants are a predictable option to replace missing teeth. Patients on antiresorptive medications used to treat disorders associated with bone resorption may need dental implants to replace missing teeth. The data on implant failure in patients on antiresorptive medication requiring dental implants, is conflicting and limited. This systematic review aims to investigate if antiresorptive medications have any clinical impact on dental implant survival. Electronic databases were searched until May 2020. The focus question (PICOS): Participants: humans, Interventions: implant placement surgery in patients on antiresorptive medication, Comparisons: patients on antiresorptive medication vs control (patients not on antiresorptive medication), Outcomes: implant survival, and Study design: clinical studies. The protocol of this systematic review was registered in PROSPERO (CRD42020209083). Fourteen nonrandomized studies were selected for data extraction and risk of bias assessment using the ROBINS-1 tool. Only studies with a control were included for the meta-analysis, 8 articles were included in the meta-analysis using implant-level data, and 5 articles were included in the meta-analysis using patient-level data. There was no statistical significance between the 2 groups at the patient level based on 265 patients. However, there was a statistically significant difference at the implant level based on 2697 implants. Therefore, antiresorptive medications, mainly bisphosphonates (BPs), may significantly contribute to implant failure. Antiresorptive medications, especially BPs may reduce implant survival and impair the osseointegration of dental implants. Failed implants in patients on BPs may not lead to osteonecrosis and may be replaced with success.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA
- Think Dental Learning Institute, Paoli, PA
- General Dental Practice Residency, Einstein Medical Center, Philadelphia, PA
- Private Practice, Paoli, PA
| | - Benzon H Huynh
- Indian Health Service, U.S. Department of Health and Human Services
| | - Henok G Woldu
- The Center for Health Analytics for National and Global Equity (C.H.A.N.G.E.), Columbia, MO
- Biostatistician, Private Company, CA
| | - Ibrahim Gamal
- Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Jon B Suzuki
- University of Maryland School of Dentistry, Baltimore, MD
- University of Washington School of Dentistry, Seattle, WA
- Nova Southeastern University College of Dental Medicine, Fort Lauderdale, FL
- Temple University Schools of Medicine and Dentistry, Philadelphia, PA
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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [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: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Leonard JF, Taxel P, Kuo CL, Da Cunha Godoy L, Freilich M. Dental implant and bone augmentation treatment in bone-compromised patients: Oral health-related quality of life outcomes. J Prosthet Dent 2023:S0022-3913(23)00049-5. [PMID: 36804393 PMCID: PMC10435665 DOI: 10.1016/j.prosdent.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/21/2023]
Abstract
STATEMENT OF PROBLEM Patient-reported outcomes represent an additional and often overlooked measure of dental implant and bone augmentation treatment. Few implant studies have evaluated patient-reported outcomes in those with systemic bone compromise. PURPOSE The purpose of this cohort study was to assess oral health-related quality of life (OHRQoL) outcomes in postmenopausal women receiving dental implants with normal bone density or mild osteopenia ("healthy" group; all DXA T-scores at femoral neck, total hip, and L1-L4 spine>-2.0) versus moderate osteopenia or osteoporosis ("bone compromised" group; any DXA T-score at femoral neck, total hip, or L1-L4 spine≤-2.0). MATERIAL AND METHODS A total of 115 patients were recruited at the University of Connecticut School of Dental Medicine as part of a standard of care, prospective, nonrandomized cohort study. All participants received 1 of 3 bone augmentation procedures with implant placement. At baseline and at various intervals after implant placement, OHRQoL was measured by using the Oral Health Impact Profile-14 (OHIP-14) and surveys of patient expectations and satisfaction. These measures were compared between healthy and bone compromised groups (α=.05). RESULTS For all OHRQoL measures across linear mixed effects models, no significant differences were found between bone groups at baseline and at each time point after implant placement (P>.05). Using the minimally important difference (MID) for OHIP-14, no definitive clinical differences were found in patient outcomes between bone groups at all postimplant time points (P>.05). From baseline to 24 months after implant placement, both healthy and bone compromised groups exhibited significant improvements in OHIP-14 and patient expectations scores (P<.05). While no within group differences were found in patient satisfaction scores, the mean satisfaction score remained high over time in both groups. CONCLUSIONS Patient-reported outcomes as measured through OHIP-14, patient expectations, and patient satisfaction surveys suggest similar postimplant OHRQoL improvement in healthy and bone compromised individuals. OHRQoL improvements between bone groups were similar both in continuity and in scope, with no evidence of statistically significant score differences between groups at 24 months after implant placement across all measures and with no definitive evidence of clinical differences as measured by OHIP-14 MID comparisons across all timepoints.
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Affiliation(s)
- Jonathan F Leonard
- Predoctoral Dental Student, University of Connecticut School of Dental Medicine, Farmington, Conn.
| | - Pamela Taxel
- Professor, Division of Endocrinology and Metabolism, University of Connecticut School of Medicine, Farmington, Conn
| | - Chia-Ling Kuo
- Professor, Public Health Sciences, University of Connecticut School of Medicine, Farmington, Conn
| | | | - Martin Freilich
- Professor, Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, Conn
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9
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Evaluation of oral implant survival rate in postmenopausal women with osteopenia/osteoporosis. A retrospective pilot study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e777-e781. [PMID: 35772700 DOI: 10.1016/j.jormas.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Implant placement is a common part of dental rehabilitation in older individuals. The role of diminished bone mineral density on the healing of dental implants remains to be elucidated. OBJECTIVE The aim of this study was to assess the implant survival rate in postmenopausal women with osteopenia/osteoporosis. METHODS A retrospective cohort study was conducted of postmenopausal women treated with dental implants and stratified into two groups: those receiving antiresorptive therapy (W ≥ 50 years S) or those not receiving treatment (W ≥ 50 years U). The predictor variable was osteopenia/osteoporosis treatment. The outcome variable was implant failure rate at stage two uncovering. Other study variables included: age, implant location, and bone graft placement. T-test, chi-square test, and univariate and multivariate logistic regression were computed. A p-value<0.05 was considered statistically significant. RESULTS The sample was composed of 93 W ≥ 50 years U (197 implants) and 114 W ≥ 50 years S (189 implants). W ≥ 50 years U showed a statistically higher implant failure rate with chi-square testing compared to W ≥ 50 years S (p=0.022). However, univariate, and multivariate logistic regression between age, location, bone grafting, and implant failure did not demonstrate significant associations. CONCLUSION Both groups integrated dental implants successfully, with a low failure rate. Implant location, bone grafting, and osteopenia/osteoporosis treatment did not significantly affect osseointegration at uncovering.
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Stefos S, Kourtis S, Vrekoussis T, Augoulea A, Kalantaridou S. Quality of Life in Menopausal Women with Dental Restorations and Implants. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia.
Materials and Methods:
Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone (FSH) values, estradiol, and clinical risk factors.
Results:
Participants had a statistically significantly better “functional” and “psychological” feeling after prosthodontic rehabilitation with and without implants. Three out of four reported that their dentist informed them of the possible implant problems that might arise from osteoporosis and its treatment (medications). Moreover, osteopenia was found to be associated with a very lower problem percentage. The bisphosphonate treatment had the highest rate (80%) of reported implant problems than non-bisphosphonate treatment (30%). The hormone replacement therapy (HRT) for menopause was reported to be more associated with problems in implant placement (19%) than in those without treatment (27.3%).
Conclusion:
The questionnaires revealed a significant improvement concerning women’s life quality and well-documented information about the problems their dental implants and restorations may cause in association with menopause and/or osteoporosis.
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Chiang CW, Chen CH, Manga YB, Huang SC, Chao KM, Jheng PR, Wong PC, Nyambat B, Satapathy MK, Chuang EY. Facilitated and Controlled Strontium Ranelate Delivery Using GCS-HA Nanocarriers Embedded into PEGDA Coupled with Decortication Driven Spinal Regeneration. Int J Nanomedicine 2021; 16:4209-4224. [PMID: 34188470 PMCID: PMC8235953 DOI: 10.2147/ijn.s274461] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 03/03/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND PURPOSE Strontium ranelate (SrR) is an oral pharmaceutical agent for osteoporosis. In recent years, numerous unwanted side effects of oral SrR have been revealed. Therefore, its clinical administration and applications are limited. Hereby, this study aims to develop, formulate, and characterize an effective SrR carrier system for spinal bone regeneration. METHODS Herein, glycol chitosan with hyaluronic acid (HA)-based nanoformulation was used to encapsulate SrR nanoparticles (SrRNPs) through electrostatic interaction. Afterward, the poly(ethylene glycol) diacrylate (PEGDA)-based hydrogels were used to encapsulate pre-synthesized SrRNPs (SrRNPs-H). The scanning electron microscope (SEM), TEM, rheometer, Fourier-transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS) were used to characterize prepared formulations. The rabbit osteoblast and a rat spinal decortication models were used to evaluate and assess the developed formulation biocompatibility and therapeutic efficacy. RESULTS In vitro and in vivo studies for cytotoxicity and bone regeneration were conducted. The cell viability test showed that SrRNPs exerted no cytotoxic effects in osteoblast in vitro. Furthermore, in vivo analysis for new bone regeneration mechanism was carried out on rat decortication models. Radiographical and histological analysis suggested a higher level of bone regeneration in the SrRNPs-H-implanted groups than in the other experimental groups. CONCLUSION Local administration of the newly developed formulated SrR could be a promising alternative therapy to enhance bone regeneration in bone-defect sites in future clinical applications.
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Affiliation(s)
- Chih-Wei Chiang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, 10617, Taiwan
- Department of Orthopedics, Taipei Medical University Hospital, Taipei, 11031, Taiwan
| | - Chih-Hwa Chen
- Department of Orthopedics, Taipei Medical University–Shuang Ho Hospital, New Taipei City, 23561, Taiwan
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei, 11031, Taiwan
| | - Yankuba B Manga
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Shao-Chan Huang
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Kun-Mao Chao
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, 10617, Taiwan
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, 10617, Taiwan
| | - Pei-Ru Jheng
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Pei-Chun Wong
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Batzaya Nyambat
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Mantosh Kumar Satapathy
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
| | - Er-Yuan Chuang
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan
- Cell Physiology and Molecular Image Research Center, Taipei Medical University–Wan Fang Hospital, Taipei, 116, Taiwan
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12
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Siqueira R, Ferreira JA, Rizzante FAP, Moura GF, Mendonça DBS, de Magalhães D, Cimões R, Mendonça G. Hydrophilic titanium surface modulates early stages of osseointegration in osteoporosis. J Periodontal Res 2020; 56:351-362. [PMID: 33368275 DOI: 10.1111/jre.12827] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/16/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Using a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process. BACKGROUND Based on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short- and long-term clinical outcomes in osteoporosis is necessary. MATERIAL AND METHODS Fifty female, 3-month-old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE-HD). Calcium (Ca) and phosphorus (P) content was measured by energy-dispersive X-ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone-to-implant contact (BIC) and bone volume fraction (BV) by nano-computed tomography (nano-CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL-1β, IL-10, Tnf-α, and Nos2) by qRT-PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05. RESULTS The amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE-HD compared to SAE on the intra-group analysis. Nano-CT and histology revealed more BV and BIC for SAE-HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment. CONCLUSION Both surfaces were able to modulate bone responses toward osteoblast differentiation. SAE-HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.
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Affiliation(s)
- Rafael Siqueira
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Jessica Afonso Ferreira
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil.,Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Fábio Antônio Piola Rizzante
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Guilherme Faria Moura
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil.,Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | | | - Denildo de Magalhães
- Department of Periodontology and Implant Dentistry, School of Dentistry, Federal University of Uberlandia, Uberlândia, Brazil
| | - Renata Cimões
- Department of Prosthesis and Maxillofacial Surgery, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Gustavo Mendonça
- Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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13
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Mardas N, Dereka X, Stavropoulos A, Patel M, Donos N. The role of strontium ranelate and guided bone regeneration in osteoporotic and healthy conditions. J Periodontal Res 2020; 56:330-338. [PMID: 33368312 DOI: 10.1111/jre.12825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 10/03/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND/ OBJECTIVES SR is a chemical agent developed for the treatment of osteoporosis. In vitro, SR enhanced replication of osteoprogenitor cells and bone formation. In vivo, in ovariectomized rats SR prevented the biomechanical deterioration of bone while in non-ovariectomized rats, enhanced bone architecture and increased trabecular and cortical bone mass. The aim of this study was to evaluate the effect of SR on bone healing of calvarial critical size defects treated with a deproteinized bovine bone mineral (DBBM) and a collagen barrier (CM), in healthy and osteoporotic rats. MATERIAL AND METHODS Sixty-four, 4-month-old Wistar female rats were used. Osteoporosis was induced by ovariectomy and calcium-deficient diet in half of them. Sixteen ovariectomized (OSR) and 16 healthy (HSR) rats were treated with SR while no medication was administered in the remaining 16 healthy (H) and 16 ovariectomized (O) rats. At 6 weeks after ovariectomy, a 5mm defect was created in each parietal bone of every animal. One defect was treated with DBBM and CM, while the contralateral was left untreated. Qualitative and quantitative histological analysis was performed at 30 and 60 days of healing. A generalized estimating equations test was performed to evaluate the effect of SR and osteoporosis, on new bone formation (NB). RESULTS After 30 days of healing, NB in the untreated defects was 3.4%±1.7%, 4.3%±6.2%, 3.2±4.5%, 15.9±23.5% in O, OSR, H and HSR groups, respectively; after 60 days, NB was 4.7%±4.3%, 11.3%±7%, 7.1%±13.2, 12.1%±13.5%, respectively. In the GBR-treated defects, after 30 days, NB was 2.6%±1.4%, 2.4%±1.6%, 4.5%±4.1%, 10.3%±14.4% in O, OSR, H and HSR groups, respectively; after 60 days, NB was 2.2%±1.6%, 4.3%±4.2%, 7%±5.1%, 10.8%±17.4%, respectively. Osteoporosis (p=0.008) and the absence of strontium ranelate treatment (p=0.01) had a negative impact on NB. CONCLUSION SR may promote bone formation in calvarial defects in healthy and osteoporotic rats, albeit in a moderate extent.
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Affiliation(s)
- Nikos Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London, London, UK.,Centre for Oral Clinical Research, Institute of Dentistry, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London, London, UK
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Stavropoulos
- Division of Regenerative Dental Medicine and Periodontology, CUMD, University of Geneva, Geneva, Switzerland.,Department of Periodontology, Malmö University, Malmö, Sweden
| | | | - Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London, London, UK.,Centre for Oral Clinical Research, Institute of Dentistry, Bart's & The London School of Dentistry & Medicine, Queen Mary University of London, London, UK
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14
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Tabrizi R, Mousavi F, Ghasemi S, Ozkan BT. Does osteoporosis increase marginal bone loss around dental implants in the posterior of the maxilla? Int J Oral Maxillofac Surg 2020; 50:964-968. [PMID: 33376042 DOI: 10.1016/j.ijom.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/25/2020] [Accepted: 12/03/2020] [Indexed: 01/09/2023]
Abstract
Osteoporosis is caused by an imbalance in bone remodelling. The aim of this study was to compare the marginal bone loss (MBL) around dental implants placed in the posterior maxilla between osteoporotic and non-osteoporotic female patients. This was a prospective cohort study. Female patients needing a dental implant restoration in the posterior maxilla were included. Dual-energy X-ray absorptiometry was performed and the T-score recorded. MBL was measured at 12 months after loading. The patients were assigned to one of two groups: group 1, osteoporotic (T-score ≥2.5); group 2, non-osteoporotic (T-score <2.5). In this study, osteoporosis was the primary predictor variable and MBL was the outcome variable. The mean MBL was compared between the two groups using an independent t-test. Pearson's correlation test was applied to identify any correlation between the T-score and MBL. Ninety female patients were studied, 44 in group 1 and 46 in group 2. The mean MBL was 1.20±0.29mm in group 1 and 0.87±0.15 in group 2; this difference in mean MBL was statistically significant (P=0.001). There was a correlation between T-score and MBL (P=0.001). Despite the correlation between T-score and MBL, this study did not provide enough evidence to prove any causal relationship between MBL and osteoporosis.
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Affiliation(s)
- R Tabrizi
- Oral and Maxillofacial Surgery Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - F Mousavi
- Oral and Maxillofacial Surgery Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Ghasemi
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - B T Ozkan
- Institute of Health Science, Toros University, Mersin, Turkey
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15
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Diachkova E, Abramova EV, Blagushina NA, Tarasenko S. Surgical treatment with dental implants in a patient with secondary loss of teeth and osteoporosis caused by an imbalance of vitamin D. BMJ Case Rep 2020; 13:13/11/e235585. [PMID: 33257353 DOI: 10.1136/bcr-2020-235585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In recent years, the success of long-term dental implants has remained problematic, especially because of the increasing rate of mineral balance changes in patients with partial loss of teeth, regardless of their age, race and sex. This article describes the experience of 6 years of treatment with dental implants in a patient with secondary loss of tooth and mineral imbalance (osteopenia) due to vitamin D deficiency, in collaboration with endocrinologist. Along with basic dental care, special medicine was prescribed for this pathology. The bone system was monitored through regular blood tests, skeletal bone densitometry and X-ray of the maxillofacial region. This management plan allowed dental implants to be maintained in good condition for 7 years.
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Affiliation(s)
- Ekaterina Diachkova
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Elizaveta V Abramova
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Natalia A Blagushina
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Svetlana Tarasenko
- Dental Surgery, I M Sechenov First Moscow State Medical University, Moscow, Russian Federation
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16
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Lan Y, Jin Q, Xie H, Yan C, Ye Y, Zhao X, Chen Z, Xie Z. Exosomes Enhance Adhesion and Osteogenic Differentiation of Initial Bone Marrow Stem Cells on Titanium Surfaces. Front Cell Dev Biol 2020; 8:583234. [PMID: 33224950 PMCID: PMC7674173 DOI: 10.3389/fcell.2020.583234] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
Successful osseointegration involves the biological behavior of bone marrow stem cells (BMSCs) on an implant surface; however, the role of BMSC-derived extracellular vesicles (EVs)/exosomes in osseointegration is little known. This study aimed to: (i) explore the interaction force between exosomes (Exo) and cells on a titanium surface; (ii) discuss whether the morphology and biological behavior of BMSCs are affected by exosomes; and (iii) preliminarily investigate the mechanism by which exosomes regulate cells on Ti surface. Exosomes secreted by rat BMSCs were collected by ultracentrifugation and analyzed using transmission electron microscopy and nanoparticle tracking analysis. Confocal fluorescence microscopy, scanning electron microscopy, Cell Counting Kit-8 (CCK-8), quantitative real-time polymerase chain reaction techniques, and alkaline phosphatase bioactivity, Alizarin Red staining, and quantification were used to investigate the exosomes that adhere to the Ti plates under different treatments as well as the morphological change, adhesion, spread, and differentiation of BMSCs. We found that exosomes were efficiently internalized and could regulate cell morphology and promoted the adhesion, spreading, and osteogenic differentiation of BMSCs. These were achieved partly by activating the RhoA/ROCK signaling pathway. Our discovery presents a new insight into the positive regulatory effect of exosomes on the biological behaviors of BMSCs on Ti surface and provides a novel route to modify the surface of a Ti implant.
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Affiliation(s)
| | | | | | | | | | | | - Zhuo Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhijian Xie
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
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17
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Yasuda K, Okada S, Okazaki Y, Hiasa K, Tsuga K, Abe Y. Bone turnover markers to assess jawbone quality prior to dental implant treatment: a case-control study. Int J Implant Dent 2020; 6:67. [PMID: 33140835 PMCID: PMC7606420 DOI: 10.1186/s40729-020-00264-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/09/2020] [Indexed: 12/04/2022] Open
Abstract
Background Bone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the relationship at baseline and during follow-up in patients with prosthodontic implants. Computed tomography (CT) scans were obtained and BTM (osteocalcin, bone-specific alkaline phosphatase, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen, and crosslinked N-telopeptide of type I collagen) levels in blood samples were measured in partially edentulous eighteen patients before implant surgery. During the follow-up observation after implant surgery, marginal bone loss (MBL) was measured on dental radiography. We investigated the relationship between the presence of BTM abnormalities and radiographic bone density. Results More women than men had abnormal BTM values. Bone turnover was accelerated in the group of women with abnormal BTM values. The density of cancellous bone at the implant placement site was significantly lower in the patients with abnormally high BTM values than in their counterparts with BTM values in the normal range. Conclusions Female patients who undergo implant treatments may have reduced bone quality; evaluations of bone strength will require assessments of both BTMs and the density of cancellous bone.
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Affiliation(s)
- Keisuke Yasuda
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Shinsuke Okada
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yohei Okazaki
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kyou Hiasa
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yasuhiko Abe
- Department of Advanced Prosthodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
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18
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Shaheen MY, Basudan AM, Niazy AA, van den Beucken JJJP, Jansen JA, Alghamdi HS. Impact of Single or Combined Drug Therapy on Bone Regeneration in Healthy and Osteoporotic Rats. Tissue Eng Part A 2020; 27:572-581. [PMID: 32838702 DOI: 10.1089/ten.tea.2020.0122] [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: 11/13/2022] Open
Abstract
Complications in bone regeneration in patients with systemic impaired bone metabolism (e.g., osteoporosis) represent a rapidly increasing clinical challenge. Alendronate and simvastatin are drugs commonly used to promote bone metabolism in osteoporotic conditions. The aim of this study was to evaluate initial bone regeneration within osseous defects grafted with beta-tricalcium phosphate (β-TCP) in adjunction with systemic coadministrations of alendronate and simvastatin (i.e., daily subcutaneous injection for 3 weeks) in healthy and osteoporotic rats. Eighty Wistar female rats were ovariectomized (OVX; n = 40) or sham operated (n = 40). Six weeks later, osseous defects (a 3-mm critical-sized defect) were created in the left femoral condyles and then grafted with β-TCP. From the day following graft installation, OVX and sham animals received for 3 weeks a daily subcutaneous injection of alendronate (50 μg/kg of body weight) and simvastatin (5 mg/kg of body weight), alone or in combination. A control group was included, which received subcutaneous saline administration. At the end of the 3 weeks, rats were euthanized and specimens (femoral condyles) were retrieved for histological evaluation and histomorphometric measurements, that is, bone area (BA%) and remaining bone graft (RBG%). In osteoporotic rats, 3 weeks of daily subcutaneous injection of combined therapy (alendronate plus simvastatin) led to a significant (p < 0.05) increase in BA% and a significant decrease in RBG% compared to healthy controls in osseous defects grafted with β-TCP (BA%: 28.6 ± 12.0 vs. 18.2 ± 7.6, RBG% 61.3 ± 11.1 vs. 70.7 ± 7.3). No significant differences in BA% and RBG% were found in the OVX rats for single treatments. Furthermore, healthy controls showed similar BA% and RBG% upon single or combined therapy compared to nontreated control rats. Daily coinjections (for 3 weeks) of alendronate plus simvastatin result in a significant enhancement of bone regeneration within osseous defects grafted with β-TCP in osteoporotic rats. Despite the expected effects on osteoporotic bone, our study did not confirm the hypothesized benefit of alendronate and simvastatin on bone regeneration in osseous defects in healthy conditions. The efficacy of the combination drug therapy on bone regeneration demands further investigation to elucidate molecular and cellular aspects underlying this therapy.
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Affiliation(s)
- Marwa Y Shaheen
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Amani M Basudan
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdurahman A Niazy
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - John A Jansen
- Department of Dentistry - Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hamdan S Alghamdi
- Department of Periodontics and Community Dentistry and College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Dentistry - Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
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19
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Karakaya M, Demirbaş AE. Effect of low-level laser therapy on osseointegration of titanium dental implants in ovariectomized rabbits: biomechanics and micro-CT analysis. Int J Implant Dent 2020; 6:61. [PMID: 33043397 PMCID: PMC7548265 DOI: 10.1186/s40729-020-00257-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The primary aim of this study is to assess, in an animal model, whether biostimulation of osteoporotic bone with low-level laser therapy improves the osseointegration of dental implants. MATERIAL AND METHODS Twenty-two female rabbits were randomly divided into two groups: sham-ovariectomy and bilateral-ovariectomy. Laser therapy was applied to the implants placed in the right tibial bones and was not applied to implants placed in the left tibial bones. The periotest device was used for the stability test. Periotest values were recorded after the implantation (T0) and when the animals were euthanized (T1). The removal torque test and micro-computed tomography examination were evaluated. RESULTS As a result of removal torque, the mean of ovariectomy-laser group (56.1 ± 5.1 Ncm) was higher than sham-ovariectomy group (55.4 ± 18.5 Ncm) (p = 0.9). In periotest analysis, a significant difference was found between the values of T1 and T0 in all groups, except sham-ovariectomy group (p < 0.05); and the highest difference was found in the ovariectomy-laser group. Micro-CT examination demonstrated that ovariectomy-laser group showed an increase of implant-bone contact when compared with ovariectomy (p < 0.05). CONCLUSIONS The values obtained from biomechanical tests and micro-CT in the ovariectomy-laser group were significantly higher than the ovariectomy group and achieved the values in the healthy bone.
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Affiliation(s)
- Mustafa Karakaya
- Sancaktepe Oral and Dental Health Hospital, Department of Oral and Maxillofacial Surgery, Ministry of Health, İstanbul, Turkey.
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Erciyes University Faculty of Dentistry, Melikgazi, Kayseri, Turkey
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20
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Lotz EM, Cohen DJ, Schwartz Z, Boyan BD. Titanium implant surface properties enhance osseointegration in ovariectomy induced osteoporotic rats without pharmacologic intervention. Clin Oral Implants Res 2020; 31:374-387. [PMID: 31953969 PMCID: PMC7771214 DOI: 10.1111/clr.13575] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 12/03/2019] [Accepted: 01/04/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study determined whether implant surfaces that promote osseointegration in normal rats can promote osseointegration in osteoporotic rats without pharmacologic intervention. MATERIALS AND METHODS Virgin female 8-month-old CD Sprague Dawley rats (N = 25) were ovariectomized. At 6 weeks, microstructured/non-nanostructured/hydrophobic, microstructured/nanostructured/hydrophobic, or microstructured/nanostructured/hydrophilic Ti implants (Ø2.5 × 3.5 mm; Institut Straumann AG, Basel, Switzerland) were placed in the distal metaphysis of each femur. At 28 days, bone quality and implant osseointegration were assessed using microCT, histomorphometrics, and removal torque values (RTVs). Calvarial osteoblasts were isolated and cultured for 7 days on Ø15 mm Ti disks processed to exhibit similar surface characteristics as the implants used for the in vivo studies. The phenotype was assessed by measuring the production of osteocalcin, osteoprotegerin, osteopontin, BMP2, VEGF, and RANKL. RESULTS Microstructured/nanostructured/hydrophilic implants promoted increased bone-to-implant contact and RTVs in vivo and increased osteoblastic marker production in vitro compared to microstructured/non-nanostructured/hydrophobic and microstructured/nanostructured/hydrophobic implants, suggesting that osseointegration occurs in osteoporotic animals, and implant surface properties improve its rate. CONCLUSIONS Although all modified implants were able to osseointegrate in rats with OVX-induced osteoporosis without pharmacologic intervention, the degree of osseointegration was greater around microstructured/nanostructured/hydrophilic implant surfaces. These results suggest that when appropriate microstructure is present, hydrophilicity has a greater influence on Ti implant osseointegration compared to nanostructures. Moreover, modified implant surfaces can exert their control over the altered bone turnover observed in osteoporotic patients to stimulate functional osseointegration. These results provide critical insight for developing implants with improved osseointegration in patients with metabolic disorders of bone remodeling.
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Affiliation(s)
- Ethan M. Lotz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - David J. Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Barbara D. Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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A Vitronectin-Derived Bioactive Peptide Improves Bone Healing Capacity of SLA Titanium Surfaces. MATERIALS 2019; 12:ma12203400. [PMID: 31627447 PMCID: PMC6829905 DOI: 10.3390/ma12203400] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022]
Abstract
In this study, we evaluated early bone responses to a vitronectin-derived, minimal core bioactive peptide, RVYFFKGKQYWE motif (VnP-16), both in vitro and in vivo, when the peptide was treated on sandblasted, large-grit, acid-etched (SLA) titanium surfaces. Four surface types of titanium discs and of titanium screw-shaped implants were prepared: control, SLA, scrambled peptide-treated, and VnP-16-treated surfaces. Cellular responses, such as attachment, spreading, migration, and viability of human osteoblast-like HOS and MG63 cells were evaluated in vitro on the titanium discs. Using the rabbit tibia model with the split plot design, the implants were inserted into the tibiae of four New Zealand white rabbits. After two weeks of implant insertion, the rabbits were sacrificed, the undecalcified specimens were prepared for light microscopy, and the histomorphometric data were measured. Analysis of variance tests were used for the quantitative evaluations in this study. VnP-16 was non-cytotoxic and promoted attachment and spreading of the human osteoblast-like cells. The VnP-16-treated SLA implants showed no antigenic activities at the interfaces between the bones and the implants and indicated excellent bone-to-implant contact ratios, the means of which were significantly higher than those in the SP-treated implants. VnP-16 reinforces the osteogenic potential of the SLA titanium dental implant.
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22
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Shaheen MY, Basudan AM, de Vries RB, van den Beucken JJJP, Jansen JA, Alghamdi HS. Bone Regeneration Using Antiosteoporotic Drugs in Adjunction with Bone Grafting: A Meta-Analysis. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:500-509. [PMID: 31411119 DOI: 10.1089/ten.teb.2019.0132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this review was to systematically assess bone regeneration by using antiosteoporotic drugs in adjunction with bone grafting compared with controls (bone grafting without the administration of antiosteoporotic drugs). The review also evaluated statistical differences in the effect between systemic and local routes of drugs. Also, the effect of type of drugs (anticatabolic vs. anabolic) was subevaluated. PubMed and EMBASE (via OvidSP) resulted in inclusion of 60 animal studies. The studies were assessed for reporting quality and risk of bias. Outcome data from selected studies were categorized as either experimental (bone grafting with the administration of antiosteoporotic drugs) or control. Meta-analysis of selected studies was done for these outcomes: histomorphometrical bone area (BA%) and micro-CT bone volume (BV%). In this review, several animal models (52 healthy, 6 osteoporotic, and 2 both conditions) were subjected to examine the effect of antiosteoporotic drugs on bone grafting, with a predominant use of rodent species. Assessment indicates poor reporting quality and unclear risk of bias in the majority of studies. Random-effects meta-analysis revealed a significant increase in overall BA% (mean difference [MD]: 2.6, confidence interval [CI]: 2.25 to 2.92) and BV% (MD: 0.12, CI: 0.05 to 0.19) due to osteoporotic drug treatment compared with controls. For subgroups, both routes of antiosteoporotic drug administration showed similar effects on BA%. In contrast, systemic antiosteoporotic drug administration led to significantly higher BV% (MD: 6.75, CI: 5.30 to 8.19) compared with local administration (MD: 0.02, CI: -0.03 to 0.08). Further, administration of anabolic drugs significantly increased BA% (MD: 5.75, CI: 4.62 to 6.87) compared with anticatabolic drugs (MD: 1.86, CI: 1.47 to 2.26). In conclusion, both histomorphometrical and micro-CT scan analysis indicated an overall effect of using the antiosteoporotic drugs toward bone regeneration in adjunction with grafting. However, not all studies showed a positive effect and the present results need to be applied with care, as the included papers showed experimental heterogeneity for animal models. Further (pre)clinical research is warranted to explore whether drug-based strategies can be an effective adjunctive with bone grafting. Impact Statement The aim of this meta-analysis was to assess whether antiosteoporotic drugs can promote bone regeneration in adjunction with bone grafting by using preclinical animal models. Although the majority of included studies indicated poor reporting quality and unclear risk of bias, an overall positive effect of the antiosteoporotic drugs toward bone regeneration related to bone grafts can be highlighted.
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Affiliation(s)
- Marwa Y Shaheen
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Amani M Basudan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Rob B de Vries
- Regenerative Biomaterials, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen J J P van den Beucken
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence (Section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - John A Jansen
- Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence (Section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hamdan S Alghamdi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE), Department for Health Evidence (Section HTA), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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23
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Dereka X, Calciolari E, Donos N, Mardas N. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies. J Periodontal Res 2018; 53:933-940. [PMID: 29845622 DOI: 10.1111/jre.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed, owing to the limited information on animal housing and husbandry, baseline characteristics and health status, ethical statement and allocation to the experimental groups provided. Although the available studies seem to suggest a lower osseointegration in osteoporotic-like conditions, no robust conclusions can be drawn due to the great heterogeneity and overall low quality of the available studies. Future studies with emphasis on minimizing the possible sources of bias and evaluating osseointegration of dental implants placed into jawbones instead of long bones are warranted.
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Affiliation(s)
- X Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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24
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Hefni EK, Bencharit S, Kim SJ, Byrd KM, Moreli T, Nociti FH, Offenbacher S, Barros SP. Transcriptomic profiling of tantalum metal implant osseointegration in osteopenic patients. BDJ Open 2018; 4:17042. [PMID: 30479835 PMCID: PMC6251902 DOI: 10.1038/s41405-018-0004-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/16/2018] [Accepted: 07/18/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The long-term success of dental implants is established by literature. Although clinically well defined, the complex genetic pathways underlying osseointegration have not yet been fully elucidated. Furthermore, patients with osteopenia/osteoporosis are considered to present as higher risk for implant failure. Porous tantalum trabecular metal (PTTM), an open-cell porous biomaterial, is suggested to present enhanced biocompatibility and osteoconductivity. The goal of this study was to evaluate the expression patterns of a panel of genes closely associated with osteogenesis and wound healing in osteopenic patients receiving either traditional titanium (Ti) or PTTM cylinders to assess the pathway of genes activation in the early phases of osseointegration. MATERIAL AND METHODS Implant cylinders made of Ti and PTTM were placed in osteopenic volunteers. At 2- and 4 weeks of healing, one Ti and one PTTM cylinder were removed from each subject for RT-PCR analysis using osteogenesis PCR array. RESULTS Compared to Ti, PTTM-associated bone displayed upregulation of bone matrix proteins, BMP/TGF tisuperfamily, soluble ligand and integrin receptors, growth factors, and collagen genes at one or both time points. Histologically, PTTM implants displayed more robust osteogenesis deposition and maturity when compared to Ti implants from the same patient. CONCLUSIONS Our results indicate that PTTM properties could induce an earlier activation of genes associated with osteogenesis in osteopenic patients suggesting that PTTM implants may attenuate the relative risk of placing dental implants in this population.
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Affiliation(s)
- E. K. Hefni
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
| | - S. Bencharit
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, VA USA
| | - S. J. Kim
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
| | - K. M. Byrd
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
| | - T. Moreli
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
| | - F. H. Nociti
- Department of Periodontology, School of Dentistry, State University of Campinas, Campinas, Brazil
| | - S. Offenbacher
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
| | - S. P. Barros
- Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, NC USA
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25
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Zarean P, Zarean P, Kanounisabet N, Moghareabed A, Rismanchian M, Yadegarfar G. Dental Implant Rehabilitation in Patients Suffering from Mucocutaneous Diseases: A Systematic Review and Meta-Analysis. Open Dent J 2018. [DOI: 10.2174/1874210601812010873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
Dental implantations are widely used for oral rehabilitation of edentulous patients. Despite high success rate, there are some risk factors that have been associated with failures. Oral mucocutaneous diseases are one of these risk factors for implant insertion due to the immunosuppressive therapy.
There are limited studies that have dealt with the subject of dental implantology in oral mucosal disorders mainly with patients with oral lichenplanus, pemphigoid, pemphigus vulgaris, and systemic lupus erythematosus. In order to assess the result of implantations in such patients, we have reviewed the studies.
Materials and Methods:
We searched PubMed, Science Direct, and Cochrane databases for articles published from Jan 2000 to Dec 2017, using key search word “dental implants”, “oral lichen planus”, “pemphigoid”, “pemphigus vulgaris” and ”systemic lupus erythematosus”.
Results:
The random effects analysis result shows overall failure rates of 22% in patients with oral lichen planus. A systematic review revealed some failures that are not definitely related to these diseases.
Conclusion:
Due to the lack of adequate studies, a meta-analysis was only possible for oral lichen planus. Presently, there is no definite guideline regarding the placement of implant in patients suffering from mucocutaneous diseases; nevertheless, we should always consider that these patients are specific cases and need more attention in the first step of treatment and follow-ups. So there is a need to further clinical studies in order to evaluate more risk factors accurately and make a definitive conclusion.
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26
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Zhao H, Huang Y, Zhang W, Guo Q, Cui W, Sun Z, Eglin D, Liu L, Pan G, Shi Q. Mussel-Inspired Peptide Coatings on Titanium Implant to Improve Osseointegration in Osteoporotic Condition. ACS Biomater Sci Eng 2018; 4:2505-2515. [PMID: 33435114 DOI: 10.1021/acsbiomaterials.8b00261] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Huan Zhao
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Yingkang Huang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Wen Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Qianping Guo
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Wenguo Cui
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
| | - Zhiyong Sun
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
| | - David Eglin
- AO Research Institute Davos, Clavadelerstrasse 8, Davos, 7270, Switzerland
| | - Lei Liu
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Guoqing Pan
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Qin Shi
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China
- Orthopedic Institute, Soochow University, 708 Renmin Road, Suzhou, 215007, China
- Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, 199 Renai Road, Suzhou, 215123, China
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27
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Oki Y, Doi K, Makihara Y, Kobatake R, Kubo T, Tsuga K. Effects of continual intermittent administration of parathyroid hormone on implant stability in the presence of osteoporosis: an in vivo study using resonance frequency analysis in a rabbit model. J Appl Oral Sci 2017; 25:498-505. [PMID: 29069147 PMCID: PMC5804386 DOI: 10.1590/1678-7757-2016-0561] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/22/2017] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the effects of continual intermittent administration of parathyroid hormone (PTH) on implant stability in the presence of osteoporosis, using rabbit models. MATERIAL AND METHODS Fifteen female New Zealand white rabbits underwent ovariectomy and were administered glucocorticoids to induce osteoporosis, following which they were divided into three groups. The first group received intermittent subcutaneous PTH for 4 weeks until implant placement (PTH1), while the second and third groups received PTH (PTH2) and saline (control), respectively, for 4 weeks before and after implant placement. After intermittent administration of PTH or saline, titanium implants were inserted into the left femoral epiphyses of all animals, and the implant stability quotient (ISQ) was measured immediately after placement to assess the primary stability and at 2 and 4 weeks after implant placement to assess osseointegration. At 4 weeks after implant placement, histological and histomorphometric evaluations were conducted and the bone area around the implant socket was measured as a ratio of the total bone area to the total tissue area. RESULTS Regarding primary stability, the ISQ values for the PTH1 and PTH2 groups were significantly higher than those for the control group (p<0.05). Concerning osseointegration, the ISQ values at 2 and 4 weeks were significantly higher for the PTH2 group than for the PTH1 and control (p<0.05) groups. Histological assessments showed a thicker and more trabecular bone around the implant sockets in the PTH2 specimens than in the PTH1 and control specimens. The bone area around the implant socket was significantly greater in the PTH2 group than in the PTH1 and control groups (p<0.05). CONCLUSIONS Our results suggest that continual intermittent PTH administration before and after dental implant placement is effective for the achievement of favorable stability and osseointegration in the presence of osteoporosis.
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Affiliation(s)
- Yoshifumi Oki
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
| | - Kazuya Doi
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
| | - Yusuke Makihara
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
| | - Reiko Kobatake
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
| | - Takayasu Kubo
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Hiroshima University, Graduate School of Biomedical & Health Sciences, Department of Advanced Prosthodontics, Division of Dental Sciences, Hiroshima, Japan
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28
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de Medeiros FCFL, Kudo GAH, Leme BG, Saraiva PP, Verri FR, Honório HM, Pellizzer EP, Santiago Junior JF. Dental implants in patients with osteoporosis: a systematic review with meta-analysis. Int J Oral Maxillofac Surg 2017; 47:480-491. [PMID: 28651805 DOI: 10.1016/j.ijom.2017.05.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 05/09/2017] [Accepted: 05/24/2017] [Indexed: 11/16/2022]
Abstract
There is currently no consensus regarding the survival rate of osseointegrated implants in patients with osteoporosis. A systematic review with meta-analysis was performed to evaluate the survival rate of implants in such patients. The PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases were used to identify articles published up to September 2016. The systematic review was performed in accordance with PRISMA/PICO requirements and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk (RR) of implant failure and mean marginal bone loss were analyzed within a 95% confidence interval (CI). Fifteen studies involving 8859 patients and 29,798 implants were included. The main outcome of the meta-analysis indicated that there was no difference in implant survival rate between patients with and without osteoporosis, either at the implant level (RR 1.39, 95% CI 0.93-2.08; P=0.11) or at the patient level (RR 0.98, 95% CI 0.50-1.89; P=0.94). However, the meta-analysis for the secondary outcome revealed a significant difference in marginal bone loss around implants between patients with and without osteoporosis (0.18mm, 95% CI 0.05-0.30, P=0.005). Data heterogeneity was low. An increase in peri-implant bone loss was observed in the osteoporosis group. Randomized and controlled clinical studies should be conducted to analyze possible biases.
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Affiliation(s)
- F C F L de Medeiros
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - G A H Kudo
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - B G Leme
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - P P Saraiva
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil
| | - F R Verri
- Dental School of Araçatuba, UNESP - Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - H M Honório
- Department of Scientific Methodology and Statistics, Bauru School of Dentistry, USP - University of São Paulo, São Paulo, Brazil
| | - E P Pellizzer
- Dental School of Araçatuba, UNESP - Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - J F Santiago Junior
- Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração, Bauru, SP, Brazil.
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29
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Yang S, Wang L, Feng S, Yang Q, Yu B, Tu M. Enhanced bone formation by strontium modified calcium sulfate hemihydrate in ovariectomized rat critical-size calvarial defects. ACTA ACUST UNITED AC 2017; 12:035004. [PMID: 28580902 DOI: 10.1088/1748-605x/aa68bc] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The development of a new generation of biomaterials with high osteogenic ability for treatment of osteoporotic fractures is being intensively investigated. The objective of this paper was to investigate new bone formation in an ovariectomized rat (OVX rat) calvarial model of critical size bone defects filled with Sr-containing α-calcium sulfate hemihydrate (SrCSH) cement compared to an α-calcium sulfate hemihydrate (α-CSH) cement and empty defect. X-ray diffraction analysis verified the partial substitution of Sr2+ for Ca2+ did not change the phase composition of α-CSH. Scanning electron microscopy showed that Sr-substituted α-CSH significantly increased the surface roughness. The effects of Sr substitution on the biological properties of SrCSH cement were evaluated by adhesion, proliferation, alkaline phosphatase (ALP) activity of osteoblast-like cells MC3T3-E1. The results showed that SrCSHs enhanced MC3T3-E1 cell proliferation, differentiation, and ALP activity. Furthermore, SrCSH cement was used to repair critical-sized OVX rat calvarial defects. The in vivo results revealed that SrCSH had good osteogenic capability and stimulated new blood vessel formation in a critical sized OVX calvarial defect within 12 weeks, suggesting that SrCSH cement has more potential for application in bone tissue regeneration.
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Affiliation(s)
- Shenyu Yang
- Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, People's Republic of China. Engineering Research Center of Artificial Organs and Materials, Ministry of Education, Jinan University, Guangzhou 510632, People's Republic of China
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30
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Liu J, Wu Z, He H, Cai K, Zhang H, Xu L. Gallium and silicon synergistically promote osseointegration of dental implant in patients with osteoporosis. Med Hypotheses 2017; 103:35-38. [DOI: 10.1016/j.mehy.2017.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/28/2017] [Indexed: 01/16/2023]
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31
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Oki Y, Doi K, Makihara Y, Kubo T, Oue H, Tsuga K. Intermittent administration of parathyroid hormone enhances primary stability of dental implants in a bone-reduced rabbit model. J Oral Sci 2017; 58:241-6. [PMID: 27349546 DOI: 10.2334/josnusd.15-0717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of the study was to investigate the effect of parathyroid hormone (PTH) on primary stability of dental implants in a bone-reduced model. Ten female New Zealand white rabbits underwent ovariectomy and were administered glucocorticoid to induce osteoporosis. One group was administered PTH intermittently by subcutaneous injection for 4 weeks (PTH-group) and the other group was given injections of saline for 4 weeks (Osteoporosis; OP-group). After the administration period, implants were inserted into the distal femoral epiphyses of each animal. At implant placement, insertion torque (IT) and implant stability quotient (ISQ) were measured. Histological examination revealed newly formed trabecular bone around the implant socket in the PTH-group but not in the OP-group. The trabecular bone structures in the PTH-group appeared thicker than those in the OP-group. In the PTH-group, the mean IT value was significantly greater than that in the OP-group (29.8 ± 6.2 Ncm and 10.0 ± 2.1 Ncm, respectively; P < 0.05). The ISQ value in the PTH-group was significantly higher than that in the OP-group (74.7 ± 11.2 and 55.9 ± 13.5, respectively; P < 0.05). Intermittent PTH administration could be an effective treatment for achieving favorable primary stability of dental implants in patients with osteoporosis. (J Oral Sci 58, 241-246, 2016).
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Affiliation(s)
- Yoshifumi Oki
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences
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Liu Y, Hu J, Liu B, Jiang X, Li Y. The effect of osteoprotegerin on implant osseointegration in ovariectomized rats. Arch Med Sci 2017; 13:489-495. [PMID: 28261305 PMCID: PMC5332467 DOI: 10.5114/aoms.2017.65468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/12/2015] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Osteoprotegerin (OPG), the endogenous inhibitor of RANKL, prevents or reverses bone loss in a variety of preclinical models of bone disease. Preclinical studies indicate that osteoporosis significantly impairs implant fixation. This study aims to investigate the role of OPG in implant osseointegration in ovariectomized rats. MATERIAL AND METHODS Twelve weeks after bilateral ovariectomy, each rat accepted two titanium screws in the proximal tibiae. All animals were then randomly divided into two groups: the control (10 rats) and OPG group (10 rats). Subcutaneous injection of OPG (10 mg/kg) or vehicle was performed three times a week. Eight weeks later, tibiae with screws were harvested for micro-computed tomography (μCT), histological and biomechanical analysis. RESULTS Compared to control, OPG increased the percent bone volume by 124%, the percent osseointegration by 167%, the mean trabecular number by 111%, the mean trabecular thickness by 92% (p < 0.01), the mean connective density by 95% (p < 0.05); and decreased the mean trabecular separation by 64% in μCT analysis (p < 0.05). Osteoprotegerin also increased bone area density by 160% and bone-to-implant contact by 234% in histomorphometric evaluation (p < 0.01), and increased the maximal push-out force by 228% in biomechanical test (p < 0.01). CONCLUSIONS Systemic administration of OPG improved implant osseointegration and fixation in ovariectomized rats, resulting from the increased peri-implant bone mass and improved trabecular microarchitecture.
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Affiliation(s)
- Yiming Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Biao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiliang Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yunfeng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Guo X, Wei S, Lu M, Shao Z, Lu J, Xia L, Lin K, Zou D. Dose-dependent Effects of Strontium Ranelate on Ovariectomy Rat Bone Marrow Mesenchymal Stem Cells and Human Umbilical Vein Endothelial Cells. Int J Biol Sci 2016; 12:1511-1522. [PMID: 27994515 PMCID: PMC5166492 DOI: 10.7150/ijbs.16499] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/26/2016] [Indexed: 12/13/2022] Open
Abstract
In clinic, strontium ranelate (SrR) is a useful drug to treat osteoporosis by orally taken method, but some side effect appeared in recent years. The aim of this study is to evaluate the effectiveness and safety of SrR on cells by direct application, to study the possibility of local application of this drug. Qualitative ALP staining, quantitative ALP activity assay, alizarin red staining, realtime PCR and westernblot assay were used to evaluate the osteogenesis ability of SrR under normal or osteogenic induction environment of ovariectomy bone marrow mesenchymal stem cells (OVX-BMSCs). The angiogenesis ability of SrR was studied by immunofluorescence staining of CD31 and vWF of OVX-BMSCs under angiogenesis induction environment, transwell, tubeformation and realtime PCR assay of HUVECs. Signaling pathway of PI3K/AKT/mTOR was also studied. The result demonstrated that SrR could enhance proliferation and osteogenic differentiation of OVX-BMSCs. The osteogenesis effect of SrR has been proved by the better performed of ALP activity, alizarin red staining and the remarkable up-regulation of ALP, Col-I, Runx2, OCN, BMP-2, BSP, OPG of the OVX-BMSCs, and reduction of RANKL. In addition, SrR promotes angiogenesis differentiation of both OVX-BMSCs and HUVECs. Higher intensity of immunostaining of CD31 and vWF, better result of transwell and tubeformation assay could be observed in SrR treated group, and increasing mRNA levels of VEGF and Ang-1 in the OVX-BMSCs, VEGF in HUVECs were learnt. Signaling pathway assay showed that PI3K/AKT/mTOR signaling pathway was involved in this SrR triggered angiogenesis procedure. The thrombosis marker ET-1, PAI-1 and t-PA were up-regulated, but no significant differences for low concentration (<0.5mM). The concentration between 0.25-0.5mM may be more appropriate for local application, and locally application of SrR could be considered as a promising way for bone regeneration.
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Affiliation(s)
- Xiaojing Guo
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Silong Wei
- Department of Oral and Craniomaxillofacial Sciences, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Mengmeng Lu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Zhengwei Shao
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Jiayu Lu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Lunguo Xia
- Department of Oral and Craniomaxillofacial Sciences, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Kaili Lin
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Derong Zou
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
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Abstract
Several systemic diseases (and relative medications) have been reported to impair or in some cases complicate dental implant surgery. In broader terms, when dealing with patients suffering from systemic diseases, the monitoring of the medical condition and of the related post-operative complications is of great importance in order to avoid risks which could jeopardise the health of the patient. In this review, the available evidence on implant survival/success, as well as relevant surgical recommendations in patients affected by systemic diseases, are evaluated and when possible, practical suggestions for the clinician are provided.
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Li Y, He S, Hua Y, Hu J. Effect of osteoporosis on fixation of osseointegrated implants in rats. J Biomed Mater Res B Appl Biomater 2016; 105:2426-2432. [PMID: 27618689 DOI: 10.1002/jbm.b.33787] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/29/2016] [Accepted: 08/28/2016] [Indexed: 02/05/2023]
Abstract
The effect of osteoporosis on implant osseointegration has been widely investigated, whereas osteoporosis may also newly occur in patient with previously osseointegrated implant. This study was designed to investigate the effect of osteoporosis on implant fixation in rats after successful osseointegration had been obtained. Seventy female Sprague-Dawley rats were included, and each animal received two titanium implants in the distal metaphysis of femur bilaterally. Eight weeks later, ten rats were sacrificed to confirm the establishment of implant osseointegration. All left rats were randomly subjected to bilateral ovariectomy (OVX) or sham operation. Three, six, and twelve weeks later, implant osseointegration, peri-implant bone tissue, and biomechanical properties of implant were analyzed. Right femurs with implants were used for micro-CT and histological analysis, and left femurs with implants were used for biomechanical test. Micro-CT, histology, and biomechanical test confirmed the destructive effect of OVX on previously osseointegrated implant in rats; when compared to sham-operated rats, peri-implant bone volume, trabecular architecture, bone-to-implant contact ratio, as well as biomechanical parameters decreased progressively within 12 weeks. Results also indicated that the effect of OVX on undisturbed bone (proximal tibiae) was much stronger than that on peri-implant bone. Osteoporosis produced a progressive negative effect on previously osseointegrated implant in distal femora of rats during 12 weeks. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2426-2432, 2017.
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Affiliation(s)
- Yunfeng Li
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Sheng He
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yunwei Hua
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jing Hu
- Department of Oral & Maxillofacial surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
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Li Y, He D, Liu B, Hu J. SEMA3A suspended in matrigel improves titanium implant fixation in ovariectomized rats. J Biomed Mater Res B Appl Biomater 2016; 105:2060-2065. [PMID: 27403923 DOI: 10.1002/jbm.b.33730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/16/2016] [Accepted: 05/24/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Yunfeng Li
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Dongming He
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Biao Liu
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
| | - Jing Hu
- Department of Oral and Maxillofacial surgery; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University; Chengdu 610041 China
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Neves J, de Araújo Nobre M, Oliveira P, Martins Dos Santos J, Malo P. Risk Factors for Implant Failure and Peri-Implant Pathology in Systemic Compromised Patients. J Prosthodont 2016; 27:409-415. [PMID: 27348845 DOI: 10.1111/jopr.12508] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To identify the possible risk factors for implant failure and peri-implant pathology in a population of systemically compromised patients. MATERIALS AND METHODS This retrospective clinical study included a total of 721 systemically compromised patients (422 women, 299 men), with an average age of 51 years (range: 20 to 87) rehabilitated with dental implants. The average follow-up time was 7.3 years. The patients' demographic variables (age and gender) and clinical variables (implant location, type of implant surface, and systemic conditions) were recorded. Outcome measures were implant failure and peri-implant pathology. Binary logistic regression models were performed to investigate the effect of the patients' demographic and clinical characteristics on the dependent variables implant failure and peri-implant pathology. A linear regression model was performed to correlate the patient's characteristics with the number of failed implants. Odds ratios (OR) with 95% confidence intervals and corresponding levels of significance were estimated for each variable. RESULTS Multivariate logistic regression disclosed increased age (patients over 40 years of age) as a risk factor for implant failure (OR = 2.63) and hepatitis as a risk factor for peri-implant pathology (OR = 3.74). Multivariate linear regression disclosed rheumatologic and cardiac diseases to be correlated with a higher number of failed implants. CONCLUSIONS Within the limitations of this study, the results suggest no absolute contraindications for implant rehabilitation in a population of systemically compromised patients. Nevertheless, this study suggests that increasing age, rheumatological condition, cardiovascular condition, and hepatitis should be considered when performing implant-supported rehabilitations due to their negative influence on the outcome.
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Affiliation(s)
- Joana Neves
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal.,Oral Hygiene Department, Maló Clinic, Lisbon, Portugal
| | | | - Pedro Oliveira
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal
| | | | - Paulo Malo
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
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Mardas N, Busetti J, de Figueiredo JAP, Mezzomo LA, Scarparo RK, Donos N. Guided bone regeneration in osteoporotic conditions following treatment with zoledronic acid. Clin Oral Implants Res 2016; 28:362-371. [PMID: 26920844 DOI: 10.1111/clr.12810] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate new bone formation in calvarial critical size defects (CSD) under dense polytetrafluoroethylene (d-PTFE), microporous membranes for guided bone regeneration (GBR) in healthy, osteoporotic and osteoporotic treated with zoledronic acid (ZA) rats. METHODS Forty-eight, female, 6-month old Wistar rats were included in the study. Osteoporosis was induced by ovariectomy (OVX) and calcium-deficient diet in 32 rats. Sixteen OVX rats were treated with a single dose of Zolendronic Acid (ZA) (OZ), while 16 OVX rats received no treatment (O). The remaining 16 rats were sham-operated and used as healthy controls (C). At 6 weeks following osteoporosis induction, two 5 mm CSD were created in the parietal bones and one of them was treated with a double d-PTFE membrane. The healing periods were 30 and 60 days. New bone formation (NB) was assessed by qualitative and quantitative histological analysis. RESULTS After 30 days of healing, NB (mean% (95% CI)) was 78.9% (21), 93.1% (9.3) and 84.2% (26.9) in the membrane treated defects and 18.8% (24.1), 27.1% (7.9) and 31% (38.8) in the untreated defects of group O, OZ and C, respectively. After 60 days of healing, NB was 78.3% (14.4), 95.8% (9) and 90.1% (26.1) in the membrane treated defects and 10.8% (17.4), 51.6% (39.4) and 15.7% (12.1) in the untreated defects of group O, OZ and C, respectively. Hierarchical analysis of variance showed that treatment with ZA (P = 0.001) and the use of membrane (P = 0.000) significantly increased new bone formation while presence of osteoporosis may have reduced new bone formation (P = 0.028). CONCLUSION d-PTFE membranes for GBR promote bone healing in osteoporotic and healthy rats. Treatment with ZA may improve new bone formation in osteoporotic rats.
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Affiliation(s)
- Nikos Mardas
- Centre for Adult Oral Health, Institute of Dentistry, Bart's & The London School of Medicine & Dentistry, Queen Mary University, London, UK
| | - Juliano Busetti
- Dental School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luis André Mezzomo
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Nikolaos Donos
- Clinical Oral Research Centre, Institute of Dentistry, Bart's & The London School of Medicine & Dentistry, Queen Mary University, London, UK
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Merheb J, Temmerman A, Rasmusson L, Kübler A, Thor A, Quirynen M. Influence of Skeletal and Local Bone Density on Dental Implant Stability in Patients with Osteoporosis. Clin Implant Dent Relat Res 2016; 18:253-60. [DOI: 10.1111/cid.12290] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joe Merheb
- Unit of Periodontology, Department of Oral Health Sciences; University of Leuven; Leuven Belgium
| | - Andy Temmerman
- Unit of Periodontology, Department of Oral Health Sciences; University of Leuven; Leuven Belgium
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery; The Sahlgrenska Academy, University of Gothenburg; Gothenburg Sweden
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery; University of Wuerzburg; Wuerzburg Germany
| | - Andreas Thor
- Department of Oral and Maxillofacial Surgery; Institute of Surgical Sciences, Uppsala University; Uppsala Sweden
| | - Marc Quirynen
- Unit of Periodontology, Department of Oral Health Sciences; University of Leuven; Leuven Belgium
- Research Group Periodontology & Oral microbiology, Department of Oral Health Sciences, University of Leuven; Leuven Belgium
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Liu C, Zhang Y, Wang L, Zhang X, Chen Q, Wu B. A Strontium-Modified Titanium Surface Produced by a New Method and Its Biocompatibility In Vitro. PLoS One 2015; 10:e0140669. [PMID: 26529234 PMCID: PMC4631518 DOI: 10.1371/journal.pone.0140669] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/28/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To present a new and effective method of producing titanium surfaces modified with strontium and to investigate the surface characteristics and in vitro biocompatibility of titanium (Ti) surfaces modified with strontium (Sr) for bone implant applications. MATERIALS AND METHODS Sr-modified Ti surfaces were produced by sequential treatments with NaOH, strontium acetate, heat and water. The surface characteristics and the concentration of the Sr ions released from the samples were examined. Cell adhesion, morphology and growth were investigated using osteoblasts isolated from the calvaria of neonatal Sprague-Dawley rats. Expression of osteogenesis-related genes and proteins was examined to assess the effect of the Sr-modified Ti surfaces on osteoblasts. RESULTS The modified titanium surface had a mesh structure with significantly greater porosity, and approximately5.37±0.35at.% of Sr was incorporated into the surface. The hydrophilicity was enhanced by the incorporation of Sr ions and water treatment. The average amounts of Sr released from the Sr-modified plates subjected to water treatment were slight higher than the plates without water treatment. Sr promoted cellular adhesion, spreading and growth compared with untreated Ti surfaces. The Sr-modified Ti plates also promoted expression of osteogenesis-related genes,and expression of OPN and COL-І by osteoblasts. Ti plates heat treated at 700°C showed increased bioactivity in comparison with those treated at 600°C. Water treatment upregulated the expression of osteogenesis-related genes. CONCLUSIONS These results show that Sr-modification of Ti surfaces may improve bioactivity in vitro. Water treatment has enhanced the response of osteoblasts. The Sr-modified Ti heat-treated at 700°C exhibited better bioactivity compared with that heated at 600°C.
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Affiliation(s)
- Chundong Liu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China
- College of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Yanli Zhang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China
- College of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Lichao Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China
- College of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Xinhua Zhang
- Department of Stomatology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P. R. China
| | - Qiuyue Chen
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China
- College of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Buling Wu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China
- College of Stomatology, Southern Medical University, Guangzhou, P. R. China
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Reich KM, Huber CD, Heimel P, Ulm C, Redl H, Tangl S. A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex. Clin Oral Implants Res 2015; 27:583-90. [PMID: 26037688 DOI: 10.1111/clr.12627] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Sinus augmentation is a standard procedure to increase vertical bone supply for dental implants in the atrophic posterior maxilla. Despite the longstanding application of this method, information about some basic factors that could potentially influence bone regeneration after sinus augmentation is rare. The objective of this study was therefore to quantify the impact of the maxillary region (premolar/molar) and patients' age and sex on bone regeneration after sinus grafting. MATERIAL AND METHODS Sinus augmentation procedures were performed in 107 patients (66 female: 52.8 ± 11.0 years, 41 male: 50.6 ± 11.3 years). After 6 ± 1 months, 201 sinus biopsies were harvested and histomorphometrically analysed. Height (oldHt) and bone volume fraction of pristine bone (oldBV/TV), as well as the amount of new bone (newBV/TV) and bone-to-bone substitute contact (BBSC) in the augmentation area, were assessed. RESULTS In women, newBV/TV in the augmented sinus decreased significantly by 0.22 ± 0.08% per year. In men, no similar trend was observed. There were strong influences of the maxillary region and the dimensions of the host bone. In the premolar region, newBV/TV was 23.1 ± 7.9% and 25.1 ± 10.1%; in the molar region, newBV/TV averaged 20.4 ± 9.4% and 17.8 ± 8.8% for women and men, respectively. The greater the thickness of the wall of the sinus floor (mainly in the former premolar region), the greater was the amount of new bone tissue formed in the spaces in-between bone substitute particles. CONCLUSIONS These empirical results derived from a large human sample, link factors that influence the quality of biomaterial integration to the known clinical risks for the success of dental implants.
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Affiliation(s)
- Karoline Maria Reich
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Christian Domitian Huber
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Patrick Heimel
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria
| | - Christian Ulm
- Department of Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Heinz Redl
- Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in the Trauma Research Center of AUVA, Vienna, Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Donos N, Dereka X, Mardas N. Experimental models for guided bone regeneration in healthy and medically compromised conditions. Periodontol 2000 2015; 68:99-121. [DOI: 10.1111/prd.12077] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 02/06/2023]
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Calciolari E, Donos N, Park JC, Petrie A, Mardas N. A systematic review on the correlation between skeletal and jawbone mineral density in osteoporotic subjects. Clin Oral Implants Res 2015; 27:433-42. [DOI: 10.1111/clr.12597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Elena Calciolari
- Periodontology Unit; UCL Eastman Dental Institute; London UK
- Section of Periodontology, Implantology and Gnathology; Centre of Dentistry; University of Parma; Parma Italy
| | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Jung-Chul Park
- Department of Periodontology; College of Dentistry; Dankook University; Cheonan South Korea
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Periodontology Unit; UCL Eastman Dental Institute; London UK
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Osteoporosis and bisphosphonate-related osteonecrosis in a dental school implant patient population. IMPLANT DENT 2015; 24:328-32. [PMID: 25764480 DOI: 10.1097/id.0000000000000234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Studies have demonstrated an inconsistent association between implant failure and bone mineral density. The prevalence of osteoporosis in US adults has been reported to range from 5% to 10% in women and from 2% to 4% in men. The prevalence of bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) has been reported to range from 0% to 4.3% of patients taking oral BPs. The purpose of this study was to calculate the risk of dental implant loss and the incidence of BRONJ in patients with osteoporosis at the University of Kentucky College of Dentistry (UKCD). MATERIALS AND METHODS This study analyzed data collected from patients who had implants placed between 2000 and 2004 at UKCD. Data were gathered from patient interviews regarding implant survival and patient-satisfaction parameters, and interviews were conducted either chairside at a scheduled maintenance appointment or by telephone interview. RESULTS Among 203 patients who received 515 implants, the prevalence of osteoporosis was 23.3% for women and 1.2% for men. None of the 20 patients who reported a history of oral BP use exhibited BRONJ, and there were no implant failures in patients with a history of osteoporosis. CONCLUSIONS In this study, osteoporosis conferred no risk of implant failure, and oral BP therapy was not associated with BRONJ.
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Du Z, Lee RSB, Hamlet S, Doan N, Ivanovski S, Xiao Y. Evaluation of the first maxillary molar post-extraction socket as a model for dental implant osseointegration research. Clin Oral Implants Res 2015; 27:1469-1478. [DOI: 10.1111/clr.12571] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Zhibin Du
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Brisbane Qld Australia
| | - Ryan S. B. Lee
- School of Dentistry and Oral Health; Griffith University; Southport Qld Australia
| | - Stephen Hamlet
- School of Dentistry and Oral Health; Griffith University; Southport Qld Australia
| | - Nghiem Doan
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Brisbane Qld Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health; Griffith University; Southport Qld Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Kelvin Grove Brisbane Qld Australia
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Abstract
Dental implants are an important treatment option for patients interested in replacing lost or missing teeth. Although a robust body of literature has reviewed risk factors for tooth loss, the evidence for risk factors associated with dental implants is less well defined. This article focuses on key systemic risk factors relating to dental implant failure, as well as on perimucositis and peri-implantitis.
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Affiliation(s)
- Dolphus R Dawson
- Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536, USA.
| | - Samuel Jasper
- Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536, USA
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Liang YQ, Qi MC, Xu J, Xu J, Liu HW, Dong W, Li JY, Hu M. Low-magnitude high-frequency loading, by whole-body vibration, accelerates early implant osseointegration in ovariectomized rats. Mol Med Rep 2014; 10:2835-42. [PMID: 25270245 PMCID: PMC4227418 DOI: 10.3892/mmr.2014.2597] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 07/04/2014] [Indexed: 01/12/2023] Open
Abstract
Osteoporosis deteriorates jaw bone quality and may compromise early implant osseointegration and early implant loading. The influence of low-magnitude, high-frequency (LMHF) vibration on peri-implant bone healing and implant integration in osteoporotic bones remains poorly understood. LMHF loading via whole-body vibration (WBV) for 8 weeks has previously been demonstrated to significantly enhance bone-to-implant contact, peri-implant bone fraction and implant mechanical properties in osteoporotic rats. In the present study, LMHF loading by WBV was performed in osteoporotic rats, with a loading duration of 4 weeks during the early stages of bone healing. The results indicated that 4-week LMHF loading by WBV partly reversed the negative effects of osteoporosis and accelerated early peri-implant osseointegration in ovariectomized rats.
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Affiliation(s)
- Yong-Qiang Liang
- Department of Stomatology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Meng-Chun Qi
- College of Stomatology, Hebei United University, Tangshan, Hebei 063000, P.R. China
| | - Jiang Xu
- Department of Stomatology, Tongchuan City People's Hospital, Tongchuan, Shaanxi 727100, P.R. China
| | - Juan Xu
- Department of Stomatology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Hua-Wei Liu
- Department of Stomatology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Wei Dong
- College of Stomatology, Hebei United University, Tangshan, Hebei 063000, P.R. China
| | - Jin-Yuan Li
- College of Stomatology, Hebei United University, Tangshan, Hebei 063000, P.R. China
| | - Min Hu
- Department of Stomatology, Chinese PLA General Hospital, Beijing 100853, P.R. China
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Merheb J, Temmerman A, Coucke W, Rasmusson L, Kübler A, Thor A, Quirynen M. Relation between Spongy Bone Density in the Maxilla and Skeletal Bone Density. Clin Implant Dent Relat Res 2014; 17:1180-7. [PMID: 24909074 DOI: 10.1111/cid.12228] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Osteoporosis is a disease affecting more than 300 million people worldwide and is responsible for numerous medical complications. This study aimed to investigate the relation between skeletal and maxillary bone density. MATERIALS AND METHODS Seventy-three patients were recruited and divided between group A (osteoporosis), group B (healthy, control), and group C (osteopenia) on the basis of a dual-energy x-ray absorptiomery (DXA) scan. These patients also received a CT scan on which bone density measurements were performed at five sites: maxilla midline, retromolar tuberosities, incisor, premolars, and molar regions. RESULTS The bone density was lower in osteoporotic patients compared with the control patients. The bone mineral density (BMD) of the tuberosities showed the strongest correlations with the BMD of the hip and the spine (respectively, r = 0.50 and r = 0.61). The midline region showed moderate correlations with the hip (r = 0.47) and the spine (r = 0.46). For potential implant sites, the correlations with the BMD of the hip and spine were, however, small to insignificant. Based on measurements of bone density of the maxilla, it was possible to predict if the patient was osteoporotic or not with a sensitivity of 65% and a specificity of 83%. CONCLUSIONS The maxillary bone density of subjects with osteoporosis is significantly lower than that of healthy patients. Moreover, there is a direct correlation between the density of the skeleton and the density of some sites of the maxilla. Using measurements of maxillary bone density in order to predict skeletal bone density might be a useful tool for the screening of osteoporosis.
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Affiliation(s)
- Joe Merheb
- Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Kapucijnenvoer, Belgium
| | - Andy Temmerman
- Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Kapucijnenvoer, Belgium
| | - Wim Coucke
- Scientific Institute of Public Health, Brussels, Belgium
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery, University of Würzburg, Würzburg, Germany
| | - Andreas Thor
- Department of Oral and Maxillofacial Surgery, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Marc Quirynen
- Unit of Periodontology, Department of Oral Health Sciences, University of Leuven, Kapucijnenvoer, Belgium
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Haïat G, Wang HL, Brunski J. Effects of biomechanical properties of the bone-implant interface on dental implant stability: from in silico approaches to the patient's mouth. Annu Rev Biomed Eng 2014; 16:187-213. [PMID: 24905878 DOI: 10.1146/annurev-bioeng-071813-104854] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Dental implants have become a routinely used technique in dentistry for replacing teeth. However, risks of failure are still experienced and remain difficult to anticipate. Multiscale phenomena occurring around the implant interface determine the implant outcome. The aim of this review is to provide an understanding of the biomechanical behavior of the interface between a dental implant and the region of bone adjacent to it (the bone-implant interface) as a function of the interface's environment. First, we describe the determinants of implant stability in relation to the different multiscale simulation approaches used to model the evolution of the bone-implant interface. Then, we review the various aspects of osseointegration in relation to implant stability. Next, we describe the different approaches used in the literature to measure implant stability in vitro and in vivo. Last, we review various factors affecting the evolution of the bone-implant interface properties.
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Affiliation(s)
- Guillaume Haïat
- CNRS, Laboratoire Modélisation et Simulation Multiéchelle, UMR CNRS 8208, 94010 Créteil, France;
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Vohra F, Al-Rifaiy MQ, Almas K, Javed F. Efficacy of systemic bisphosphonate delivery on osseointegration of implants under osteoporotic conditions: lessons from animal studies. Arch Oral Biol 2014; 59:912-20. [PMID: 24908376 DOI: 10.1016/j.archoralbio.2014.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/09/2014] [Accepted: 05/09/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND The aim was to systematically review the role of systemic bisphosphonate (BP) delivery on osseointegration of implants under osteoporotic conditions. METHODS The addressed focused question was "Does systemic BP delivery enhance osseointegration of implants under osteoporotic conditions?" PubMed/MEDLINE and Google-Scholar databases were searched from 1994 up to and including December 2013 using different combinations of the following keywords: "bone to implant contact", "implant", "bisphosphonate", "osseointegration" and "osteoporosis". Review articles, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were excluded. RESULTS Fifteen animal studies fulfilled our eligibility criteria. Osteoporotic conditions were induced via bilateral ovariectomy (OVX). BPs used in the studies were ibandronate, zoledronic acid and alendronate. Results from 12 studies showed that systemic BP delivery significantly increased bone volume and bone-to-implant contact under osteoporotic conditions. Two studies reported no significant difference in osseointegration among OVX animals with and without systemic BP delivery. In one study, systemic BP delivery negatively influenced implant osseointegration. Rough-surfaced and polished implants were used in 11 and one study respectively. In 3 studies implant surface characteristics remained unclear. CONCLUSION Within the limits of the present study, it is concluded that systemic BP delivery enhances implant osseointegration in animals with induced osteoporotic conditions. However, in a clinical scenario, the potential risk of BP related ONJ in osteoporotic patients undergoing dental implant therapy cannot be disregarded.
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Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia.
| | - Mohammad Qasim Al-Rifaiy
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia
| | - Khalid Almas
- Division of Periodontology, School of Dental Medicine, University of Connecticut, Farmington, CT, USA
| | - Fawad Javed
- Eng. A.B. Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia.
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