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Wong I, Zhang Z, Dang X, Yu X, Lin X, Li Y, Deng F, Xu R. Single missing molar with wide mesiodistal length restored using a single or double implant-supported crown: A self-controlled case report and 3D finite element analysis. J Prosthodont Res 2024:JPR_D_23_00278. [PMID: 38644231 DOI: 10.2186/jpr.jpr_d_23_00278] [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: 04/23/2024]
Abstract
PURPOSE Based on a self-controlled case, this study evaluated the finite element analysis (FEA) results of a single missing molar with wide mesiodistal length (MDL) restored by a single or double implant-supported crown. METHODS A case of a missing bilateral mandibular first molar with wide MDL was restored using a single or double implant-supported crown. The implant survival and peri-implant bone were compared. FEA was conducted in coordination with the case using eight models with different MDLs (12, 13, 14, and 15 mm). Von Mises stress was calculated in the FEA to evaluate the biomechanical responses of the implants under increasing vertical and lateral loading, including the stress values of the implant, abutment, screw, crown, and cortical bone. RESULTS The restorations on the left and right sides supported by double implants have been used for 6 and 12 years, respectively, and so far have shown excellent osseointegration radiographically.The von Mises stress calculated in the FEA showed that when the MDL was >14 mm, both the bone and prosthetic components bore more stress in the single implant-supported strategy. The strength was 188.62-201.37 MPa and 201.85-215.9 MPa when the MDL was 14 mm and 15 mm, respectively, which significantly exceeded the allowable yield stress (180 MPa). CONCLUSIONS Compared with the single implant-supported crown, the double implant-supported crown reduced peri-implant bone stress and produced a more appropriate stress transfer model at the implant-bone interface when the MDL of the single missing molar was ≥14 mm.
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Affiliation(s)
- Iohong Wong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaobing Dang
- Guangdong Janus Biotechnology Co., Ltd., Guangzhou, China
- Guangdong CAS Angels Biotechnology Co., Ltd., Foshan, China
| | - Xiaoran Yu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yiming Li
- Department of Stomatology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Bérczy K, Göndöcs G, Komlós G, Shkolnik T, Szabó G, Németh Z. Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study. Maxillofac Plast Reconstr Surg 2024; 46:6. [PMID: 38416263 PMCID: PMC10902233 DOI: 10.1186/s40902-024-00419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants. METHODS Patients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed. RESULTS Thirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally). CONCLUSIONS In this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.
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Affiliation(s)
- Kinga Bérczy
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary.
| | - György Göndöcs
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Komlós
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Tatiana Shkolnik
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Szabó
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Zsolt Németh
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
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3
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McColl E, Macbeth N. Missing the point. Br Dent J 2023; 235:841-843. [PMID: 38066121 DOI: 10.1038/s41415-023-6618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 12/18/2023]
Affiliation(s)
- E McColl
- Peninsula Dental School, Plymouth, United Kingdom.
| | - N Macbeth
- Lichfield, Staffordshire, United Kingdom.
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Khaohoen A, Sornsuwan T, Chaijareenont P, Poovarodom P, Rungsiyakull C, Rungsiyakull P. Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review. J Clin Med 2023; 12:6924. [PMID: 37959389 PMCID: PMC10649288 DOI: 10.3390/jcm12216924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand;
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Huo J, Hirsch JM, Gamstedt EK. Analytical Study of Stress Distributions around Screws in Flat Mandibular Bone under In-Plane Loading. Bioengineering (Basel) 2023; 10:786. [PMID: 37508813 PMCID: PMC10376365 DOI: 10.3390/bioengineering10070786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
A known complication for mechanically loaded bone implants is the instability due to screw loosening, resulting in infection and the non-union of fractures. To investigate and eventually prevent such bone degradation, it is useful to know the stress state in the bone around the screw. Considering only in-plane loadings and simplifying the mandibular bone into an orthotropic laminated plate, the analysis was reduced to a two-dimensional pin-loaded plate problem. An analytic model, based on the complex stress analysis, was introduced to the bone biomechanics field to obtain the stress distributions around the screw hole in the bone. The dimensionless normalized stresses were found to be relatively insensitive to the locations of the screw hole over the mandible. Parametric analyses were carried out regarding the friction coefficient and load direction. It was found that the load direction had a negligible influence. On the contrary, the friction coefficient had a significant effect on the stress distributions. Whether the screw was well bonded or not thus played an important role. The proposed analytic model could potentially be used to study bone failure together with stress-based failure criteria.
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Affiliation(s)
- Jinxing Huo
- Division of Applied Mechanics, Department of Materials Science and Engineering, Uppsala Univeristy, Box 35, SE-751 03 Uppsala, Sweden
| | - Jan-Michaél Hirsch
- Department of Surgical Sciences, Oral & Maxillofacial Surgery, Uppsala University, SE-751 85 Uppsala, Sweden
| | - E Kristofer Gamstedt
- Division of Applied Mechanics, Department of Materials Science and Engineering, Uppsala Univeristy, Box 35, SE-751 03 Uppsala, Sweden
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Revuru P, Mc SS. Influence of disclusion time reduction on changes in posterior implant prosthesis occlusion and its association with crestal bone loss: A clinical study. J Prosthet Dent 2023:S0022-3913(23)00281-0. [PMID: 37321940 DOI: 10.1016/j.prosdent.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 06/17/2023]
Abstract
STATEMENT OF PROBLEM A prolonged period of high magnitude occlusal contact can be associated with rapid changes of the occlusal surfaces and, in turn, may lead to overloading of an implant-supported prosthesis. Crestal bone loss may be one of the repercussions of overloading, but the influence of disclusion time (DT) reduction (DTR) is unclear. PURPOSE The purpose of this clinical study was to evaluate the role of DTR in preventing the occlusal changes and crestal bone loss at progressive time intervals of 1 week, 3 months, and 6 months in posterior implant-supported prostheses. MATERIAL AND METHODS Twelve participants with posterior implant-supported prostheses and opposing natural teeth were enrolled in the study. Occlusion time (OT) and DT were evaluated with the T-scan Novus (version 9.1). By performing immediate complete anterior guidance development (ICAGD) coronoplasty, prolonged contacts were selectively ground to achieve OT ≤0.2 seconds and DT ≤0.4 seconds in maximum intercuspal position and laterotrusion after cementation and during follow-up visits after 1 week, 3 months, and 6 months. Crestal bone levels were evaluated after cementation and at the 6-month follow-up. Repeated measures ANOVA and Bonferroni post hoc analysis were done for OT and DT. Student paired t test was done for crestal bone level evaluation (α=.05 for all tests). RESULTS A significant decrease in OT from 0.59 ±0.24 seconds to 0.21 ±0.06 seconds (P<.001) and in DT from 1.51 ±0.6 seconds to 0.37 ±0.06 seconds (P<.001) were detected in posterior implant-supported occlusion immediately after attaining ICAGD and at the 6-month follow-up period. The mean crestal bone levels at the mesial and distal sides of the implant from day 1 (0.4 ±0.13 mm, 0.36 ±0.20 mm) to 6 months (0.40 ±0.13 mm, 0.37 ±0.19 mm) showed no significant changes (P>.05). CONCLUSIONS Minimal occlusal changes in implant prosthesis and negligible crestal bone loss were observed up to 6 months by achieving DTR according to the ICAGD protocol.
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Affiliation(s)
- Pradusha Revuru
- Postgraduate student, Department of Prosthodontics and Implantology, Vishnu Dental College, NTR University of Health Sciences, Bhimavaram, Andhra Pradesh, India.
| | - Suresh Sajjan Mc
- Professor and Head, Department of Prosthodontics and Implantology, Vishnu Dental College, NTR University of Health Sciences, Bhimavaram, Andhra Pradesh, India
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8
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Son M, Song Y, Yu Y, Kim SY, Huh JB, Bae EB, Cho WT, Na HS, Chung J. The oral microbiome of implant-abutment screw holes compared with the peri-implant sulcus and natural supragingival plaque in healthy individuals. J Periodontal Implant Sci 2023; 53:53.e20. [PMID: 37336525 DOI: 10.5051/jpis.2300100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/14/2023] [Accepted: 04/27/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE An implant-supported prosthesis consists of an implant fixture, an abutment, an internal screw that connects the abutment to the implant fixture, and the upper prosthesis. Numerous studies have investigated the microorganisms present on the implant surface, surrounding tissues, and the subgingival microflora associated with peri-implantitis. However, there is limited information regarding the microbiome within the internal screw space. In this study, microbial samples were collected from the supragingival surfaces of natural teeth, the peri-implant sulcus, and the implant-abutment screw hole, in order to characterize the microbiome of the internal screw space in healthy subjects. METHODS Samples were obtained from the supragingival region of natural teeth, the peri-implant sulcus, and the implant screw hole in 20 healthy subjects. DNA was extracted, and the V3-V4 region of the 16S ribosomal RNA was sequenced for microbiome analysis. Alpha diversity, beta diversity, linear discriminant analysis effect size (LEfSe), and network analysis were employed to compare the characteristics of the microbiomes. RESULTS We observed significant differences in beta diversity among the samples. Upon analyzing the significant taxa using LEfSe, the microbial composition of the implant-abutment screw hole's microbiome was found to be similar to that of the other sampling sites' microbiomes. Moreover, the microbiome network analysis revealed a unique network complexity in samples obtained from the implant screw hole compared to those from the other sampling sites. CONCLUSIONS The bacterial composition of the biofilm collected from the implant-abutment screw hole exhibited significant differences compared to the supra-structure of the implant. Therefore, long-term monitoring and management of not only the peri-implant tissue but also the implant screw are necessary.
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Affiliation(s)
- MinKee Son
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Yuri Song
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Korea
- Oral Genomics Research Center, Pusan National University, Yangsan, Korea
| | - Yeuni Yu
- Interdisciplinary Program of Genomic Science, Pusan National University, Yangsan, Korea
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Busan, Korea
| | - Si Yeong Kim
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Korea
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jung-Bo Huh
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea
- Department of Prosthodontics, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Eun-Bin Bae
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea
- Department of Prosthodontics, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Won-Tak Cho
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea
- Department of Prosthodontics, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Hee Sam Na
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Korea
- Oral Genomics Research Center, Pusan National University, Yangsan, Korea
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Jin Chung
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan, Korea
- Oral Genomics Research Center, Pusan National University, Yangsan, Korea
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan, Korea.
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Boldeanu LC, Popa-Wagner A, Boariu M, Stratul SI, Rusu D, Vela O, Roman A, Surlin P, Kardaras G, Chinnici S, Vaduva A. Influence of Section Thickness on the Accuracy and Specificity of Histometric Parameters Using Confocal Laser Scanning Microscopy in a Canine Model of Experimental Peri-Implantitis-A Proof of Concept. J Clin Med 2023; 12:jcm12072462. [PMID: 37048546 PMCID: PMC10095515 DOI: 10.3390/jcm12072462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES Tissue breakdown was assessed by confocal laser scanning microscopy (CLSM) using autofluorescence around implants with ligatures, on a dog hemimandible. Influence of section thickness on the accuracy of histometrical observations was also evaluated, in comparison with thin sections in light microscopy. MATERIAL AND METHODS Three months after tooth extraction, implants were placed. Two months after abutment placement, ligatures were placed with no plaque control. 11 months post-implantation, the animal was sacrificed. Undecalcified thin (30 µm) sections were cut, stained and evaluated by light microscopy to be used as a reference. Additional sections were performed, so that another pair of unstained thick sections resulted (250-300 µm). Tissue loss was assessed using histomorphometric parameters under CLSM and was compared to the light microscopy reference ones. RESULTS Morphometry confirmed tissue loss more pronounced on the "thick" and quick sections, when compared to the time-consuming and technique-sensitive "thin" ones. CONCLUSIONS Within the limits of the present study, the adequacy of histometrical observations under CLSM reveal commensurable information about soft-tissue-bone-implant details, when compared to traditional light microscopy histological protocols. The CLSM investigation may seem demanding, yet the richness of data acquired may justify this approach, provided seatbacks caused by improper manipulation of "thick" sections are avoided.
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Affiliation(s)
- Lucia-Camelia Boldeanu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Aurel Popa-Wagner
- Department of Neurology, Chair of Vascular Neurology and Dementia, University Hospital Essen, 45147 Essen, Germany
- Center for Experimental and Clinical Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Octavia Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Roman
- Applicative Periodontal Regeneration Research Unit, Department of Peridontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Georgios Kardaras
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Salvatore Chinnici
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Adrian Vaduva
- Department of Pathology, Faculty of Medicine, ANAPATMOL Research Center, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
- County Emergency Hospital, L. Rebreanu Street, nr. 156, 300723 Timisoara, Romania
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Omi M, Mishina Y. Roles of osteoclasts in alveolar bone remodeling. Genesis 2022; 60:e23490. [PMID: 35757898 PMCID: PMC9786271 DOI: 10.1002/dvg.23490] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/25/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022]
Abstract
Osteoclasts are large multinucleated cells from hematopoietic origin and are responsible for bone resorption. A balance between osteoclastic bone resorption and osteoblastic bone formation is critical to maintain bone homeostasis. The alveolar bone, also called the alveolar process, is the part of the jawbone that holds the teeth and supports oral functions. It differs from other skeletal bones in several aspects: its embryonic cellular origin, the form of ossification, and the presence of teeth and periodontal tissues; hence, understanding the unique characteristic of the alveolar bone remodeling is important to maintain oral homeostasis. Excessive osteoclastic bone resorption is one of the prominent features of bone diseases in the jaw such as periodontitis. Therefore, inhibiting osteoclast formation and bone resorptive process has been the target of therapeutic intervention. Understanding the mechanisms of osteoclastic bone resorption is critical for the effective treatment of bone diseases in the jaw. In this review, we discuss basic principles of alveolar bone remodeling with a specific focus on the osteoclastic bone resorptive process and its unique functions in the alveolar bone. Lastly, we provide perspectives on osteoclast-targeted therapies and regenerative approaches associated with bone diseases in the jaw.
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Affiliation(s)
- Maiko Omi
- Department of Biologic and Materials Sciences & ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Yuji Mishina
- Department of Biologic and Materials Sciences & ProsthodonticsUniversity of Michigan School of DentistryAnn ArborMichiganUSA
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Di Fiore A, Montagner M, Sivolella S, Stellini E, Yilmaz B, Brunello G. Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J Clin Med 2022; 11:jcm11164812. [PMID: 36013048 PMCID: PMC9409652 DOI: 10.3390/jcm11164812] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | | | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Department of Oral Surgery, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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Domiciliary Use of Chlorhexidine vs. Postbiotic Gels in Patients with Peri-Implant Mucositis: A Split-Mouth Randomized Clinical Trial. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062800] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Peri-implant mucositis is a pathological condition characterized by an inflammatory process in the peri-implant soft tissues. Progression to peri-implantitis takes place in case of peri-implant bone resorption. Recently, an aid for non-surgical treatment by mechanical debridement (SRP) has been identified in probiotics. As there are no recent studies regarding their use for peri-implant mucositis, the aim of this study was to test a new postbiotic gel for this clinical condition. A split-mouth randomized clinical trial was performed. Twenty patients undergoing SRP were randomly assigned to two treatments based on the following oral gels: chlorhexidine-based Curasept Periodontal Gel (Group 1) and postbiotic-based Biorepair Parodontgel Intensive (Group 2). At baseline (T0) and after three (T1) and six (T2) months, the following peri-implant mucositis indexes were recorded: Probing Pocket Depth (PPD), Plaque Index (PI), Gingival Bleeding Index (GBI), Bleeding Score (BS), Marginal Mucosal Condition (MMC). A significant decrease is reported for both postbiotic and chlorhexidine for all peri-implant mucositis indices studied. Quite the opposite, no significant variation was present in intergroup comparisons. Greater improvements for BS, GBI and MMC inflammatory indices of the postbiotic gel compared to chlorhexidine suggest the importance of further studies to investigate the relevance of the product alone.
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Occlusal change in posterior implant-supported single crowns and its association with peri-implant bone level: a 5-year prospective study. Clin Oral Investig 2022; 26:4217-4227. [PMID: 35129663 DOI: 10.1007/s00784-022-04394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aims to analyze the 5-year occlusal change in posterior implant-supported single crowns and the association between the relative occlusal force (ROF) and peri-implant bone level. MATERIALS AND METHODS Partially edentulous patients who had received implant-supported single crowns in the posterior region were included. Occlusal examinations with a computerized occlusion analysis system were conducted at 0.5, 3, 6, 12, 24, 36, 48, and 60 months after delivery of the implant-supported single crown. The ROFs of implant-supported single crowns, mesial adjacent teeth, and control natural teeth were recorded. Intraoral periapical radiographs were taken at each follow-up time to evaluate marginal bone level (MBL). Ordinary least square regression was used to analyze the association between ROF and MBL. RESULTS Thirty-seven posterior implant-supported single crowns in 33 participants (23.9 to 70.0 years) were followed up for 0.5 to 60 months [(42.4 ± 26.0) months]. The ROF of implant-supported single crowns increased from 2 weeks to 3 months (P < 0.01) and increased continuously between all two sequential time points from 6 to 36 months, with significant differences (P < 0.05). Then ROFs of implant-supported single crowns were significantly higher than those of control teeth at 48 and 60 months (P < 0.05). Regression analysis showed that ROF was significantly associated with MBL with a coefficient of 0.008 (P < 0.05). CONCLUSION The ROFs of posterior implant-supported single crown have significant change during 5 years' follow-up. The association between ROF and MBL has limited clinical significance. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-ROC-17012240. CLINICAL RELEVANCE The occlusion of implant-supported single crowns should be carefully monitored during follow-up examinations, and occlusal adjustment should be considered to prevent overloading.
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14
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Das D, Shenoy N. Peri-Implant Diseases. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1736452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractOsseointegrated dental implants have become an increasingly popular modality of treatment for the replacement of absent or lost teeth because of its high rates of long-term survival when used to support various types of dental prostheses. However, complications and implant failure can still occur and are considered by many clinicians as a major obstacle for implant treatment. Biological complications mainly refer to inflammatory conditions of the soft tissues and bone surrounding implants and their restorative components, which are induced by the accumulation of bacterial biofilm. Two clinical varieties may be distinguished: peri-implant mucositis and peri-implantitis. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit, whereas peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant. Diagnosing and managing these biological complications is of utmost importance for the implant surgeon and dental practitioner. This review encompasses the etiology, diagnostic aspects, prevention, and management of biological complications.
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Affiliation(s)
- Dipanjan Das
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
| | - Nina Shenoy
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, Nitte (deemed to be) University, Derlakatte, Mangalore, India
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Cantó-Navés O, Medina-Galvez R, Marimon X, Ferrer M, Figueras-Álvarez Ó, Cabratosa-Termes J. A 3D Finite Element Analysis Model of Single Implant-Supported Prosthesis under Dynamic Impact Loading for Evaluation of Stress in the Crown, Abutment and Cortical Bone Using Different Rehabilitation Materials. MATERIALS (BASEL, SWITZERLAND) 2021; 14:3519. [PMID: 34202625 PMCID: PMC8269525 DOI: 10.3390/ma14133519] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/13/2021] [Accepted: 06/18/2021] [Indexed: 12/19/2022]
Abstract
In the literature, many researchers investigated static loading effects on an implant. However, dynamic loading under impact loading has not been investigated formally using numerical methods. This study aims to evaluate, with 3D finite element analysis (3D FEA), the stress transferred (maximum peak and variation in time) from a dynamic impact force applied to a single implant-supported prosthesis made from different materials. A 3D implant-supported prosthesis model was created on a digital model of a mandible section using CAD and reverse engineering. By setting different mechanical properties, six implant-supported prostheses made from different materials were simulated: metal (MET), metal-ceramic (MCER), metal-composite (MCOM), carbon fiber-composite (FCOM), PEEK-composite (PKCOM), and carbon fiber-ceramic (FCCER). Three-dimensional FEA was conducted to simulate the collision of 8.62 g implant-supported prosthesis models with a rigid plate at a speed of 1 m/s after a displacement of 0.01 mm. The stress peak transferred to the crown, titanium abutment, and cortical bone, and the stress variation in time, were assessed.
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Affiliation(s)
- Oriol Cantó-Navés
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain; (O.C.-N.); (R.M.-G.); (Ó.F.-Á.); (J.C.-T.)
| | - Raul Medina-Galvez
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain; (O.C.-N.); (R.M.-G.); (Ó.F.-Á.); (J.C.-T.)
| | - Xavier Marimon
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya (UIC), 08190 Barcelona, Spain
- Automatic Control Department, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), 08034 Barcelona, Spain
| | - Miquel Ferrer
- Department of Strength of Materials and Structural Engineering, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), 08034 Barcelona, Spain;
| | - Óscar Figueras-Álvarez
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain; (O.C.-N.); (R.M.-G.); (Ó.F.-Á.); (J.C.-T.)
| | - Josep Cabratosa-Termes
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), 08017 Barcelona, Spain; (O.C.-N.); (R.M.-G.); (Ó.F.-Á.); (J.C.-T.)
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16
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Okawara H, Arai Y, Matsuno H, Marcián P, Borák L, Aoki K, Wakabayashi N. Effect of load-induced local mechanical strain on peri-implant bone cell activity related to bone resorption and formation in mice: An analysis of histology and strain distributions. J Mech Behav Biomed Mater 2021; 116:104370. [PMID: 33545417 DOI: 10.1016/j.jmbbm.2021.104370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to investigate the effect of load-induced local mechanical strain on bone cell activity of peri-implant bone in mice. Titanium implants were placed in the maxillae of 13-week-old male C57BL/6J mice and subjected to intermittent 0.15 N, 0.3 N, or 0.6 N loads for 30 min/day for 6 days. The animals were sacrificed 2 days after the final loading. Unloaded mice were used as controls. An animal-specific three-dimensional finite element model was constructed based on morphological data retrieved from in vivo microfocus computed tomography for each mouse to calculate the mechanical strain distribution. Strain distribution images were overlaid on corresponding histological images of the same site in the same animal. The buccal cervical region of the peri-implant bone was predetermined as the region of interest (ROI). Each ROI was divided by four strain intensity levels: 0-20 με, 20-60 με, 60-100 με, and ≥100 με, and the bone histomorphometric parameters were analyzed by the total area of each strain range for all loaded samples. The distance between the calcified front and calcein labeling as a parameter representing the mineral apposition rate was significantly greater in the areas with strain intensity ≥100 με than in the area with strain intensity <100 με, suggesting that the bone formation activity of osteoblasts was locally enhanced by a higher mechanical strain. However, the shrunken osteocytes and the empty osteocyte lacunae were significantly lower in the highest strain area, suggesting that osteoclastogenesis was more retarded in higher strain areas than in lower strain areas. The histomorphometric parameters were not affected geometrically in the unloaded animals, suggesting that the load-induced mechanical strain caused differences in the histomorphometric parameters. Our findings support the hypothesis that bone cell activity related to bone resorption and formation is local strain-dependent on implant loading.
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Affiliation(s)
- Hisami Okawara
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuki Arai
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hitomi Matsuno
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Petr Marcián
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Technická 2896/2, 616 69, Brno, Czech Republic
| | - Libor Borák
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Technická 2896/2, 616 69, Brno, Czech Republic
| | - Kazuhiro Aoki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Noriyuki Wakabayashi
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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Schmid E, Roccuzzo A, Morandini M, Ramseier CA, Sculean A, Salvi GE. Clinical and radiographic evaluation of implant-supported single-unit crowns with cantilever extension in posterior areas: A retrospective study with a follow-up of at least 10 years. Clin Implant Dent Relat Res 2021; 23:189-196. [PMID: 33448601 DOI: 10.1111/cid.12973] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Implant-supported restorations with cantilever extension may display high rates of biological and technical complications. PURPOSE To report the outcomes of single-unit crowns with cantilever extension (SCCs). MATERIALS AND METHODS Patients with SCCs were reevaluated after ≥10 years of loading. Radiographic marginal bone levels (mBLs) at baseline (ie, delivery of SCCs) and follow-up were calculated and compared between implant surfaces adjacent to and distant from the cantilever extension. Implant survival and success rates were calculated. RESULTS Twenty-one patients with 25 SCs supported by 25 implants were reevaluated after a mean of 13.6 ± 3.8 years (range: 10-19 years). No implants were lost. The mean overall mBLs changed from 0.99 mm ± 0.95 at baseline to 0.95 mm ± 0.99 at follow-up (p = 0.853). The mean pocket probing depths changed from 3.39 mm ± 0.62 at baseline to 3.34 mm ± 0.54 at follow-up (p = 0.635). Loss of retention occurred 3× in 2 patients (14.3%). At follow-up, peri-implant health was diagnosed in 10 (48%) and peri-implant mucositis in 11 (52%) patients, respectively. CONCLUSIONS Within the limitations of the present study, the use of implant-supported SCs with cantilever extension in posterior areas represents a reliable long-term treatment option with a 100% implant survival rate and minimal marginal bone level changes.
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Affiliation(s)
- Eric Schmid
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Michele Morandini
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Cruz RS, Lemos CAA, de Luna Gomes JM, Fernandes E Oliveira HF, Pellizzer EP, Verri FR. Clinical comparison between crestal and subcrestal dental implants: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:408-417. [PMID: 33358610 DOI: 10.1016/j.prosdent.2020.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM How the performance of dental implants is related to their occlusogingival placement, crestal or subcrestal, is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate marginal bone loss, implant survival rate, and peri-implant soft tissue parameters between implants placed at the crestal and subcrestal bone level. MATERIAL AND METHODS Two independent reviewers searched the PubMed/MEDLINE, Embase, and Cochrane Library databases for randomized clinical trials published up to September 2020. The meta-analysis was based on the Mantel-Haenszel and the inverse variance methods (α=.05). RESULTS The search identified 928 references, and 10 studies met the eligibility criteria. A total of 393 participants received 709 implants, 351 at crestal bone levels and 358 at subcrestal bone levels. Meta-analysis indicated that crestal bone level implants showed similar marginal bone loss to that seen with subcrestal bone level implants (mm) (P=.79), independent of the subcrestal level (P=.05) and healing protocol (P=.24). The bone level implant placement did not affect the implant survival rate (P=.76), keratinized tissue (mm) (P=.91), probing depth (mm) (P=.70), or plaque index (%) (P=.92). CONCLUSIONS The evidence suggests that both approaches of implant placement are clinically acceptable in terms of peri-implant tissue parameters and implant-supported restoration survival.
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Affiliation(s)
- Ronaldo Silva Cruz
- Researcher, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil.
| | - Cleidiel Aparecido Araújo Lemos
- Adjunct Professor, Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora, Campus Avançado Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil
| | - Jéssica Marcela de Luna Gomes
- PhD student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Hiskell Francine Fernandes E Oliveira
- PhD student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil; PhD candidate, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Titular Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo Ramos Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
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Hong SJ, Lee H, Lee YY, Kwon KR. Retention force and stress distribution analysis of the cementless double crown-type implant-supported prosthesis. J Prosthet Dent 2020; 127:626-633. [PMID: 33386135 DOI: 10.1016/j.prosdent.2020.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported fixed dental prostheses have been classified into screw-retained and cement-retained types, and each retaining type has complications. A novel retentive cementless double crown (CLD) type of the implant-supported fixed prosthesis has been developed. CLD has air pockets in the intaglio surface of the crown and does not require cement or a screw hole. However, studies on the retention force and stress distribution of the system are lacking. PURPOSE The purpose of this in vitro study was to evaluate the retention force and stress distribution in the CLD system. MATERIAL AND METHODS The specimen comprised an implant, a titanium abutment, and a zirconia crown. Retention forces of 10 specimens of the CLD type were measured at no loading and after cyclic loading for 50, 100, 200, 600, 10 000, and 1 000 000 cycles by using a universal testing machine with a custom attachment device. Forty specimens of the stress distribution test were divided into 4 groups based on the retention type (cement-retained or CLD type) and load direction (vertical or oblique). Strain gauges were attached onto the buccal and lingual sides of the implant, and microstrain values were measured. One-way analysis of variance with the post hoc Tukey honestly significant difference test was performed on the retention force data, and the t test was performed to analyze the microstrain value data (α=.05). RESULTS Retention forces after 0, 50, 100, 200, 600, 10 000, and 1 000 000 load cycles were 18.12 ±6.16 N, 20.47 ±5.78 N, 19.79 ±6.61 N, 18.46 ±5.23 N, 19.60 ±6.93 N, 21.75 ±5.03 N, and 40.91 ±9.32 N, respectively, and after 1 000 000 cycles, the retention force was significantly higher than that of other load cycles (P<.05). The mean of maximum microstrain values under the vertical load were similar in the cement-retained type (buccal side, 834.96 ±53.69 μm/m; lingual side, 490.76 ±34.12 μm/m) and the CLD type (buccal side, 814.28 ±71.20 μm/m; lingual side, 479.10 ±30.74) (P>.05), and the mean of maximum microstrain values under the oblique load was also similar in the cement-retained type (buccal side, 1991.04 ±109.89 μm/m; lingual side, -2232.41 ±189.88) and the CLD type (buccal side, 1932.47 ±152.51 μm/m; lingual side, -2097.47 ±130.69 μm/m) (P>.05). CONCLUSIONS The CLD type had clinically acceptable retention during 1 000 000 load cycles and had a similar or better stress distribution capability than the cement-retained type.
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Affiliation(s)
- Seoung-Jin Hong
- Clinical Assistant Professor, Department of Prosthodontics, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - Hyeonjong Lee
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Yeun-Yi Lee
- Graduate student, Department of Prosthodontics, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Kung-Rock Kwon
- Professor, Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Viña-Almunia J, Pellicer-Chover H, García-Mira B, Romero-Millán J, Peñarrocha-Oltra D, Peñarrocha-Diago M. Influence of occlusal loading on peri-implant inflammatory cytokines in crevicular fluid: a prospective longitudinal study. Int J Implant Dent 2020; 6:71. [PMID: 33111201 PMCID: PMC7591645 DOI: 10.1186/s40729-020-00262-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 09/09/2020] [Indexed: 11/12/2022] Open
Abstract
Objective The objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported complete fixed prostheses in both arches. Material and methods A prospective longitudinal clinical study was performed at a university clinic. Fifteen patients were selected and 11 were included. All patients had bimaxillary implant-supported complete fixed ceramo-metallic prostheses loaded at least 12 months before the beginning of the study. Allocation was established for each patient using a computerized occlusal analysis system. The test implant was the maxillary implant closest to the point of highest occlusal loading. The maxillary implant with least loading was the control implant. Occlusal adjustment was performed using a round diamond burr. This occlusal distribution was verified with the occlusal analysis system. Expression of cytokines from peri-implant crevicular fluid (TNF-α, IL-10, IL-6, IL-1β, IL-8) were recorded and analyzed in both test and control implants before (baseline: T0) and 2 (T1) and 12 months (T2) after occlusal adjustment. The Brunner-Langer non-parametric test was performed. Results At T0, the expression of IL-10 was significantly higher in the test group implants (p = 0.018). Between T0 and T1, the expression of all the cytokines decreased in the implants of both groups with statistically significant differences, except for TNF (p = 0.271). When comparing both groups at T1, there was no statistically significant difference in any of the analyzed cytokines. At T2, TNF-α suffered when compared with baseline, a statistical decrease in both study and control implants (p < 0,001). At T2, there were no statistically significant differences between groups in any of the cytokines analyzed. Conclusions Implants with higher occlusal load presented higher expression of IL-10 in peri-implant crevicular fluid. Occlusal adjustment produced a decrease in the expression of all the analyzed cytokines, both in test and control implants.
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Affiliation(s)
- Jose Viña-Almunia
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | - Hilario Pellicer-Chover
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | - Berta García-Mira
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain.
| | - Javier Romero-Millán
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | - David Peñarrocha-Oltra
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Oral Surgery and Implantology Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
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Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
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Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
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Cantó-Navés O, Marimon X, Ferrer M, Cabratosa-Termes J. Comparison between experimental digital image processing and numerical methods for stress analysis in dental implants with different restorative materials. J Mech Behav Biomed Mater 2020; 113:104092. [PMID: 33010696 DOI: 10.1016/j.jmbbm.2020.104092] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022]
Abstract
The aim of this study is to evaluate the stresses transferred to peri-implant areas from single implants restored with different restorative materials and subjected to a static vertical load with low eccentricity. A total of 12 crowns were made with four types of materials: carbon fiber-composite, metal-ceramic, metal-composite, and full-metal, all of them cemented over a titanium abutment. Three different ways of approaching the problem have been used independently to verify the robustness of the conclusions. The experimental results of stress distribution around the implant were obtained by two image processing techniques: Digital Photoelasticity and Digital Image Correlation (DIC). The tests have been modelled by 3D Finite Element Method (FEM). The FEM models have also been used to study the sensitivity of the results to slight changes in geometry or loads, so that the robustness of the experimental techniques can be analyzed. In addition, the realistic bone morphology of the mandible has also been modelled by FEM, including the cortical and trabecular bone property distinctions.
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Affiliation(s)
- Oriol Cantó-Navés
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Xavier Marimon
- Automatic Control Department, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), Barcelona, Spain.
| | - Miquel Ferrer
- Department of Strength of Materials and Structural Engineering, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), Barcelona, Spain
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Majzoub J, Chen Z, Saleh I, Askar H, Wang HL. Influence of restorative design on the progression of peri-implant bone loss: A retrospective study. J Periodontol 2020; 92:536-546. [PMID: 32902855 DOI: 10.1002/jper.20-0327] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Clinical data on the restorative designs affecting the early progression of peri-implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri-implantitis. METHODS Implants diagnosed with peri-implantitis having 1- (T1) and 2-year (T2) follow-ups were included. In addition, within 6 months pre-diagnosis (Tb), all cases required to have full documentation in which no evidence of peri-implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations. RESULTS Eighty-three bone-level implants from 65 patients were selected. The mean follow-up before peri-implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants' bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow-up year. CONCLUSIONS Significant marginal bone loss occurred in the early post-diagnosis period of peri-implantitis, which could be affected by the restoration emergence angle. Peri-implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.
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Affiliation(s)
- Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Islam Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Houssam Askar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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Aljohani M, Yong SL, Bin Rahmah A. The effect of surgical regenerative treatment for peri-implantitis: A systematic review. Saudi Dent J 2020; 32:109-119. [PMID: 32180667 PMCID: PMC7063412 DOI: 10.1016/j.sdentj.2019.10.006] [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: 08/14/2019] [Revised: 10/14/2019] [Accepted: 10/21/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The purpose of the present study was to systematically review literature on the effectiveness of surgical regenerative treatment for peri-implantitis. METHODS Different databases were searched including the Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE. Primary outcomes were changes in probing pocket depth (PPD), bleeding on probing (BOP), radiographic marginal bone level (RBL) and signs of infection. Secondary outcomes were facial marginal recession, aesthetic outcomes and cost of treatment. Only randomised controlled trials (RCTs) with a minimum of 12 months follow-up period after regenerative surgical treatment were selected according to PRISMA guidelines. MAIN RESULTS Five studies were selected. The highest mean reduction of PPD was 3.1 mm in a bovine-derived xenograft (BDX) group. The highest percentage reduction of BOP occurred in patients treated with implantoplasty and saline (a reduction of 85.2%). The highest mean defect fill of RBL was reported in the porous titanium granules group (3.6 mm). Mean reductions of PPD, RBL and facial marginal soft tissue recession were statistically insignificant (p-value > 0.05) in the studies included. However, the mean reduction in BOP was statistically significant (p-value < 0.05) in four studies as compared to the baseline (before treatment). A high heterogeneity among the studies included, regarding surgical protocols, defects morphology and selection of biomaterials, was found. CONCLUSION All studies included showed an improvement in clinical conditions after surgical regenerative treatment for peri-implantitis. However, no study has shown any statistical significance in its approach. There is a lack of scientific evidence in literature regarding which type of bone substitute has superiority in the treatment of peri-implantitis, as well as the role of barrier membranes, methods for detoxification of implant surfaces and antimicrobial prescriptions. For these reasons further well-designed RCTs are recommended.
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Affiliation(s)
- Marwan Aljohani
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madina, Saudi Arabia
- Faculty of Biology, Medicine and Health, Division of Dentistry, the University of Manchester, United Kingdom
| | - Sin L Yong
- Faculty of Biology, Medicine and Health, Division of Dentistry, the University of Manchester, United Kingdom
| | - Abdullah Bin Rahmah
- Faculty of Biology, Medicine and Health, Division of Dentistry, the University of Manchester, United Kingdom
- Department of Periodontics and Community Dentistry, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
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25
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Accuracy of complete-arch implant impression made with occlusal registration material. J Prosthet Dent 2020; 123:143-148. [DOI: 10.1016/j.prosdent.2018.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 11/19/2022]
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26
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 402] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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27
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2019; 45 Suppl 20:S246-S266. [PMID: 29926484 DOI: 10.1111/jcpe.12954] [Citation(s) in RCA: 384] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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28
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de Avila ED, van Oirschot BA, van den Beucken JJJP. Biomaterial-based possibilities for managing peri-implantitis. J Periodontal Res 2019; 55:165-173. [PMID: 31638267 PMCID: PMC7154698 DOI: 10.1111/jre.12707] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/22/2019] [Accepted: 09/18/2019] [Indexed: 12/13/2022]
Abstract
Peri‐implantitis is an inflammatory disease of hard and soft tissues around osseointegrated implants, followed by a progressive damage of alveolar bone. Oral microorganisms can adhere to all types of surfaces by the production of multiple adhesive factors. Inherent properties of materials will influence not only the number of microorganisms, but also their profile and adhesion force onto the material surface. In this perspective, strategies to reduce the adhesion of pathogenic microorganisms on dental implants and their components should be investigated in modern rehabilitation concepts in implant dentistry. To date, several metallic nanoparticle films have been developed to reduce the growth of pathogenic bacteria. However, the main drawback in these approaches is the potential toxicity and accumulative effect of the metals over time. In view of biological issues and in attempt to prevent and/or treat peri‐implantitis, biomaterials as carriers of antimicrobial substances have attracted special attention for application as coatings on dental implant devices. This review will focus on biomaterial‐based possibilities to prevent and/or treat peri‐implantitis by describing concepts and dental implant components suitable for engagement in preventing and treating this disease. Additionally, we raise important criteria referring to the geometric parameters of dental implants and their components, which can directly affect peri‐implant tissue conditions. Finally, we overview currently available biomaterial systems that can be used in the field of oral implantology.
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Affiliation(s)
- Erica D de Avila
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands.,Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Sao Paulo State University-UNESP, Araraquara, São Paulo, Brazil
| | - Bart A van Oirschot
- Regenerative Biomaterials, Radboudumc, Nijmegen, The Netherlands.,Department of Implantology & Periodontology, Radboudumc, Nijmegen, The Netherlands
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29
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Lima LA, Bosshardt DD, Chambrone L, Araújo MG, Lang NP. Excessive occlusal load on chemically modified and moderately rough titanium implants restored with cantilever reconstructions. An experimental study in dogs. Clin Oral Implants Res 2019; 30:1142-1154. [PMID: 31529643 DOI: 10.1111/clr.13539] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the outcomes of excessively loaded implants. MATERIAL AND METHODS In five dogs, all mandibular premolars were extracted. After 3 months, six implants (three SLA® and three SLActive®) were placed (S). After 4 weeks, implants were restored: one single crown with stable occlusal contacts (SC), one crown and a cantilever unit with excessive occlusal contacts (OL), and a non-loaded implant (NL). Bleeding-on-probing (BoP), attachment level (AL), mucosal margin (GM) were assessed. Resonance frequency analysis (RFA) was assessed weekly. Standardized X-rays were taken at S, 4 and 24 weeks. RESULTS Similar findings were observed for SLA® and SLActive® implants regarding PlI, GI, GM, AL, and BL. No significant differences were detected between baseline and 24-weeks or between treatment modalities for all clinical parameters (p > .05). Six months after loading, RFA values were significantly greater than at implant placement. No significant differences between treatment modalities were found. Linear radiographic measurements yielded similar results between SLA® and SLActive® implants. SLA® OL implants yielded a statistically significant gain on peri-implant bone density over all other groups (p = .012). Radiographic results were confirmed by descriptive histology. Technically, loosened occlusal screws occurred in 13.3% (SC = 3.3%; OL = 10%), while abutment fractures totalized 23.3% (SC = 6.6%; OL = 16.6%). CONCLUSIONS Excessive occlusal load applied to implants (SLA® or SLActive®) restored with cantilevers did not cause loss of osseointegration or significant changes in their clinical, radiographic, or histologic outcomes. Early excessive occlusal load on SLA® implants promoted a gain in peri-implant bone density. Excessively loaded implants showed more technical complications.
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Affiliation(s)
- Luiz A Lima
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Leandro Chambrone
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mauricio G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Niklaus P Lang
- School of Dental Medicine, University of Berne, Berne, Switzerland.,Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong.,Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Berne, Berne, Switzerland
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30
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Zandim-Barcelos DL, Carvalho GGD, Sapata VM, Villar CC, Hämmerle C, Romito GA. Implant-based factor as possible risk for peri-implantitis. Braz Oral Res 2019; 33:e067. [PMID: 31576951 DOI: 10.1590/1807-3107bor-2019.vol33.0067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 11/21/2022] Open
Abstract
Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.
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Affiliation(s)
- Daniela Leal Zandim-Barcelos
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Gabriel Garcia de Carvalho
- Universidade Estadual Paulista - Unesp, Araraquara School of Dentistry, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Vitor Marques Sapata
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, Dental School, Department of Stomatology, São Paulo, Brazil
| | - Christoph Hämmerle
- University of Zurich, Clinic for Fixed and Removable Prosthodontics and Dental Material Science, Zurich, Switzerland
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31
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Berridge JP, Johnson TM, Erley KJ, Hill RB, Lane JD, Schlam KK, Dunham DD, Miller PD. Focus on Epithelialized Palatal Grafts. Part 2: Implant Site Development. Clin Adv Periodontics 2019; 9:147-156. [PMID: 31490040 DOI: 10.1002/cap.10064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 03/31/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The epithelialized palatal graft (EPG), introduced in 1963, has persisted as the gold standard for gingival augmentation, and in the present era, mucosal augmentation around dental implants has become an important concern. A limited body of evidence suggests peri-implant mucosal augmentation may favorably impact bone and mucosal stability and peri-implant health under some circumstances. Although more contemporary procedures for peri-implant mucosal augmentation are often preferred based on convenience and esthetic considerations, EPG augmentation at dental implant sites is distinguishable from methods which do not deepen the vestibule and eliminate unfavorable superficial soft tissue. Implant sites augmented with EPG are qualitatively distinct from sites augmented using other methods. CASE SERIES Seven generally healthy patients received EPG augmentation before dental implant placement, at implant placement, before implant uncovering, or after implant uncovering. In each case, the patient exhibited a favorable zone of attached peri-implant mucosa following treatment. CONCLUSIONS Reliable mucosal augmentation with EPG is achievable at multiple phases in the course of dental implant therapy. EPG augmentation offers distinct clinical advantages and may be preferable to other mucosal augmentation strategies at some dental implant sites.
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Affiliation(s)
- Joshua P Berridge
- Department of Periodontics, United States Army Dental Health Activity, Fort Bragg, NC
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Kenneth J Erley
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Richard B Hill
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Jonathan D Lane
- Department of Periodontics, United States Army Dental Health Activity, Joint Base Lewis-McChord, WA
| | - Kimberly K Schlam
- Department of Prosthodontics, United States Army Dental Health Activity, Fort Bragg, NC
| | - Daniel D Dunham
- Department of Prosthodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Preston D Miller
- Distinguished visiting lecturer, New York University, New York, NY
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32
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Dixon DR, London RM. Restorative design and associated risks for peri‐implant diseases. Periodontol 2000 2019; 81:167-178. [DOI: 10.1111/prd.12290] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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33
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Matsuzaki T, Ayukawa Y, Matsushita Y, Sakai N, Matsuzaki M, Masuzaki T, Haraguchi T, Ogino Y, Koyano K. Effect of post-osseointegration loading magnitude on the dynamics of peri-implant bone: a finite element analysis and in vivo study. J Prosthodont Res 2019; 63:453-459. [PMID: 31350187 DOI: 10.1016/j.jpor.2018.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 09/03/2018] [Accepted: 10/10/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE Much research has been invested in determining the effects of postoperative loading of implants and whether this loading contributes to implant failure, but the issue remains controversial. The present study aimed to elucidate whether cyclic lateral loading of an implant causes bone resorption or bone formation at various loading magnitudes, using a finite element method (FEM) and peri-implant morphologic and morphometric analyses. METHODS An FEM model was created using Digital Imaging and Communications in Medicine (DICOM) data of rabbit tibia. For the animal study, implants were inserted into rabbit tibia and, after osseointegration, were subjected to lateral cyclic loading of 20N, 40N or 60N. RESULTS Bone-implant contact was significantly higher in both 40N and 60N groups. Bone-abutment contact (BAC) was extraordinarily observed in all experimental groups. Bone height was higher than the implant platform level at higher levels of loading (60N). Among the three experimental groups, those receiving 40N loading had the highest bone height and BAC. Larger BAC values were observed on the compressive side than the tensile side. CONCLUSIONS Peri-implant bone formation was enhanced with increased loading, with bone formation predominantly on the compressive side. BAC was highest in the 40N group, implying existence of a loading threshold for peri-implant bone formation and resorption.
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Affiliation(s)
- Tatsuya Matsuzaki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
| | - Yasuyuki Matsushita
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Nobuo Sakai
- Kyushu Institute of Technology, Fukuoka, Japan
| | - Maki Matsuzaki
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Tomohiro Masuzaki
- Department of Oral and Maxillofacial Prosthodontics, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutic Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuya Haraguchi
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kiyoshi Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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34
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Sadowsky SJ. Occlusal overload with dental implants: a review. Int J Implant Dent 2019; 5:29. [PMID: 31332553 PMCID: PMC6646429 DOI: 10.1186/s40729-019-0180-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Controversy persists as to the role of occlusal overload in peri-implantitis. Animal studies have not revealed the biological threshold for fatigue failure in the peri-implant bone. On the other hand, clinical studies have demonstrated a link between parafunction and implant failure, although variables such as intensity and frequency of loads, as well as bone density, have led to different outcomes. The absence of specific engineering “building codes” for the clinician has relegated prosthetic design planning to intuitive guidelines for all patients. For example, higher crown to implant ratios (2–3:1), implant cantilever prostheses and non-splinted restorative designs have been avoided because of the concern for overload. However, evidence has not supported this general approach. A call for preclinical research to establish specific patient load thresholds is in order to establish a customized treatment plan.
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Affiliation(s)
- Steven J Sadowsky
- Preventive and Restorative Department, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
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Bordin D, Cury AADB, Faot F. Influence of Abutment Collar Height and Implant Length on Stress Distribution in Single Crowns. Braz Dent J 2019; 30:238-243. [DOI: 10.1590/0103-6440201902533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/21/2019] [Indexed: 11/22/2022] Open
Abstract
Abstract This in silico study evaluated the influence of the abutment collar height and implants length on the biomechanical behavior of morse taper single dental implants with different crown-to-implant ratio. Six virtual models were constructed (S11, M11, L11, S13, M13 and L13) by combining short (S: 2.5 mm), medium (M: 3.5 mm) or long (L: 4.5 mm) abutment collar heights with different implant lengths (11 or 13-mm). An upper central incisor of 11-mm height was constructed on top of each abutment. Each set was positioned in a virtual bone model and exported to analyze mathematically. A 0.60-mm mesh was created after convergence analysis and a 49 N load was applied to the cingulum of the crown at an angle of 45°. Load-generated stress distribution was analyzed in the prosthetic components according to von Mises stress criteria (σvM) and in the cortical and cancellous bone by means of shear stress (εmax). The use of longer collar abutments (L11) increased the stress on the abutment by 250% and resulted in 40% higher stresses on the screw and 92% higher cortical shear stresses compared to short collared abutments (S11). Increasing the implant length produced a slight stress reduction on cortical bone. Cancellous bone was not affected by the crown-to-implant ratio. Longer abutment collars concentrate stresses at the implant level and cortical bone by increasing the crown-to-implant ratio.
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Acharya A, Leung MCT, Ng KT, Fan MHM, Fokas G, Mattheos N. Peri-implant marginal bone loss rate pre- and post-loading: An exploratory analysis of associated factors. Clin Oral Implants Res 2019; 30:410-419. [PMID: 30921476 DOI: 10.1111/clr.13424] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/21/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To perform an exploratory analysis of factors influencing annual rates of peri-implant marginal bone loss (RBL) calculated over different time frames, at implants unaffected by peri-implantitis. MATERIAL AND METHODS A total of 154 implants from 86 patients were reviewed at 1.6-6.8 years after placement. Marginal bone levels (MBL) were assessed on intraoral radiographs at three time-points: immediately post-placement, time of loading, and least 1-year post-loading. RBLs (mm/year) were computed using these three time frames and corresponding MBL changes as: RBL placement-loading, RBL loading-review, RBL placement-review. Exploratory ordination of three RBLs, corresponding time durations, and 17 background factors were used for visualization. Hierarchical linear mixed-effects models (MEM) with predictor selection were applied to RBL outcomes. The correlation of actual MBL with MBLs predicted by RBL placement-loading and RBL loading-review was tested. RESULTS Median RBL placement-loading was 0.9 mm/year (IQR = 2.02), loading-review was 0.06 mm/year (IQR = 0.16), and overall RBL placement-review was 0.21 mm/year (IQR = 0.33). Among-patient variance was highest for RBL placement-loading (SD = 0.66). Longer time predicted lower RBL in all time frames. Shorter time of loading significantly predicted lower RBL placement-review. Augmentation predicted lower RBL placement-loading, while anterior location and older age predicted lower RBLs placement-loading placement-review. Only MBL projected using RBL placement-loading significantly correlated with actual MBL. CONCLUSIONS Exploratory analysis indicated RBL varied with the time duration used for calculation in pre- and post-loading, and overall periods. In each period, RBL declined with increasing time. Earlier loading predicted lower overall RBL. Higher pre-loading RBL predicted worse actual bone level.
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Affiliation(s)
- Aneesha Acharya
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Department of Periodontology, Dr. D.Y.Patil Dental College and Hospital, Pimpri, Pune
| | - Ming Chi Terrence Leung
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - King Tung Ng
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Michael H M Fan
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - George Fokas
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Nikos Mattheos
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Maiorana C, Poli PP, Mascellaro A, Ferrario S, Beretta M. Dental implants placed in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts: A 26-year median follow-up retrospective study. J Craniomaxillofac Surg 2019; 47:805-814. [PMID: 30797661 DOI: 10.1016/j.jcms.2019.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/30/2018] [Accepted: 02/04/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To evaluate the long-term outcome of dental implants placed with a staged procedure in resorbed alveolar ridges reconstructed with iliac crest autogenous onlay grafts. MATERIALS AND METHODS All consecutive patients treated with iliac crest onlay bone grafts and dental implants were retrospectively evaluated. During the appointment, clinical and radiological examinations were conducted to assess implant survival. A survived implant was defined as an implant still stable and in function at the follow-up visit. Implant survival was estimated at the implant level using Kaplan-Meier analyses. The cumulative survival rate was estimated using a life-table analysis. Subgroup analyses were performed for age, position, and type of retention using the log-rank test. A p-value of <0.05 was considered statistically significant. RESULTS The cohort consisted of 21 female subjects receiving a total of 140 rough-surface titanium implants. Of them, 128 survived and 12 failed, yielding a cumulative survival rate of 91.1% over a median survival time of 312 months. Implants supporting cement-retained prostheses exhibithed lower survival rate compared to screw-retained restorations (p = 0.001). CONCLUSION Implants placed in bone augmented with iliac crest onlay grafts showed high long-term survival rates. Cement-retained restorations were more prone to develop implant failures.
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Affiliation(s)
- Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Via della Commenda 10, 20122 Milan, Italy.
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Via della Commenda 10, 20122 Milan, Italy.
| | - Anna Mascellaro
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Via della Commenda 10, 20122 Milan, Italy.
| | - Susanna Ferrario
- School of Dentistry, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy.
| | - Mario Beretta
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Via della Commenda 10, 20122 Milan, Italy.
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Pammer D. Evaluation of postoperative dental implant primary stability using 3D finite element analysis. Comput Methods Biomech Biomed Engin 2019; 22:280-287. [DOI: 10.1080/10255842.2018.1552682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dávid Pammer
- Department of Materials Science and Engineering, Budapest University of Technology and Economics, Budapest, Hungary
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Ligature-Induced Experimental Peri-Implantitis-A Systematic Review. J Clin Med 2018; 7:jcm7120492. [PMID: 30486492 PMCID: PMC6306937 DOI: 10.3390/jcm7120492] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Abstract
This systematic review sought to analyze different experimental peri-implantitis models, their potential to induce marginal bone resorption (MBR) and the necessity of bacteria for bone loss to occur in these models. An electronic search in PubMed/Medline, Web of Science, and ScienceDirect was undertaken. A total of 133 studies were analyzed. Most studies induced peri-implantitis with ligatures that had formed a biofilm, sometimes in combination with inoculation of specific bacteria but never in a sterile environment. Most vertical MBR resulted from new ligatures periodically packed above old ones, followed by periodically exchanged ligatures and ligatures that were not exchanged. Cotton ligatures produced the most MBR, followed by steel, “dental floss” (not further specified in the studies) and silk. The amount of MBR varied significantly between different animal types and implant surfaces. None of the analyzed ligature studies aimed to validate that bacteria are necessary for the inducement of MBR. It cannot be excluded that bone loss can be achieved by other factors of the model, such as an immunological reaction to the ligature itself or trauma from repeated ligature insertions. Because all the included trials allowed plaque accumulation on the ligatures, bone resorbing capacity due to other factors could not be excluded or evaluated here.
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Ng KT, Fan M, Leung MC, Fokas G, Mattheos N. Peri-implant inflammation and marginal bone level changes around dental implants in relation to proximity with and bone level of adjacent teeth. Aust Dent J 2018; 63:467-477. [PMID: 30182386 DOI: 10.1111/adj.12650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This retrospective study assessed radiographic bone changes and prevalence of inflammation around teeth and neighbouring implants supporting a single-unit fixed dental prosthesis (FDP), in relation to implant- positioning and characteristics. MATERIAL AND METHODS Patients with an implant-supported FDP in function for at least 1 year were recruited. The radiographic horizontal and vertical position of the implants were identified. Probing depth (PD), bleeding on probing (BOP) and radiographic bone level around implants and adjacent teeth at the time of placement, prosthesis delivery, and the most recent review were assessed. RESULTS 98 patients with 195 implants were evaluated for a mean of 37.8 months. Survival rate was 99.6% and success ranged from 31.3% to 91.3% when different success criteria were utilized. Significantly greater interproximal bone loss around teeth and higher prevalence of interproximal peri-implant inflammation occurred when the horizontal distance of BL implants was <1 mm, but not with TL implants. There was no significant impact of the corono-apical positioning of the implants on marginal bone loss. CONCLUSION Proximity of implants to adjacent teeth of <1 mm leads to increased prevalence of inflammation and interproximal bone resorption at the teeth adjacent to bone level implants.
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Affiliation(s)
- K T Ng
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Mhm Fan
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - M C Leung
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - G Fokas
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - N Mattheos
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
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Madani AS, Nakhaei M, Alami M, Haghi HR, Moazzami SM. Post-insertion Posterior Single-implant Occlusion Changes at Different Intervals: A T-Scan Computerized Occlusal Analysis. J Contemp Dent Pract 2017; 18:927-932. [PMID: 28989132 DOI: 10.5005/jp-journals-10024-2151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this prospective cohort study was to evaluate the postinsertion posterior single-implant occlusion changes at 3- and 6-month intervals using T-Scan computerized occlusal analysis. MATERIALS AND METHODS A total of 21 patients received single implant, opposed by natural dentition, in posterior regions of the maxilla or mandible (13 premolar, 8 molar) and were finally restored with cemented-retained metal-ceramic crowns. The occlusal contacts were equilibrated according to the implant-protective occlusion concept to develop light contact with heavy occlusion and no contact with light occlusion in maximum inter-cuspation. The percentage of force applied to the implant crowns (POFI) and contralateral teeth (POFT) was evaluated using T-Scan computerized occlusal analysis at prosthesis insertion, 3- and 6-month follow-up appointments. The data were statistically analyzed using Friedman test and Wilcoxon post hoc test (α = 0.05). RESULTS The POFI values at the 6- and 3-month follow-up appointments were significantly higher than those at prostheses insertion (p = 0.001 and p = 0.005 respectively). In addition, there were significant differences between the POFI at 3- and 6-month follow-up (p = 0.020). However, the POFT values at 3- and 6-month follow-up appointments were significantly lower than those at baseline (p < 0.001). CONCLUSION The intensity of occlusal contacts of implant-supported prostheses opposed by natural dentition gradually increased after prosthesis insertion. Placement of single posterior implant-supported restoration decreased the percentage of occlusal force applied to contralateral arch. CLINICAL SIGNIFICANCE A periodic occlusal adjustment of implant-supported prostheses is necessary to prevent potential overloading from the movement of opposing natural dentition.
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Affiliation(s)
- Azam S Madani
- Department of Prosthodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Mohammadreza Nakhaei
- Department of Prosthodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran, Phone: +985138829501, e-mail: /
| | - Malihe Alami
- Department of Prosthodontics, Faculty of Dentistry, Golestan University of Medical Sciences, Gorgan, Islamic Republic of Iran
| | - Hamidreza Rajati Haghi
- Department of Prosthodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Saied Mostafa Moazzami
- Department of Restorative Dentistry, Faculty of Dentistry Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
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Abstract
PURPOSE Occlusal overload may cause implant biomechanical failures, marginal bone loss, or even complete loss of osseointegration. Thus, it is important for clinicians to understand the role of occlusion in implant long-term stability. This systematic review updates the understanding of occlusion on dental implants, the impact on the surrounding peri-implant tissues, and the effects of occlusal overload on implants. Additionally, recommendations of occlusal scheme for implant prostheses and designs were formulated. MATERIALS AND METHODS Two reviewers completed a literature search using the PubMed database and a manual search of relevant journals. Relevant articles from January 1950 to September 20, 2015 published in the English language were considered. RESULTS Recommendations for implant occlusion are lacking in the literature. Despite this, implant occlusion should be carefully addressed. CONCLUSION Recommendations for occlusal schemes for single implants or fixed partial denture supported by implants include a mutually protected occlusion with anterior guidance and evenly distributed contacts with wide freedom in centric relation. Suggestions to reduce occlusal overload include reducing cantilevers, increasing the number of implants, increasing contact points, monitoring for parafunctional habits, narrowing the occlusal table, decreasing cuspal inclines, and using progressive loading in patients with poor bone quality. Protecting the implant and surrounding peri-implant bone requires an understanding of how occlusion plays a role in influencing long-term implant stability.
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The Failure Envelope Concept Applied To The Bone-Dental Implant System. Sci Rep 2017; 7:2051. [PMID: 28515495 PMCID: PMC5435678 DOI: 10.1038/s41598-017-02282-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/11/2017] [Indexed: 11/23/2022] Open
Abstract
Dental implants interact with the jawbone through their common interface. While the implant is an inert structure, the jawbone is a living one that reacts to mechanical stimuli. Setting aside mechanical failure considerations of the implant, the bone is the main component to be addressed. With most failure criteria being expressed in terms of stress or strain values, their fulfillment can mean structural flow or fracture. However, in addition to those effects, the bony structure is likely to react biologically to the applied loads by dissolution or remodeling, so that additional (strain-based) criteria must be taken into account. While the literature abounds in studies of particular loading configurations, e.g. angle and value of the applied load to the implant, a general study of the admissible implant loads is still missing. This paper introduces the concept of failure envelopes for the dental implant-jawbone system, thereby defining admissible combinations of vertical and lateral loads for various failure criteria of the jawbone. Those envelopes are compared in terms of conservatism, thereby providing a systematic comparison of the various failure criteria and their determination of the admissible loads.
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BALCI YUCE H. Periodontoloji Alaninda Hayvan Çalışmaları: Deneysel Periodontal ve Periimplant Hastalığın İndüksiyonu. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.307312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Koller CD, Pereira-Cenci T, Boscato N. Parameters Associated with Marginal Bone Loss around Implant after Prosthetic Loading. Braz Dent J 2017; 27:292-7. [PMID: 27224562 DOI: 10.1590/0103-6440201600874] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/19/2016] [Indexed: 12/29/2022] Open
Abstract
This study evaluated retrospectively the association among occlusal, periodontal and implant-prosthetic parameters and marginal bone loss (MBL) around implants and survival rate at 5.7 ±3.2 years of follow-up after prosthetic loading. Eighty-two patients received 164 external hexagon implants. After the standard healing period (3 to 6 months), the implants were restored with single-tooth or up to three splinted crowns. All patients were followed according to a strict maintenance program with regular recalls and clinically evaluated by a calibrated examiner. The MBL measurements taken from standardized radiographs made at permanent crown placement (baseline) and after the last evaluation were calculated considering occlusal, periodontal and implant-prosthetic parameters. Veneer fractures and abutment loosening were not considered failure. Two implants failed during the follow-up period, resulting in a survival rate of 98.8%. Cox regression analyses showed MBL associated with non-working side contacts (p=0.047), inadequate anterior guidance (p=0.001), lateral group guidance involving teeth and implants (p=0.015), periimplant plaque index (p=0.035), prosthetic design (p=0.030) and retention (p=0.006). Inadequate occlusal pattern guide, presence of visible plaque, and cemented and splinted implant-supported restoration were associated with greater MBL around the implant.
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Affiliation(s)
- Clarissa D Koller
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil, Universidade Federal de Pelotas, Graduate Program in Dentistry, Dental School, Universidade Federal de Pelotas, Pelotas RS , Brazil
| | - Tatiana Pereira-Cenci
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil, Universidade Federal de Pelotas, Graduate Program in Dentistry, Dental School, Universidade Federal de Pelotas, Pelotas RS , Brazil
| | - Noéli Boscato
- Graduate Program in Dentistry, Dental School, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil, Universidade Federal de Pelotas, Graduate Program in Dentistry, Dental School, Universidade Federal de Pelotas, Pelotas RS , Brazil
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Kantarci A, Hasturk H, Van Dyke TE. Animal models for periodontal regeneration and peri-implant responses. Periodontol 2000 2017; 68:66-82. [PMID: 25867980 DOI: 10.1111/prd.12052] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/28/2022]
Abstract
Translation of experimental data to the clinical setting requires the safety and efficacy of such data to be confirmed in animal systems before application in humans. In dental research, the animal species used is dependent largely on the research question or on the disease model. Periodontal disease and, by analogy, peri-implant disease, are complex infections that result in a tissue-degrading inflammatory response. It is impossible to explore the complex pathogenesis of periodontitis or peri-implantitis using only reductionist in-vitro methods. Both the disease process and healing of the periodontal and peri-implant tissues can be studied in animals. Regeneration (after periodontal surgery), in response to various biologic materials with potential for tissue engineering, is a continuous process involving various types of tissue, including epithelia, connective tissues and alveolar bone. The same principles apply to peri-implant healing. Given the complexity of the biology, animal models are necessary and serve as the standard for successful translation of regenerative materials and dental implants to the clinical setting. Smaller species of animal are more convenient for disease-associated research, whereas larger animals are more appropriate for studies that target tissue healing as the anatomy of larger animals more closely resembles human dento-alveolar architecture. This review focuses on the animal models available for the study of regeneration in periodontal research and implantology; the advantages and disadvantages of each animal model; the interpretation of data acquired; and future perspectives of animal research, with a discussion of possible nonanimal alternatives. Power calculations in such studies are crucial in order to use a sample size that is large enough to generate statistically useful data, whilst, at the same time, small enough to prevent the unnecessary use of animals.
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Schwarz F, Sculean A, Engebretson SP, Becker J, Sager M. Animal models for peri-implant mucositis and peri-implantitis. Periodontol 2000 2017; 68:168-81. [PMID: 25867986 DOI: 10.1111/prd.12064] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
The treatment of infectious diseases affecting osseointegrated implants in function has become a demanding issue in implant dentistry. Since the early 1990s, preclinical data from animal studies have provided important insights into the etiology, pathogenesis and therapy of peri-implant diseases. Established lesions in animals have shown many features in common with those found in human biopsy material. The current review focuses on animal studies, employing different models to induce peri-implant mucositis and peri-implantitis.
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Effects of enamel matrix derivative on non-surgical management of peri-implant mucositis: a double-blind randomized clinical trial. Clin Oral Investig 2016; 21:2379-2388. [DOI: 10.1007/s00784-016-2033-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 12/08/2016] [Indexed: 12/20/2022]
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Graves CV, Harrel SK, Rossmann JA, Kerns D, Gonzalez JA, Kontogiorgos ED, Al-Hashimi I, Abraham C. The Role of Occlusion in the Dental Implant and Peri-implant Condition: A Review. Open Dent J 2016; 10:594-601. [PMID: 27990184 PMCID: PMC5123128 DOI: 10.2174/1874210601610010594] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/28/2016] [Accepted: 10/15/2016] [Indexed: 11/22/2022] Open
Abstract
Dental implants have become a widely used dental treatment approach. It is important to identify factors that can be detrimental to dental implants and the peri-implant complex. There is controversy regarding whether occlusion plays a role in the implant and peri-implant condition. The present study aims to review the scientific literature regarding this topic. Animal and human studies, and previous reviews on the topic are included and presented. There is a wide heterogeneity among study designs. Several articles demonstrated that occlusion and occlusion overload could detrimentally affect the peri-implant condition, while other articles did not support these results. More studies are needed to help understand the mechanisms by which occlusion might play a role in the peri-implant condition.
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Affiliation(s)
- Carmen V Graves
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Steve K Harrel
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Jeffrey A Rossmann
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - David Kerns
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Jorge A Gonzalez
- Center of Maxillofacial Prosthesis, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Elias D Kontogiorgos
- Restorative Science and Implant Dentistry, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Ibtisam Al-Hashimi
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
| | - Celeste Abraham
- Periodontics Department, Texas A&M Baylor College of Dentistry, Dallas, Texas, USA
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Biomechanical Consequences of the Elastic Properties of Dental Implant Alloys on the Supporting Bone: Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1850401. [PMID: 27995137 PMCID: PMC5138439 DOI: 10.1155/2016/1850401] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 10/31/2016] [Indexed: 11/18/2022]
Abstract
The objective of the present study is to evaluate how the elastic properties of the fabrication material of dental implants influence peri-implant bone load transfer in terms of the magnitude and distribution of stress and deformation. A three-dimensional (3D) finite element analysis was performed; the model used was a section of mandibular bone with a single implant containing a cemented ceramic-metal crown on a titanium abutment. The following three alloys were compared: rigid (Y-TZP), conventional (Ti-6Al-4V), and hyperelastic (Ti-Nb-Zr). A 150-N static load was tested on the central fossa at 6° relative to the axial axis of the implant. The results showed no differences in the distribution of stress and deformation of the bone for any of the three types of alloys studied, mainly being concentrated at the peri-implant cortical layer. However, there were differences found in the magnitude of the stress transferred to the supporting bone, with the most rigid alloy (Y-TZP) transferring the least stress and deformation to cortical bone. We conclude that there is an effect of the fabrication material of dental implants on the magnitude of the stress and deformation transferred to peri-implant bone.
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