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Yin D, Zhan S, Liu Y, Yan L, Shi B, Wang X, Zhang S. Experimental models for peri-implant diseases: a narrative review. Clin Oral Investig 2024; 28:378. [PMID: 38884808 DOI: 10.1007/s00784-024-05755-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Peri-implant diseases, being the most common implant-related complications, significantly impact the normal functioning and longevity of implants. Experimental models play a crucial role in discovering potential therapeutic approaches and elucidating the mechanisms of disease progression in peri-implant diseases. This narrative review comprehensively examines animal models and common modeling methods employed in peri-implant disease research and innovatively summarizes the in vitro models of peri-implant diseases. MATERIALS AND METHODS Articles published between 2015 and 2023 were retrieved from PubMed/Medline, Web of Science, and Embase. All studies focusing on experimental models of peri-implant diseases were included and carefully evaluated. RESULTS Various experimental models of peri-implantitis have different applications and advantages. The dog model is currently the most widely utilized animal model in peri-implant disease research, while rodent models have unique advantages in gene knockout and systemic disease induction. In vitro models of peri-implant diseases are also continuously evolving to meet different experimental purposes. CONCLUSIONS The utilization of experimental models helps simplify experiments, save time and resources, and promote advances in peri-implant disease research. Animal models have been proven valuable in the early stages of drug development, while technological advancements have brought about more predictive and relevant in vitro models. CLINICAL RELEVANCE This review provides clear and comprehensive model selection strategies for researchers in the field of peri-implant diseases, thereby enhancing understanding of disease pathogenesis and providing possibilities for developing new treatment strategies.
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Affiliation(s)
- Derong Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030032, Shanxi, China
| | - Suying Zhan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yanbo Liu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030032, Shanxi, China
| | - Lichao Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Binmian Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiayi Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Shiwen Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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Pesce P, Del Fabbro M, Menini M, De Giovanni E, Annunziata M, Khijmatgar S, Canullo L. Effects of abutment materials on peri-implant soft tissue health and stability: A network meta-analysis. J Prosthodont Res 2023; 67:506-517. [PMID: 37081626 DOI: 10.2186/jpr.jpr_d_22_00223] [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: 04/22/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effect of the abutment material on peri-implant soft tissue health and stability. STUDY SELECTION An electronic and hand search was conducted until February 2022. Only prospective randomized trials (RCTs) and controlled clinical trials (CCTs) comparing titanium abutments with abutments made of different materials, with a follow-up of at least 6 months, were selected by two independent reviewers. Data on marginal bone loss (MBL) and peri-implant tissue indexes, i.e., plaque index (PI), bleeding on probing (BOP), probing depth (PD), and recession (REC), were collected. The risk of bias for RCTs and non-RCTs was evaluated according to the tool reported in the Cochrane Handbook for Systematic Reviews of Interventions and the ROBINS-I tool, respectively. Both pairwise and network meta-analyses (NMA) were performed. RESULTS We included 18 relevant studies from 1,437 identified studies. Overall, 612 patients were treated, and 848 abutments were inserted. Five studies presented a low risk of bias. Pairwise meta-analysis showed that, as compared to titanium, zirconia abutments presented a significantly reduced MBL (0.20 mm, 95% Confidence Interval CI [0.14-0.26], P < 0.00001). No significant differences were found for the other outcomes. In the NMA, zirconia abutments demonstrated an 83.3% probability of achieving the highest rank in PI, an 87.0% in BOP, and a 65.0% in PD outcome, suggesting that zirconia abutments generally performed better than titanium and alumina abutments. CONCLUSIONS Within the limits of the present study, zirconia abutments seem a viable alternative to titanium ones.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Emanuele De Giovanni
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
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Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
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Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
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Mechanical stability of angulated zirconia abutments supporting maxillary anterior single crowns on narrow-diameter implants. Clin Oral Investig 2023; 27:221-233. [PMID: 36161530 DOI: 10.1007/s00784-022-04715-3] [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: 04/13/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To investigate the fracture strength of angulated hybrid abutments supporting anterior single crowns on narrow-diameter implants (NDIs). MATERIAL AND METHODS Zirconia abutment with angulations of labial inclination 0° (TZ0Z), 15° (TZ15Z), 30° (TZ30Z) and palatal inclination 15° (TZ - 15Z) was designed on 3.3-mm titanium-zirconium (Ti-Zr) NDIs. Titanium abutment connected with Ti-Zr implant (TZ0T) and 0° zirconia abutment connected with pure titanium (Ti) implant (T0Z) were control groups. Thirty-six un-restored abutments and 36 abutments restored with highly translucent zirconia (HTZ) crowns were tested. Failure loads were compared among 6 groups, and bending moments were calculated for comparison between un-restored and restored abutments. RESULTS Failure loads of un-restored abutments were affected by the abutment angle. Sixty-seven percent samples in TZ30Z and 83% samples in TZ - 15Z group fractured at the thinnest part of the zirconia abutment and exhibited lower failure load (p < .05). Failure loads of restored abutments were close to or exceeded the maximum bite force of anterior teeth, and no differences were found among six groups (p > .05). Except TZ15Z and TZ0T group, the bending moment increased with the crown construction, especially for TZ30Z and TZ - 15Z groups (p < .001). CONCLUSIONS The fracture strength of hybrid abutments restored with HTZ crown on Ti-Zr NDIs exceeded the bite forces of anterior teeth for all the groups and were not affected by the abutment angle. CLINICAL RELEVANCE In terms of fracture strength, Ti-Zr NDIs combined with angulated hybrid abutments and HTZ crowns can be used in the anterior region.
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Muacevic A, Adler JR, Darwich K, Kanout S, Husein HA. A Comparative Study Between Hybrid Abutments and Standard Abutments in Implant-Supported Prosthesis: A Split-Mouth Clinical Trial. Cureus 2022; 14:e31993. [PMID: 36600816 PMCID: PMC9800053 DOI: 10.7759/cureus.31993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Implant-supported prostheses are widely used to replace extracted teeth. Therefore, studies on abutments' designs, shapes, and benefits had increased in recent years, as the design of the standard abutment still poses many problems in periodontal and cosmetic aspects. So, could the hybrid abutment solve some of these problems? Aim We aim to conduct a clinical comparison between standard and hybrid abutments in terms of the state of peri-implant gingival tissues and patients' aesthetic and functional satisfaction after the cementation of the final prostheses. Material and methods The study sample consisted of 10 patients, with 20 dental implants. Each patient received two implants as a standard abutment was placed over one implant and a hybrid abutment was placed over the other. Clinical assessment of the peri-implant gingival tissue and patients' aesthetic and functional satisfaction was performed (immediately, three months, six months, and one year) after the cementation of the final prostheses. The Mann-Whitney U test was used to detect statistically significant differences between groups. Results The percentage of the thick gingival biotype was 80%, and the percentage of the thin gingival biotype was 20% in each group during the follow-up periods. In addition, all papilla fill the whole interdental space in all samples of the two groups after six months and one year. Finally, there were no significant differences in patients' aesthetic satisfaction between groups during one year of follow-up (P = 0.631), and there were no significant differences in patients' functional satisfaction between groups during one year of follow-up (P = 0.684). Conclusion Within the limitations of the current work, there are no differences between standard and hybrid abutments in terms of affecting the peri-implant gingival tissue and patients' aesthetic and functional satisfaction.
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Nemec M, Behm C, Maierhofer V, Gau J, Kolba A, Jonke E, Rausch-Fan X, Andrukhov O. Effect of Titanium and Zirconia Nanoparticles on Human Gingival Mesenchymal Stromal Cells. Int J Mol Sci 2022; 23:ijms231710022. [PMID: 36077419 PMCID: PMC9456558 DOI: 10.3390/ijms231710022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Nano- and microparticles are currently being discussed as potential risk factors for peri-implant disease. In the present study, we compared the responses of human gingival mesenchymal stromal cells (hG-MSCs) on titanium and zirconia nanoparticles (<100 nm) in the absence and presence of Porphyromonas gingivalis lipopolysaccharide (LPS). The primary hG-MSCs were treated with titanium and zirconia nanoparticles in concentrations up to 2.000 µg/mL for 24 h, 72 h, and 168 h. Additionally, the cells were treated with different nanoparticles (25−100 µg/mL) in the presence of P. gingivalis LPS for 24 h. The cell proliferation and viability assay and live−dead and focal adhesion stainings were performed, and the expression levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein (MCP)-1 were measured. The cell proliferation and viability were inhibited by the titanium (>1000 µg/mL) but not the zirconia nanoparticles, which was accompanied by enhanced apoptosis. Both types of nanoparticles (>25 µg/mL) induced the significant expression of IL-8 in gingival MSCs, and a slightly higher effect was observed for titanium nanoparticles. Both nanoparticles substantially enhanced the P. gingivalis LPS-induced IL-8 production; a higher effect was observed for zirconia nanoparticles. The production of inflammatory mediators by hG-MSCs is affected by the nanoparticles. This effect depends on the nanoparticle material and the presence of inflammatory stimuli.
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Affiliation(s)
- Michael Nemec
- Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Behm
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Vera Maierhofer
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Jonas Gau
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Anastasiya Kolba
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Erwin Jonke
- Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Xiaohui Rausch-Fan
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40070-2620
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Plasma of Argon Treatment of the Implant Surface, Systematic Review of In Vitro Studies. Biomolecules 2022; 12:biom12091219. [PMID: 36139059 PMCID: PMC9496338 DOI: 10.3390/biom12091219] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022] Open
Abstract
This paper aims to review the evidence of the cellular activity on titanium samples exposed to Plasma of Argon (PoA) treatment. A systematic review was carried out based on the PRISMA statement by searching the Cochrane Library, PubMed, Web of Science, EMBASE and Scopus, up to October 2020. Papers were selected according to PICOS format that is: Population (P): osteoblasts, fibroblasts, gingival cells; Intervention (I): PoA disinfection treatment; Comparison (C): untreated controls; Outcome (O): cell culture; Setting (S): in vitro assays. The quality assessment was performed according to the CRIS Guidelines (Checklist for Reporting In vitro Studies). A total of 661 articles were found, of which 16 were included. The quality assessment revealed an overall poor quality of the studies analyzed. In vitro studies on the potential of PoA showed a potential effect in promoting higher cell adhesion and protein adsorption in the earliest times (hours). This outcome was not so evident when later stages of cell growth on the surfaces were tested and compared to the control groups. Only one study was conducted in vivo on a human sample regarding abutment cleaning. No meta-analysis was conducted because of the variety of experimental settings, mixed methods and different cell lines studied. PoA seems to be effective in promoting cell adhesion and protein adsorption. The duration of this effect remains unclear. Further evidence is required to demonstrate the long-term efficacy of the treatment and to support the use of PoA treatment in clinical practice.
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Halim FC, Pesce P, De Angelis N, Benedicenti S, Menini M. Comparison of the Clinical Outcomes of Titanium and Zirconia Implant Abutments: A Systematic Review of Systematic Reviews. J Clin Med 2022; 11:jcm11175052. [PMID: 36078982 PMCID: PMC9456707 DOI: 10.3390/jcm11175052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Dental implants are widely used and in order to answer to esthetic demands, zirconia has been introduced as an abutment material as an alternative to titanium. Several studies have been published on this topic, but the results have been often inconsistent. The objective of the present study is to systematically analyze the existing literature comparing clinical outcomes of titanium and zirconia implant abutments. The study was designed as a systematic review of systematic reviews. Methods: This systematic review is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. A MEDLINE/PubMed, Cochrane Database of Systematic Reviews and SCOPUS literature search was performed up to and including June 2021. Data were extracted independently by two reviewers and tAMSTAR2 was used to assess the quality of the systematic reviews. Results: The electronic search identified 1146 papers, and 175 duplicates were removed. After manual screening, 954 studies were excluded and the final analysis was conducted on 11 papers. Both mechanical and esthetic outcomes and biological complications were analyzed. Conclusions: It can be concluded that titanium abutments have a better mechanical resistance than zirconia ones. Plaque accumulation is reported to be slightly higher on titanium but without any significant inflammatory process. The esthetic outcomes seem to be more related to the thickness (>3 mm) of the soft tissues than to the abutment material.
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Affiliation(s)
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Nicola De Angelis
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
- Dental Department, University Tunku Abdul Raman, Sungai Buloh 47000, Malaysia
- Dental Department, University Trisakti, Jakarta 11440, Indonesia
- Correspondence:
| | - Stefano Benedicenti
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
| | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
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Full-Arch Rehabilitation Using Trans-Mucosal Tissue-Level Implants with and without Implant-Abutment Units: A Case Report. Dent J (Basel) 2022; 10:dj10070116. [PMID: 35877390 PMCID: PMC9320847 DOI: 10.3390/dj10070116] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 01/27/2023] Open
Abstract
Recently, tissue-level implants with a convergent collar have been introduced. While different studies have investigated the outcomes of this implant design in the rehabilitation of single teeth, its use in full-arch rehabilitation has yet to be investigated. The present case report describes the clinical outcomes of a full-arch immediate loading rehabilitation using tissue-level implants, with and without using implant-abutment units, with 2 years of follow-up. A female patient with mandibular terminal dentition and a high level of bone resorption (distal areas with a few millimeters of residual bone in the vertical dimension and both distal and anterior areas with narrow crestal bone in the horizontal dimension) was seen at the C.I.R Dental School, Turin, Italy. The patient was seeking to be rehabilitated with fixed prosthodontics, and she was found eligible for an immediate loading implant full-arch rehabilitation. Four implants were inserted in the same appointment. The two anterior implants were inserted straight and connected directly to the prosthesis (no abutments); the two distal implants were tilted in order to avoid the alveolar nerve and connected to two 30° angulated abutments. Two years post-implant placement, all of the implants were successfully integrated, resulting in an implant survival rate of 100%. The peri-implant soft tissues were stable at all the implant sites. No differences were highlighted between those implants with and without abutments. Within the limitations of the present clinical report, implant full-arch rehabilitations with tissue-level implants both with and without implant-abutment units showed optimal outcomes after two years of follow-up. Further research is encouraged to confirm whether this implant design may be a valid alternative to traditional implants in this type of rehabilitation, with or without implant-abutment units.
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Histologic Evaluation of Soft Tissues around Dental Implant Abutments: A Narrative Review. MATERIALS 2022; 15:ma15113811. [PMID: 35683109 PMCID: PMC9181750 DOI: 10.3390/ma15113811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 01/28/2023]
Abstract
The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans. The aim of this review paper was to analyze the literature focusing on histological clinical studies in humans which have examined different materials or different surface treatments and their effects on peri-implant soft tissues. The research was conducted according to the following PICO question: “Do different implant/abutment materials affect peri-implant soft tissues adhesion and health?”. Nine articles were analyzed in this review. The results of this review show the influence of different abutment materials on the peri-implant soft tissues, and the need of further research regarding the effect that abutment materials, surface treatments, and surface properties have on soft tissues.
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11
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Radiographic evaluation of a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis. BMC Oral Health 2021; 21:655. [PMID: 34922521 PMCID: PMC8684668 DOI: 10.1186/s12903-021-02019-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background To evaluate a cross-shaped incision technique for thick-gingiva and thin-gingiva patients treated with implant-supported fixed prosthesis. Methods Total 55 patients receiving cross-shaped incision were assigned into thick-gingiva group (29 cases) and thin-gingiva group (26 cases). Follow-up was performed at 3 and 12-month after final restoration. Results Mesial and distal papilla height was significantly greater in thick-gingiva group than thin-gingiva group at 3 and 12 months, while periodontal depth and crestal marginal bone level around implant had no significant difference between the two groups during follow-up. No case of recession of buccal marginal gingiva was observed in thick-gingiva group. However, the recession of marginal gingiva of buccal aspect of the crown was found in 5 patients (19.2%) with thin-gingiva. Conclusions The cross-shaped incision may be applied to reconstruct gingival papillae and avoid the gingival recession in patients with thick-gingiva phenotype. Trial registration This study was registered at ClinicalTrials.gov (registration number NCT04706078, date 12 January 2021, Retrospectively registered).
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12
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Zheng Z, Ao X, Xie P, Zheng X, Lee K, Chen W. Nonthermal Plasma Brush Treatment on Titanium and Zirconia To Improve Periabutment Epithelium Formation. ACS Biomater Sci Eng 2021; 7:5039-5047. [PMID: 34637254 DOI: 10.1021/acsbiomaterials.1c00895] [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: 02/08/2023]
Abstract
The peri-implant soft tissue with inferior adhesion takes a long healing period to form, which is undesirable for the reaction around the peri-implant soft tissues. The aim of this study is to improve the physicochemical properties of titanium (Ti) and zirconia (ZrO2) implant abutments and shorten the formation period of periabutment epithelium tissue. A nonthermal atmospheric plasma brush (NTAPB, N) was employed for Ti and ZrO2 activation. The surface topographies, roughness, crystallinity, wettability, and chemical elements of the abutment materials were examined. The epithelial cell behavior analysis and tissue remodeling of the periabutment epithelial tissue were performed in vitro and in vivo. N-Ti and N-ZrO2 had a similar good surface wettability, with a 65 and 70% increase in oxygen content and a 70 and 75% decrease in carbon content, respectively. Both N-Ti and N-ZrO2 showed excellent adhesion, spread, and proliferation of epithelial cells in vitro, with improved adhesion molecule expression levels compared to untreated samples. N-Ti and N-ZrO2 abutments were placed in the implantation sites of rats. From week 2 to week 6 after implantation, N-Ti and N-ZrO2 had similar periabutment epithelium tissue formation, and both had increased plectin-positive and laminin γ2-positive cell numbers compared to Ti and ZrO2. The NTAPB shows promising abutment modification abilities. It promotes the expression levels of adhesion molecules and the epithelial cell performance, which later leads to a quicker formation and remodeling of the important periabutment epithelial tissue.
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Affiliation(s)
- Zheng Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiaogang Ao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Peng Xie
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Kevin Lee
- Department of Stomatology, Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
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13
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Areid N, Willberg J, Kangasniemi I, Närhi TO. Organotypic in vitro block culture model to investigate tissue-implant interface. An experimental study on pig mandible. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:136. [PMID: 34709465 PMCID: PMC8553714 DOI: 10.1007/s10856-021-06608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
In vitro studies of implant-tissue attachment are primarily based on two-dimensional cell culture models, which fail to replicate the three-dimensional native human oral mucosal tissue completely. Thus, the present study aimed to describe a novel tissue culture model using pig mandibular block including alveolar bone and gingival soft tissues to evaluate the tissue attachment to titanium implant provided with hydrothermally induced TiO2 coating. Tissue attachment on TiO2 coated and non-coated implants were compared. Ti-6Al-4V alloy posts were used to function as implants that were inserted in five pig mandibles. Implants were delivered with two different surface treatments, non-coated (NC) titanium and hydrothermal induced TiO2 coated surfaces (HT). The tissue-implant specimens were cultured at an air/liquid interface for 7 and 14 days. The tissue-implant interface was analyzed by histological and immunohistochemical stainings. The microscopic evaluation suggests that pig tissue explants established soft and hard tissue attachment to both implant surfaces. The epithelial cells appeared to attach to the coated implant. The epithelium adjacent to the implant abutment starts to change its phenotype during the early days of the healing process. New bone formation was seen within small pieces of bone in close contact with the coated implant. In conclusion, this in vitro model maintains the viability of pig tissue and allows histologically and immunohistochemically evaluate the tissue-implant interface. HT-induced TiO2 coating seems to have a favorable tissue response. Moreover, this organotypic tissue culture model is applicable for further studies with quantitative parameters to evaluate adhesion molecules present at the implant-tissue interface.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Jaana Willberg
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Pathology, Turku University Central Hospital, Turku, Finland
- Welfare Division, Oral Health Care, Turku, Finland
| | - Ilkka Kangasniemi
- Turku Clinical Biomaterials Centre (TCBC), University of Turku, Turku, Finland
| | - Timo O Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, Oral Health Care, Turku, Finland
- Turku Clinical Biomaterials Centre (TCBC), University of Turku, Turku, Finland
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14
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Wang M, Zhang S, Chen L, Zou H, Wang Y, Xia H. Early soft tissue response to zirconium oxide and titanium healing abutments in vivo: a study in dogs. BMC Oral Health 2021; 21:416. [PMID: 34429083 PMCID: PMC8383379 DOI: 10.1186/s12903-021-01748-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to investigate the clinical characteristics and early soft tissue response to zirconium oxide (Zr) and titanium (Ti) healing abutments in dogs. Methods Eight implants (four at each hemi-mandible) were inserted after bilateral mandibular third and fourth premolars and first molar extraction in dogs. Then, two Zr and two Ti healing abutments were connected to each unilateral mandible eight weeks later. The ligation method was used to create a peri-implant mucositis model and the 24 abutments were divided into four groups: Zr or Ti healing abutments with ligation (ZrL, TiL) or non-ligation (ZrN, TiN). The clinical indices, peri-implant crevicular fluid (PICF), and inflammatory cytokines (TNF-α and IL-1β) were measured and analyzed on days 0 and 28. The dogs were then sacrificed on day 28, soft tissues around the implants were harvested, and inflammation infiltration was tested by immunohistochemistry. Normal distribution test and two-way analysis of variance was used to analyze the data. Results The results showed that the clinical indices were similar for Zr and Ti healing abutments. There was significantly more PICF in the ZrL and TiL groups compared to in the ZrN and TiN groups. The TNF-α levels in PICF were significantly different between ZrL and ZrN groups on day 28. And the TNF-α levels in PICF were significantly higher in TiL group on day 28 than that on day 0. However, the number of inflammatory cells was not significantly different between the groups as measured by immunohistochemistry. Conclusions These data indicate that soft tissue responses to Zr healing abutments with peri-implant mucositis were comparable to those of Ti healing abutments in vivo, providing a theoretical foundation for the clinical application of Zr abutments.
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Affiliation(s)
- Min Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education and Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Shuang Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education and Department of Preventive Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Longjie Chen
- Lanzhou Hospital of Stomatology, Lanzhou, 730000, China
| | - Haixiao Zou
- Department of Stomatology, Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, 330006, China
| | - Yining Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education and Department of Prosthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education and Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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15
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Development of Custom Anatomic Healing Abutment Based on Cone-Beam Computer Tomography Measurement on Human Teeth Cross-Section. MATERIALS 2021; 14:ma14164570. [PMID: 34443093 PMCID: PMC8401006 DOI: 10.3390/ma14164570] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022]
Abstract
Introduction: Nowadays, the final success of implantation is not only based on obtaining osseointegration of the implant but is also determined by achieving a satisfactory aesthetic effect of the soft tissues surrounding the implant, which can be defined as an aesthetic integration. The process of obtaining this aesthetic integration already begins at the stage of placing the healing abutment, which allows us to obtain the emergence profile necessary for our prosthetic reconstruction. Materials and Methods: The study used cone-beam computer tomography (CBCT) scans of 51 patients. The measurements of the maxillary teeth (central incisor, lateral incisor, canine, first premolar, and first molar) were performed from cross-sections of the individual teeth at the transition zone to design a custom anatomic healing abutment milled from zirconium and luted to the non-index Ti-base. Results: The obtained results allowed to design and create the shape of the anatomic healing abutment. Conclusions: The use of laboratory-produced anatomical healing abutments is possible and may allow to obtain the desired and planned emergence profiles of prosthetic restorations. In addition, it might be a method of reducing work time at the dental chair but further clinical trials are necessary.
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16
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Abstract
Implant supported dental prostheses are increasingly used in dental practice. The aim of this narrative review is to present the influence of transmucosal surface of prosthetic abutment and implant on peri-implant tissue. The article describes causes of bone loss around the dental implant. Moreover, properties of different materials are compared and discussed. The advantages, disadvantages, and biomechanical concept of different implant-abutment connections are presented. The location of connections in relation to the bone level and the influence of microgap between the abutment and implant are described. Additionally, the implant abutments for cemented and screwed prosthetic restorations are compared. The influence of implant and abutment surface at the transmucosal level on peri-implant soft tissue is discussed. Finally, the biological aspect of abutment-implant connection is analyzed.
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17
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Furuhashi A, Ayukawa Y, Atsuta I, Rakhmatia YD, Koyano K. Soft Tissue Interface with Various Kinds of Implant Abutment Materials. J Clin Med 2021; 10:jcm10112386. [PMID: 34071480 PMCID: PMC8199343 DOI: 10.3390/jcm10112386] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 12/16/2022] Open
Abstract
Various materials, such as titanium, zirconia and platinum-gold (Pt-Au) alloy, have been utilized for dental implant trans-mucosal parts. However, biological understanding of soft tissue reaction toward these materials is limited. The aim of this study was to compare the response of cell lines and soft tissue to titanium, zirconia and Pt-Au substrata. The surface hydroxyl groups and protein adsorption capacities of the substrata were measured. Next, gingival epithelial-like cells (Sa3) and fibroblastic cells (NIH3T3) were cultured on the materials, and initial cell attachment was measured. Immuno-fluorescent staining of cell adhesion molecules and cytoskeletal proteins was also performed. In the rat model, experimental implants constructed from various materials were inserted into the maxillary tooth extraction socket and the soft tissue was examined histologically and immunohistochemically. No significant differences among the materials were observed regarding the amount of surface hydroxyl groups and protein adsorption capacity. Significantly fewer cells of Sa3 and NIH3T3 adhered to the Pt-Au alloy compared to the other materials. The expression of cell adhesion molecules and a well-developed cytoskeleton was observed, both Sa3 and NIH3T3 on each material. In an animal model, soft tissue with supracrestal tissue attachment was observed around each material. Laminin-5 immuno-reactivity was seen in epithelia on both titanium and zirconia, but only in the bottom of epithelia on Pt-Au alloy. In conclusion, both titanium and zirconia, but not Pt-Au alloy, displayed excellent cell adhesion properties.
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Affiliation(s)
- Akihiro Furuhashi
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (Y.A.); (Y.D.R.)
- Correspondence: ; Tel.: +81-92-642-6441
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (Y.A.); (Y.D.R.)
| | - Ikiru Atsuta
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (I.A.); (K.K.)
| | - Yunia Dwi Rakhmatia
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (Y.A.); (Y.D.R.)
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (I.A.); (K.K.)
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18
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Kunrath MF, Gupta S, Lorusso F, Scarano A, Noumbissi S. Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review. MATERIALS 2021; 14:ma14112825. [PMID: 34070589 PMCID: PMC8198172 DOI: 10.3390/ma14112825] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 12/20/2022]
Abstract
Background: Dental components manufactured with zirconia (ZrO2) represent a significant percentage of the implant prosthetic market in dentistry. However, during the last few years, we have observed robust clinical and pre-clinical scientific investigations on zirconia both as a prosthetic and an implantable material. At the same time, we have witnessed consistent technical and manufacturing updates with regards to the applications of zirconia which appear to gradually clarify points which until recently were not well understood. Methods: This critical review evaluated the “state of the art” in relation to applications of this biomaterial in dental components and its interactions with oral tissues. Results: The physico-chemical and structural properties as well as the current surface treatment methodologies for ZrO2 were explored. A critical investigation of the cellular response to this biomaterial was completed and the clinical implications discussed. Finally, surface treatments of ZrO2 demonstrate that excellent osseointegration is possible and provide encouraging prospects for rapid bone adhesion. Furthermore, sophisticated surface treatment techniques and technologies are providing impressive oral soft tissue cell responses thus leading to superior biological seal. Conclusions: Dental devices manufactured from ZrO2 are structurally and chemically stable with biocompatibility levels allowing for safe and long-term function in the oral environment.
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Affiliation(s)
- Marcel F. Kunrath
- Dentistry Department, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil;
- Materials and Nanoscience Laboratory, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil
| | - Saurabh Gupta
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Master Dental Science, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
| | - Antonio Scarano
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
- Correspondence: ; Tel.: +08713554084
| | - Sammy Noumbissi
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
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19
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Borie M, Lecloux G, Bosshardt D, Barrantes A, Haugen HJ, Lambert F, Bacevic M. Peri-implant soft tissue integration in humans - influence of materials: A study protocol for a randomised controlled trial and a pilot study results. Contemp Clin Trials Commun 2020; 19:100643. [PMID: 33083628 PMCID: PMC7554019 DOI: 10.1016/j.conctc.2020.100643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/15/2020] [Accepted: 08/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background Recently, there has been a growing interest in mucointegration as the formation of an early and long-standing soft tissue barrier seems essential for both the initial healing and long-term implant survival. Aim To develop an experimental method to characterize the mucointegration of different transgingival materials (titanium (Ti), polyetheretherketone (PEEK), polymethylmethacrylate (PMMA), zirconia (Zi), polymer infiltrated ceramic network (PICN), cobalt-chrome (Co–Cr), and lithium disilicate (LD)) in a human model. Methods The study is designed as a multi-part randomized controlled clinical trial. Ninety bone level Straumann implants will randomly receive an experimental, custom-made abutment to allow for the removal of the abutment together with the surrounding soft tissues using a punch biopsy device at 8 weeks of healing (10 per material). The specimens will be further processed for non‐decalcified histology, followed by histomorphometric analysis. The same protocol will be used for additional 90 implants-abutments, but during harvesting, soft tissues will be separated from the abutment and processed for immunohistochemistry in order to study tissue inflammation and vascularization, while the abutments will undergo SEM analysis. Additionally, in vitro analyses, including SEM and profilometry, will be performed in order to characterize surface topography of all experimental materials. Conclusion The limited number of pilot samples presented herein indicate that the use of custom-made abutments in humans is a reproducible method to study peri-implant soft tissue integration. This further intensifies the rationale to compare different abutment materials, used as transgingival components in daily practice, under the same conditions.
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Affiliation(s)
- Manon Borie
- Department of Periodontology and Oral Surgery, University Hospital of Liège, Belgium
| | - Geoffrey Lecloux
- Department of Periodontology and Oral Surgery, University Hospital of Liège, Belgium
| | - Dieter Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Switzerland
| | - Alejandro Barrantes
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Norway
| | - France Lambert
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium; Department of Periodontology and Oral Surgery, University Hospital of Liège, Belgium
| | - Miljana Bacevic
- Dental Biomaterials Research Unit, Faculty of Medicine, University of Liège, Belgium
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20
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Pansani TN, Basso FG, de Souza Costa CA. In vitro effects of photobiomodulation applied to gingival fibroblasts cultured on titanium and zirconia surfaces and exposed to LPS from Escherichia coli. Lasers Med Sci 2020; 35:2031-2038. [PMID: 32533469 DOI: 10.1007/s10103-020-03062-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/04/2020] [Indexed: 12/18/2022]
Abstract
Photobiomodulation (PBM) therapy is used to stimulate cell proliferation and metabolism, as well as reduce inflammatory cytokine synthesis, which plays a main role in the long-term stability of implants. This study assessed the response of gingival fibroblasts cultured on titanium (Ti) and zirconia (ZrO2), submitted to PBM and exposed to lipopolysaccharide (LPS). Cells seeded on Ti and ZrO2 were irradiated (InGaAsP; 780 nm, 25 mW) 3 times, using 0.5, 1.5, and 3.0 J/cm2 doses, and exposed to Escherichia coli LPS (1 μg/mL). After 24 h, cell viability (alamarBlue, n = 8), interleukin 6 (IL-6) and 8 (IL-8) synthesis (ELISA, n = 6), and IL-6 and vascular endothelial growth factor (VEGF) gene expression (qPCR, n = 5) were assessed and statistically analyzed (one-way ANOVA, α = 0.05). Cell morphology was evaluated by fluorescence microscopy. Increased cell viability occurred in all groups cultured on Ti compared with that of the control, except for cells exposed to LPS. Fibroblasts cultured on ZrO2 and LPS-exposed exhibited reduced viability. PBM at 3.0 J/cm2 and 1.5 J/cm2 downregulated the IL-6 synthesis by fibroblasts seeded on Ti and ZrO2, as well as IL-8 synthesis by cells seeded on ZrO2. Fibroblasts seeded on both surfaces and LPS-exposed showed increased IL-6 gene expression; however, this activity was downregulated when fibroblasts were irradiated at 3.0 J/cm2. Enhanced VEGF gene expression by cells seeded on Ti and laser-irradiated (3.0 J/cm2). Distinct patterns of cytoskeleton occurred in laser-irradiated cells exposed to LPS. Specific parameters of PBM can biomodulate the inflammatory response of fibroblasts seeded on Ti or ZrO2 and exposed to LPS.
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Affiliation(s)
- Taisa Nogueira Pansani
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, UNESP-Univ. Estadual Paulista, Araraquara, SP, Brazil
| | | | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara School of Dentistry, UNESP-Univ. Estadual Paulista, Humaita, 1680. Centro, Araraquara, SP, 14801-903, Brazil.
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21
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Maminskas J, Pilipavicius J, Staisiunas E, Baranovas G, Alksne M, Daugela P, Juodzbalys G. Novel Yttria-Stabilized Zirconium Oxide and Lithium Disilicate Coatings on Titanium Alloy Substrate for Implant Abutments and Biomedical Application. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E2070. [PMID: 32365921 PMCID: PMC7254192 DOI: 10.3390/ma13092070] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 12/30/2022]
Abstract
This study aimed to create novel bioceramic coatings on a titanium alloy and evaluate their surface properties in comparison with conventional prosthetic materials. The highly polished titanium alloy Ti6Al4V (Ti) was used as a substrate for yttria-stabilized zirconium oxide (3YSZ) and lithium disilicate (LS2) coatings. They were generated using sol-gel strategies. In comparison, highly polished surfaces of Ti, yttria-stabilized zirconium oxide (ZrO2), polyether ether ketone (PEEK) composite, and poly(methyl methacrylate) (PMMA) were utilized. Novel coatings were characterized by an X-ray diffractometer (XRD) and scanning electron microscope (SEM). The roughness by atomic force microscope (AFM), water contact angle (WCA), and surface free energy (SFE) were determined. Additionally, biocompatibility and human gingival fibroblast (HGF) adhesion processes (using a confocal laser scanning microscope (CLSM)) were observed. The deposition of 3YSZ and LS2 coatings changed the physicochemical properties of the Ti. Both coatings were biocompatible, while Ti-3YSZ demonstrated the most significant cell area of 2630 μm2 (p ≤ 0.05) and the significantly highest, 66.75 ± 4.91, focal adhesions (FAs) per cell after 24 h (p ≤ 0.05). By contrast, PEEK and PMMA demonstrated the highest roughness and WCA and the lowest results for cellular response. Thus, Ti-3YSZ and Ti-LS2 surfaces might be promising for biomedical applications.
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Affiliation(s)
- Julius Maminskas
- Department of Prosthodontics, Lithuanian University of Health Sciences, 50106 Kaunas, Lithuania
| | - Jurgis Pilipavicius
- Department of Chemical Engineering and Technology, Center for Physical Sciences and Technology (FTMC), 02300 Vilnius, Lithuania;
- Faculty of Chemistry and Geosciences, Vilnius University, 10257 Vilnius, Lithuania; (E.S.); (G.B.)
| | - Edvinas Staisiunas
- Faculty of Chemistry and Geosciences, Vilnius University, 10257 Vilnius, Lithuania; (E.S.); (G.B.)
| | - Gytis Baranovas
- Faculty of Chemistry and Geosciences, Vilnius University, 10257 Vilnius, Lithuania; (E.S.); (G.B.)
| | - Milda Alksne
- Institute of Biochemistry, Life Sciences Center, Vilnius University, 10257 Vilnius, Lithuania;
| | - Povilas Daugela
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, 50140 Kaunas, Lithuania; (P.D.); (G.J.)
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, 50140 Kaunas, Lithuania; (P.D.); (G.J.)
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22
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Canullo L, Genova T, Gross Trujillo E, Pradies G, Petrillo S, Muzzi M, Carossa S, Mussano F. Fibroblast Interaction with Different Abutment Surfaces: In Vitro Study. Int J Mol Sci 2020; 21:ijms21061919. [PMID: 32168919 PMCID: PMC7139398 DOI: 10.3390/ijms21061919] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Attaining an effective mucosal attachment to the transmucosal part of the implant could protect the peri-implant bone. Aim: To evaluate if chair side surface treatments (plasma of Argon and ultraviolet light) may affect fibroblast adhesion on different titanium surfaces designed for soft tissue healing. Methods: Grade 5 titanium discs with four different surface topographies were subdivided into 3 groups: argon-plasma; ultraviolet light, and no treatment. Cell morphology and adhesion tests were performed at 20 min, 24 h, and 72 h. Results: Qualitative observation of the surfaces performed at the SEM was in accordance with the anticipated features. Roughness values ranged from smooth (MAC Sa = 0.2) to very rough (XA Sa = 21). At 20 min, all the untreated surfaces presented hemispherical cells with reduced filopodia, while the cells on treated samples were more spread with broad lamellipodia. However, these differences in spreading behavior disappeared at 24 h and 72 h. Argon-plasma, but not UV, significantly increased the number of fibroblasts independently of the surface type but only at 20 min. Statistically, there was no surface in combination with a treatment that favored a greater cellular adhesion. Conclusions: Data showed potential biological benefits of treating implant abutment surfaces with the plasma of argon in relation to early-stage cell adhesion.
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Affiliation(s)
- Luigi Canullo
- Private Practice, Via Nizza, 46, 00198 Rome, Italy
- Correspondence: ; Tel.: +39-347-6201-976
| | - Tullio Genova
- Department of Life Sciences and Systems Biology, University of Torino, 10126 Turin, Italy;
- CIR Dental School—Department of Surgical Sciences, University of Torino, Via Nizza 230, 10126 Turin, Italy; (S.C.); (F.M.)
| | - Esperanza Gross Trujillo
- Department of Buccofacial Prosthesis, University Complutense, 28040 Madrid, Spain; (E.G.T.); (G.P.)
| | - Guillermo Pradies
- Department of Buccofacial Prosthesis, University Complutense, 28040 Madrid, Spain; (E.G.T.); (G.P.)
| | - Sara Petrillo
- Department of Molecular Biotechnology and Health Sciences, University of Rome III, 00133 Rome, Italy;
| | - Maurizio Muzzi
- Department of Science, University of Rome III, 00133 Rome, Italy;
| | - Stefano Carossa
- CIR Dental School—Department of Surgical Sciences, University of Torino, Via Nizza 230, 10126 Turin, Italy; (S.C.); (F.M.)
| | - Federico Mussano
- CIR Dental School—Department of Surgical Sciences, University of Torino, Via Nizza 230, 10126 Turin, Italy; (S.C.); (F.M.)
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23
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Sanchez-Perez A, Nicolas-Silvente AI, Sanchez-Matas C, Cascales-Pina E, Macia-Manresa V, Romanos GE. Control of Peri-Implant Mucous Inflammation by Using Chlorhexidine or Ultraviolet C Radiation for Cleaning Healing Abutments. Double-Blind Randomized Clinical Trial. MATERIALS 2020; 13:ma13051124. [PMID: 32138236 PMCID: PMC7084961 DOI: 10.3390/ma13051124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/25/2023]
Abstract
Two-phase implants must be exposed to the external environment after the period of osteointegration has elapsed. For this purpose, a healing abutment is placed passing through the mucosa while forming the emergence profile. The continuous connection and disconnection can lead to an alteration in the tissue maturation, both because of the contact of bacterial plaque and because of the mechanical trauma that involves its manipulation, manifesting with different degrees of erythema or bleeding. To assess whether this epithelium disruption can be counteracted, a blinded study design was developed on 150 unitary implant patients divided into three groups (n = 50), applying chlorhexidine (group 1), ultraviolet C (UV-C) at a wavelength of 254 nm (group 2)and no treatment as a control group (group 3), during each of the disconnections and connections during the prosthodontic treatment (1 time per week for four weeks). All groups showed a better epithelium aspect at the end of the evaluation. Although there were no statistically significant differences in the degree of inflammation, the UV-C treated group had the lowest plaque accumulation, and the highest was for the chlorhexidine-treated group.
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Affiliation(s)
- Arturo Sanchez-Perez
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Ana I. Nicolas-Silvente
- D.D.S., Department of Restorative Dentistry, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain
- Correspondence: ; Tel.: +34-96824-7946
| | | | - Elena Cascales-Pina
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Vanesa Macia-Manresa
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Georgios E. Romanos
- D.D.S., Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794-8712, USA;
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Kim JJ, Lee JH, Kim JC, Lee JB, Yeo ISL. Biological Responses to the Transitional Area of Dental Implants: Material- and Structure-Dependent Responses of Peri-Implant Tissue to Abutments. MATERIALS 2019; 13:ma13010072. [PMID: 31877848 PMCID: PMC6981768 DOI: 10.3390/ma13010072] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 12/12/2022]
Abstract
The stability of peri-implant tissue is essential for the long-term success of dental implants. Although various types of implant connections are used, little is known about the effects of the physical mechanisms of dental implants on the stability of peri-implant tissue. This review summarizes the relevant literature to establish guidelines regarding the effects of connection type between abutments and implants in soft and hard tissues. Soft tissue seals can affect soft tissue around implants. In external connections, micromobility between the abutment and the hex component of the implant, resulting from machining tolerance, can destroy the soft tissue seal, potentially leading to microbial invasion. Internal friction connection implants induce strain on the surrounding bone via implant wall expansion that translates into masticatory force. This strain is advantageous because it increases the amount and quality of peri-implant bone. The comparison of internal and external connections, the two most commonly used connection types, reveals that internal friction has a positive influence on both soft and hard tissues.
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Affiliation(s)
- Jung-Ju Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea; (J.-J.K.); (J.C.K.); (J.-B.L.)
| | - Jae-Hyun Lee
- Department of Prosthodontics, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul 03080, Korea;
| | - Jeong Chan Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea; (J.-J.K.); (J.C.K.); (J.-B.L.)
| | - Jun-Beom Lee
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea; (J.-J.K.); (J.C.K.); (J.-B.L.)
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-2661
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Cabanes-Gumbau G, Pascual-Moscardó A, Peñarrocha-Oltra D, García-Mira B, Aizcorbe-Vicente J, Peñarrocha-Diago MA. Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT). Med Oral Patol Oral Cir Bucal 2019; 24:e643-e651. [PMID: 31422410 PMCID: PMC6764706 DOI: 10.4317/medoral.22946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 05/20/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading. MATERIAL AND METHODS A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3. RESULTS A mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3. CONCLUSIONS The fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin.
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Affiliation(s)
- G Cabanes-Gumbau
- Departamento de Estomatología, Universitat de València, C/ Gascó Oliag 1, 46010 - Valencia (Spain),
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The Effect of Tapered Abutments on Marginal Bone Level: A Retrospective Cohort Study. J Clin Med 2019; 8:jcm8091305. [PMID: 31450607 PMCID: PMC6780335 DOI: 10.3390/jcm8091305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/17/2019] [Accepted: 08/20/2019] [Indexed: 01/16/2023] Open
Abstract
Background: Early peri-implant bone loss has been associated to long-term implant-prosthetic failure. Different technical, surgical, and prosthetic techniques have been introduced to enhance the clinical outcome of dental implants in terms of crestal bone preservation. The aim of the present cohort study was to observe the mean marginal bone level around two-part implants with gingivally tapered abutments one year after loading. Methods: Mean marginal bone levels and change were computed following radiological calibration and linear measurement on standardized radiographs. Results: Twenty patients who met the inclusion criterion of having at least one implant with the tapered prosthetic connection were included in the study. The cumulative implant success rate was 100%, the average bone loss was −0.18 ± 0.72 mm, with the final bone level sitting above the implant platform most of the time (+1.16 ± 0.91 mm). Conclusion: The results of this cohort study suggested that implants with tapered abutments perform successfully one year after loading and that they are associated with excellent marginal bone preservation, thus suggesting that implant-connection macro-geometry might have a crucial role in dictating peri-implant bone levels.
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Thoma DS, Jung UW, Gil A, Kim MJ, Paeng KW, Jung RE, Fickl S. The effects of hard and soft tissue grafting and individualization of healing abutments at immediate implants: an experimental study in dogs. J Periodontal Implant Sci 2019; 49:171-184. [PMID: 31285941 PMCID: PMC6599753 DOI: 10.5051/jpis.2019.49.3.171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa (0.88±0.48 mm and 0.37±1.1 mm, respectively). The IA and IAG groups exhibited an apical shift of the mucosa (−0.7±1.15 mm and −1.1±0.96 mm, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of 4.1±0.28 mm and 4.0±0.53 mm relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6 mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group (−0.73±0.46 mm) lost less volume on the buccal side than the control (−0.93±0.44 mm), SA (−0.97±0.73 mm), and IAG (−0.88±0.45 mm) groups. Conclusions The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Alfonso Gil
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Stefan Fickl
- Department of Periodontology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
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Gehrke P, Bleuel K, Fischer C, Sader R. Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study. BMC Oral Health 2019; 19:111. [PMID: 31200680 PMCID: PMC6567410 DOI: 10.1186/s12903-019-0809-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background The flexibility in designing the submucosal part of CAD/CAM customized implant abutments and the individual positioning of its shoulder line has been suggested to reduce the risk of leaving undetected cement residues, thus preventing adverse effects on peri-implant tissues. A high correlation between excess cement left in the soft tissues and the occurrence of increased biofilm accumulation with sulcular bleeding and/ or suppuration has been reported. This in turn may cause peri-implant inflammation and peri-implant marginal bone loss. The aim of this study was to assess the frequency of cement remnants after the luting of zirconia crowns on CAD/CAM custom molar abutments with different margin levels and to evaluate the impact of the luting material. Material and methods A total of 20 titanium molar CAD/CAM implant abutments (BEGO Medical GmbH) with internal taper connection/ internal hex anti-rotation protection, and a convex emergence profile with different margin positions (0, 1, 2 and 3 mm below the mucosa), were virtually designed (Implant Studio, 3Shape) and manufactured. A master cast was scanned, duplicated by a 3D printer and individual gingival masks were produced to simulate peri-implant soft tissues. 20 corresponding zirconia crowns were designed (Cerec 3D, Dentsply Sirona), produced and cemented to the abutments with two different luting materials; a zinc oxide non-eugenol cement (Temp Bond NE) or a methacrylate cement (Panavia V5). To ensure retrievability of the crown/abutment connection, occlusal openings providing access to the abutment screws were designed. Excess cement was thoroughly removed and the crown/abutment units were unscrewed to evaluate the occurrence of cement residues. All the quadrants of each specimen were evaluated for calculation of the ratio between the cement remnant area and the total specimen area using Adobe Photoshop. Spearman analysis was performed to detect correlations between different variables. A two-sided t-test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests were applied to detect differences between the groups. Results Cement remnants were found in every depth of the crown abutment complex and in almost every area investigated. The amount of cement residues increased as the crown-abutment margin was located more submucosally. Lingual areas were more prone to cement remnants than other surface areas (p = 0.0291). Excess cement was not only found at the margins of the crown-abutment complex, but also underneath (basal) the abutment itself, where cleaning was impossible. No statistical difference in the effect of zinc oxide non-eugenol- and methacrylate cement on the frequency of excess material at the lateral abutment surfaces could be demonstrated in vitro. The proportion of basal abutment aspects covered with cement residues was, however, significantly smaller in Panavia V5 samples with an average of 4.9 ± 3.7% compared to Temp Bond samples with an average of 8.6 ± 5.5%. Conclusions Given the results obtained in the present investigation the margin of CAD/CAM molar abutments should be located as coronally as possible to minimize the amount of cement remnants. If an epigingival or supragingival margin location is not feasible due to esthetic concerns, it cannot be recommended to place the margin of molar CAD/CAM abutments deeper than 1.5 mm in the proximal and oral regions.
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Affiliation(s)
- Peter Gehrke
- Private Practice for Oral surgery and Implant Dentsitry, Bismarckstraße 27, 67059, Ludwigshafen, Germany. .,Department of Postgraduate Education, Oral and Dental Medicine, Johann Wolfgang Goethe-University, Frankfurt, Germany.
| | | | | | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt, Germany
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Weigl P, Trimpou G, Grizas E, Hess P, Nentwig GH, Lauer HC, Lorenz J. All-ceramic versus titanium-based implant supported restorations: Preliminary 12-months results from a randomized controlled trial. J Adv Prosthodont 2019; 11:48-54. [PMID: 30847049 PMCID: PMC6400706 DOI: 10.4047/jap.2019.11.1.48] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/10/2018] [Accepted: 01/21/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of the present randomized controlled study was to compare prefabricated all-ceramic, anatomically shaped healing abutments followed by all-ceramic abutments and all-ceramic crowns and prefabricated standard-shaped (round-diameter) titanium healing abutments followed by final titanium abutments restored with porcelain-fused-to-metal (PFM) implant crowns in the premolar and molar regions. MATERIALS AND METHODS Forty-two patients received single implants restored either by all-ceramic restorations (test group, healing abutment, final abutment, and crown all made of zirconia) or conventional titanium-based restorations. Immediately after prosthetic incorporation and after 12 months of loading, implant survival, technical complications, bone loss, sulcus fluid flow rate (SFFR) as well as plaque index (PI) and implant stability (Periotest) were analyzed clinically and radiologically. RESULTS After 12 months of loading, an implant and prosthetic survival rate of 100% was observed. Minor prosthetic complications such as chipping of ceramic veneering occurred in both groups. No statistical significant differences were observed between both groups with only a minimum of bone loss, SFFR, and PI. CONCLUSION All-ceramic implant prostheses including a prefabricated anatomically shaped healing abutment achieved comparable results to titanium-based restorations in the posterior region. However, observational results indicate a benefit as shaping the peri-implant soft-tissue with successive provisional devices and subsequent compression of the soft tissue can be avoided.
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Affiliation(s)
- Paul Weigl
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Georgia Trimpou
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Eleftherios Grizas
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Pablo Hess
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Georg-Hubertus Nentwig
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Hans-Christoph Lauer
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Jonas Lorenz
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
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Hao Y, Huang X, Zhou X, Li M, Ren B, Peng X, Cheng L. Influence of Dental Prosthesis and Restorative Materials Interface on Oral Biofilms. Int J Mol Sci 2018; 19:E3157. [PMID: 30322190 PMCID: PMC6213966 DOI: 10.3390/ijms19103157] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/29/2018] [Accepted: 10/10/2018] [Indexed: 01/17/2023] Open
Abstract
Oral biofilms attach onto both teeth surfaces and dental material surfaces in oral cavities. In the meantime, oral biofilms are not only the pathogenesis of dental caries and periodontitis, but also secondary caries and peri-implantitis, which would lead to the failure of clinical treatments. The material surfaces exposed to oral conditions can influence pellicle coating, initial bacterial adhesion, and biofilm formation, due to their specific physical and chemical characteristics. To define the effect of physical and chemical characteristics of dental prosthesis and restorative material on oral biofilms, we discuss resin-based composites, glass ionomer cements, amalgams, dental alloys, ceramic, and dental implant material surface properties. In conclusion, each particular chemical composition (organic matrix, inorganic filler, fluoride, and various metallic ions) can enhance or inhibit biofilm formation. Irregular topography and rough surfaces provide favorable interface for bacterial colonization, protecting bacteria against shear forces during their initial reversible binding and biofilm formation. Moreover, the surface free energy, hydrophobicity, and surface-coating techniques, also have a significant influence on oral biofilms. However, controversies still exist in the current research for the different methods and models applied. In addition, more in situ studies are needed to clarify the role and mechanism of each surface parameter on oral biofilm development.
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Affiliation(s)
- Yu Hao
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Xiaoyu Huang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Biao Ren
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Xian Peng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China.
- National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
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Rizo-Gorrita M, Luna-Oliva I, Serrera-Figallo MÁ, Gutiérrez-Pérez JL, Torres-Lagares D. Comparison of Cytomorphometry and Early Cell Response of Human Gingival Fibroblast (HGFs) between Zirconium and New Zirconia-Reinforced Lithium Silicate Ceramics (ZLS). Int J Mol Sci 2018; 19:E2718. [PMID: 30208663 PMCID: PMC6164961 DOI: 10.3390/ijms19092718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 02/07/2023] Open
Abstract
New zirconia-reinforced lithium silicate ceramics (ZLS) could be a viable alternative to zirconium (Y-TZP) in the manufacture of implantological abutments-especially in aesthetic cases-due to its good mechanical, optical, and biocompatibility properties. Although there are several studies on the ZLS mechanical properties, there are no studies regarding proliferation, spreading, or cytomorphometry. We designed the present study which compares the surface, cellular proliferation, and cellular morphology between Y-TZP (Vita YZ® T [Vita Zahnfabrik (Postfach, Germany)]) and ZLS (Celtra® Duo [Degudent (Hanau-Wolfgang, Germany)]). The surface characterization was performed with energy dispersive spectroscopy (EDS), scanning electron microscopy (SEM), and optical profilometry. Human gingival fibroblasts (HGFs) were subsequently cultured on both materials and early cellular response and cell morphology were compared through nuclear and cytoskeletal measurement parameters using confocal microscopy. The results showed greater proliferation and spreading on the surface of Y-TZP. This could indicate that Y-TZP continues to be a gold standard in terms of transgingival implant material: Nevertheless, more in vitro and in vivo research is necessary to confirm the results obtained in this study.
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Affiliation(s)
- María Rizo-Gorrita
- Department of Oral Surgery, College of Dentistry, Seville University, Calle de Avicena s/n, 41009 Seville, Spain.
| | - Irene Luna-Oliva
- Department of Oral Surgery, College of Dentistry, Seville University, Calle de Avicena s/n, 41009 Seville, Spain.
| | | | - José-Luis Gutiérrez-Pérez
- Department of Oral Surgery, College of Dentistry, Seville University, Calle de Avicena s/n, 41009 Seville, Spain.
| | - Daniel Torres-Lagares
- Department of Oral Surgery, College of Dentistry, Seville University, Calle de Avicena s/n, 41009 Seville, Spain.
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Xu R, Hu X, Yu X, Wan S, Wu F, Ouyang J, Deng F. Micro-/nano-topography of selective laser melting titanium enhances adhesion and proliferation and regulates adhesion-related gene expressions of human gingival fibroblasts and human gingival epithelial cells. Int J Nanomedicine 2018; 13:5045-5057. [PMID: 30233172 PMCID: PMC6129016 DOI: 10.2147/ijn.s166661] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Selective laser melting (SLM) titanium is an ideal option to manufacture customized implants with suitable surface modification to improve its bioactivity. The peri-implant soft tissues form a protective tissue barrier for the underlying osseointegration. Therefore, original microrough SLM surfaces should be treated for favorable attachment of surrounding soft tissues. Material and methods In this study, anodic oxidation (AO) was applied on the microrough SLM titanium substrate to form TiO2 nanotube arrays. After that, calcium phosphate (CaP) nanoparticles were embedded into the nanotubes or the interval of nanotubes by electrochemical deposition (AOC). These two samples were compared to untreated (SLM) samples and accepted mechanically polished (MP) SLM titanium samples. Scanning electron microscopy, energy dispersive spectrometry, X-ray diffraction, surface roughness, and water contact angle measurements were used for surface characterization. The primary human gingival epithelial cells (HGECs) and human gingival fibroblasts (HGFs) were cultured for cell assays to determine adhesion, proliferation, and adhesion-related gene expressions. Results For HGECs, AOC samples showed significantly higher adhesion, proliferation, and adhesion-related gene expressions than AO and SLM samples (P<0.05) and similar exceptional ability in above aspects to MP samples. At the same time, AOC samples showed the highest adhesion, proliferation, and adhesion-related gene expressions for HGFs (P<0.05). Conclusion By comparison between each sample, we could confirm that both anodic oxidation and CaP nanoparticles had improved bioactivity, and their combined utilization may likely be superior to mechanical polishing, which is most commonly used and widely accepted. Our results indicated that creating appropriate micro-/nano-topographies can be an effective method to affect cell behavior and increase the stability of the peri-implant mucosal barrier on SLM titanium surfaces, which contributes to its application in dental and other biomedical implants.
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Affiliation(s)
- Ruogu Xu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
| | - Xiucheng Hu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
| | - Xiaolin Yu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
| | - Shuangquan Wan
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
| | - Fan Wu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
| | - Jianglin Ouyang
- Guangzhou Institute of Advanced Technology, Chinese Academy of Science, Guangzhou, PR China.,Guangzhou Janus Biotechnology Co., Ltd, Chinese Academy of Sciences, Guangzhou, PR China
| | - Feilong Deng
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China, .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China,
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Lim HC, Jung RE, Hämmerle CHF, Kim MJ, Paeng KW, Jung UW, Thoma DS. Tissue integration of zirconia and titanium implants with and without buccal dehiscence defects. J Periodontal Implant Sci 2018; 48:182-192. [PMID: 29984048 PMCID: PMC6031763 DOI: 10.5051/jpis.2018.48.3.182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/11/2018] [Indexed: 11/16/2022] Open
Abstract
Purpose The purpose of the present study was to validate an experimental model for assessing tissue integration of titanium and zirconia implants with and without buccal dehiscence defects. Methods In 3 dogs, 5 implants were randomly placed on both sides of the mandibles: 1) Z1: a zirconia implant (modified surface) within the bony housing, 2) Z2: a zirconia implant (standard surface) within the bony housing, 3) T: a titanium implant within the bony housing, 4) Z1_D: a Z1 implant placed with a buccal bone dehiscence defect (3 mm), and 5) T_D: a titanium implant placed with a buccal bone dehiscence defect (3 mm). The healing times were 2 weeks (one side of the mandible) and 6 weeks (the opposite side). Results The dimensions of the peri-implant soft tissue varied depending on the implant and the healing time. The level of the mucosal margin was located more apically at 6 weeks than at 2 weeks in all groups, except group T. The presence of a buccal dehiscence defect did not result in a decrease in the overall soft tissue dimensions between 2 and 6 weeks (4.80±1.31 and 4.3 mm in group Z1_D, and 4.47±1.06 and 4.5±1.37 mm in group T_D, respectively). The bone-to-implant contact (BIC) values were highest in group Z1 at both time points (34.15%±21.23% at 2 weeks, 84.08%±1.33% at 6 weeks). The buccal dehiscence defects in groups Z1_D and T_D showed no further bone loss at 6 weeks compared to 2 weeks. Conclusions The modified surface of Z1 demonstrated higher BIC values than the surface of Z2. There were minimal differences in the mucosal margin between 2 and 6 weeks in the presence of a dehiscence defect. The present model can serve as a useful tool for studying peri-implant dehiscence defects at the hard and soft tissue levels.
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Affiliation(s)
- Hyun-Chang Lim
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ronald Ernst Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | | | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Daniel Stefan Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Areid N, Peltola A, Kangasniemi I, Ballo A, Närhi TO. Effect of ultraviolet light treatment on surface hydrophilicity and human gingival fibroblast response on nanostructured titanium surfaces. Clin Exp Dent Res 2018; 4:78-85. [PMID: 29955391 PMCID: PMC6010723 DOI: 10.1002/cre2.108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/04/2018] [Accepted: 04/02/2018] [Indexed: 01/19/2023] Open
Abstract
This study was designed to investigate the effect of nanostructured TiO2 coatings on human gingival fibroblast and to explore the influence of ultraviolet (UV) light on surface wettability and cellular response. Ti-6Al-4V titanium alloy discs (n = 96) were divided into three groups: a sol-gel-derived MetAlive™ (MA) coating; hydrothermal (HT) coating; and a non-coated (NC) group. Forty-eight titanium substrates were further treated with UV light for 15 min. The water contact angles of the substrates were measured using the sessile drop method. Human gingival fibroblasts were used to evaluate the cell adhesion strength and cell proliferation on experimental surfaces. The strength of cell adhesion against enzymatic detachment was studied after 6 hr of adhesion using gentle trypsinization for 15 min at room temperature. A fluorescence microscope was used for cell imaging (Zeiss-stereo-lumar-v12), and images were analyzed for cell counting, and the percentage of detached cells were calculated. The proliferation of cultured cells up to 10 days was determined according to the cell activity using Alamar Blue™assay. The HT group had the lowest contact angle value (31.1°) followed by MetAlive™ (35.3°), whereas the NC group had the highest contact angle (50.3°). After UV light treatment, all surfaces become considerably more hydrophilic. There was a significant difference in the amount of adherent cells between sol-gel and HT groups when compared with the NC group (p < .05) with detachment percentages of 35.8%, 36.4%, and 70.7%, respectively. All substrate types showed an increase in cell proliferation rate until 10 days. It can be concluded that nanostructured titanium oxide implant surfaces, obtained by sol-gel and HT coating methods, enhance the surface wettability and improve human gingival fibroblast function in terms of adhesion and proliferation rate when compared with non-coated surfaces. UV light treatment clearly enhances the wettability of all titanium surfaces.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry, Stomatognathic PhysiologyUniversity of TurkuTurkuFinland
| | - Ari Peltola
- Turku Clinical Biomaterials CentreUniversity of TurkuTurkuFinland
| | | | - Ahmed Ballo
- Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, Faculty of DentistryUniversity of British ColumbiaBCCanada
| | - Timo O. Närhi
- Department of Prosthetic Dentistry, Stomatognathic PhysiologyUniversity of TurkuTurkuFinland
- Department of Oral and Maxillofacial DiseaseTurku University HospitalTurkuFinland
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Datte CE, Tribst JPM, Dal Piva AMDO, Nishioka RS, Bottino MA, Evangelhista ADM, Monteiro FMDM, Borges ALS. Influence of different restorative materials on the stress distribution in dental implants. J Clin Exp Dent 2018; 10:e439-e444. [PMID: 29849967 PMCID: PMC5971074 DOI: 10.4317/jced.54554] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/21/2018] [Indexed: 11/06/2022] Open
Abstract
Background To assist clinicians in deciding the most suitable restorative materials to be used in the crowns and abutment in implant rehabilitation. Material and Methods For finite element analysis (FEA), a regular morse taper implant was created using a computer aided design software. The implant was inserted at the bone model with 3 mm of exposed threads. An anatomic prosthesis representing a first maxillary molar was modeled and cemented on the solid abutment. Considering the crown material (zirconia, chromium-cobalt, lithium disilicate and hybrid ceramic) and abutment (Titanium and zirconia), the geometries were multiplied, totaling eight groups. In order to perform the static analysis, the contacts were considered bonded and each material was assigned as isotropic. An axial load (200 N) was applied on the crown and fixation occurred on the base of the bone. Results using Von-Mises criteria and micro strain values were obtained. A sample identical to the CAD model was made for the Strain Gauge (SG) analysis; four SGs were bonded around the implant to obtain micro strain results in bone tissue. Results FEA results were 3.83% lower than SG. According to the crown material, it is possible to note that the increase of elastic modulus reduces the stress concentration in all system without difference for bone. Conclusions Crown materials with high elastic modulus are able to decrease the stress values in the abutments while concentrates the stress in its structure. Zirconia abutments tend to concentrate more stress throughout the prosthetic system and may be more susceptible to mechanical problems than titanium. Key words:Finite element analysis, dental implants, ceramic.
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Affiliation(s)
- Carlos-Eduardo Datte
- DDs, MSc, PhD student at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - João-Paulo-Mendes Tribst
- DDs, MSc, PhD student at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Amanda-Maria-de Oliveira Dal Piva
- DDs, MSc, PhD student at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Renato-Sussumu Nishioka
- DDS, MS, PhD, Professor at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Marco-Antonio Bottino
- DDS, MS, PhD, Professor at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Alexandre-Duarte M Evangelhista
- Private Pratice at Instituto de Odontologia São Paulo (IOSP), São José dos Campos, SP, Brazil. Av Pensilvânia, Jardim Florida, Jacareí , SP, Brazil
| | - Fabrício M de M Monteiro
- DDs, MSc student at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
| | - Alexandre-Luiz-Souto Borges
- DDS, MS, PhD, Professor at Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, SP, Brazil. Avenida Engenheiro Francisco José Longo, Jardim São Dimas, São José dos Campos, SP, Brazil
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Sampatanukul T, Serichetaphongse P, Sampatanukul P, Pimkhaokham A. Bony spicules trapped in peri-implant soft tissue: a common unrecognized finding. Clin Case Rep 2017; 5:1856-1861. [PMID: 29152286 PMCID: PMC5676264 DOI: 10.1002/ccr3.1207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 08/30/2017] [Accepted: 09/01/2017] [Indexed: 11/17/2022] Open
Abstract
According to the study, there were unexpected tiny bone spicules being inspected in peri‐implant soft tissue. These displaced autogenous bone chips were probably presented when preparing implant sites. The displaced bone spicules seemed not induced significant inflammatory reactions; on contrary, defects of specimens and dissolving bone spicules pictures were demonstrated.
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Affiliation(s)
- Teeratida Sampatanukul
- Esthetic Restorative and Implant Dentistry Faculty of Dentistry Chulalongkorn University Bangkok Thailand
| | | | - Pichet Sampatanukul
- Department of Pathology Faculty of Medicine Chulalongkorn University Bangkok Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery Faculty of Dentistry Chulalongkorn University Bangkok Thailand
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Sanz-Martín I, Sanz-Sánchez I, Carrillo de Albornoz A, Figuero E, Sanz M. Effects of modified abutment characteristics on peri-implant soft tissue health: A systematic review and meta-analysis. Clin Oral Implants Res 2017; 29:118-129. [PMID: 29072346 PMCID: PMC6084371 DOI: 10.1111/clr.13097] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2017] [Indexed: 12/24/2022]
Abstract
Objectives The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri‐implant tissue health and to identify the most suitable material and surface characteristics. Methods A protocol was developed aimed to answer the following focused question: “Which is the effect of the modification of the abutment design in regard to the maintenance of the peri‐implant soft tissue health?” Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow‐up of at least 6 months after implant loading were considered as inclusion criteria. Meta‐analyses were performed whenever possible. Results Nineteen final publications from thirteen investigations were included. The results from the meta‐analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = −26.96; 95% CI (−45.00; −8.92); p = .003] and less plaque accumulation [n = 1; MD = −20.00; 95% CI (−41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = −0.44; 95% CI (−0.65; −0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences. Conclusions The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri‐implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments.
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Affiliation(s)
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | | | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Saravanakumar P, Thallam Veeravalli P, Kumar V A, Mohamed K, Mani U, Grover M, Thirumalai Thangarajan S. Effect of Different Crown Materials on the InterLeukin-One Beta Content of Gingival Crevicular Fluid in Endodontically Treated Molars: An Original Research. Cureus 2017; 9:e1361. [PMID: 28721329 PMCID: PMC5510969 DOI: 10.7759/cureus.1361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 06/16/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Crown materials used in fixed prosthodontics come into close and prolonged contact with the gingiva. OBJECTIVE The purpose of this study was to evaluate the effect of different crown materials on the interleukin-one beta (IL-1β) content of the gingival crevicular fluid and to study which crown material causes the highest inflammation on the marginal gingiva on a biochemical basis. MATERIALS AND METHODS Twenty patients with single endodontically treated tooth were examined. Contralateral teeth were taken as controls. The crown materials in contact with the marginal gingiva were divided into three groups: Group 1- metal, Group2- ceramic, Group 3-zirconia. The collected data were analyzed with International Bibliography of the Social Sciences (IBSS). Statistical Package for the Social Sciences (SPSS) Statistics software 23.0 (IBM Corp, Armonk, New York). All assay procedures were carried out and the results of the collected samples were calculated using the ELISA-AIDTM technique. RESULTS Multiple comparisons using one-way analysis of variance (ANOVA) between the materials on day zero, 45th and 90th day was highly significant with p=0.0005. Pairwise comparison using Tukey's honest significant difference (HSD) posthoc test was also highly statistically significant with p= 0.0005 except for ceramic & zirconia which were significant at p=0.04 on the 90th day. Multiple comparison using repeated measure of ANOVA with Bonferroni correction between day zero, 45th and 90th day was found to be statistically significant only for zirconia (p=0.002). CONCLUSION This study was conducted to evaluate the effect of different crown materials on the amount of marginal gingival inflammation by measuring the IL-1β content in gingival crevicular fluid (GCF). At the end of the three-month analysis, it was seen that the zirconia crowns exhibited the least marginal gingival inflammation.
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Affiliation(s)
- Prathibha Saravanakumar
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai, India
| | | | - Anand Kumar V
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai, India
| | - Kasim Mohamed
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai, India
| | - Umamaheswari Mani
- Department of Prosthodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Chennai, India
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Smeets R, Schöllchen M, Gauer T, Aarabi G, Assaf AT, Rendenbach C, Beck-Broichsitter B, Semmusch J, Sedlacik J, Heiland M, Fiehler J, Siemonsen S. Artefacts in multimodal imaging of titanium, zirconium and binary titanium-zirconium alloy dental implants: an in vitro study. Dentomaxillofac Radiol 2016; 46:20160267. [PMID: 27910719 DOI: 10.1259/dmfr.20160267] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To analyze and evaluate imaging artefacts induced by zirconium, titanium and titanium-zirconium alloy dental implants. METHODS Zirconium, titanium and titanium-zirconium alloy implants were embedded in gelatin and MRI, CT and CBCT were performed. Standard protocols were used for each modality. For MRI, line-distance profiles were plotted to quantify the accuracy of size determination. For CT and CBCT, six shells surrounding the implant were defined every 0.5 cm from the implant surface and histogram parameters were determined for each shell. RESULTS While titanium and titanium-zirconium alloy induced extensive signal voids in MRI owing to strong susceptibility, zirconium implants were clearly definable with only minor distortion artefacts. For titanium and titanium-zirconium alloy, the MR signal was attenuated up to 14.1 mm from the implant. In CT, titanium and titanium-zirconium alloy resulted in less streak artefacts in comparison with zirconium. In CBCT, titanium-zirconium alloy induced more severe artefacts than zirconium and titanium. CONCLUSIONS MRI allows for an excellent image contrast and limited artefacts in patients with zirconium implants. CT and CBCT examinations are less affected by artefacts from titanium and titanium-zirconium alloy implants compared with MRI. The knowledge about differences of artefacts through different implant materials and image modalities might help support clinical decisions for the choice of implant material or imaging device in the clinical setting.
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Affiliation(s)
- Ralf Smeets
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schöllchen
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Gauer
- 2 Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- 3 Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandre T Assaf
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Rendenbach
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedicta Beck-Broichsitter
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Semmusch
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Sedlacik
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Siemonsen
- 4 Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ajioka H, Kihara H, Odaira C, Kobayashi T, Kondo H. Examination of the Position Accuracy of Implant Abutments Reproduced by Intra-Oral Optical Impression. PLoS One 2016; 11:e0164048. [PMID: 27706225 PMCID: PMC5052018 DOI: 10.1371/journal.pone.0164048] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 09/19/2016] [Indexed: 11/23/2022] Open
Abstract
An impression technique called optical impression using intraoral scanner has attracted attention in digital dentistry. This study aimed to evaluate the accuracy of the optical impression, comparing a virtual model reproduced by an intraoral scanner to a working cast made by conventional silicone impression technique. Two implants were placed on a master model. Working casts made of plaster were fabricated from the master model by silicone impression. The distance between the ball abutments and the angulation between the healing abutments of 5 mm and 7 mm height at master model were measured using Computer Numerical Control Coordinate Measuring Machine (CNCCMM) as control. Working casts were then measured using CNCCMM, and virtual models via stereo lithography data of master model were measured by a three-dimensional analyzing software. The distance between ball abutments of the master model was 9634.9 ± 1.2 μm. The mean values of trueness of the Lava COS and working casts were 64.5 μm and 22.5 μm, respectively, greater than that of control. The mean of precision values of the Lava COS and working casts were 15.6 μm and 13.5 μm, respectively. In the case of a 5-mm-height healing abutment, mean angulation error of the Lava COS was greater than that of the working cast, resulting in significant differences in trueness and precision. However, in the case of a 7-mm-height abutment, mean angulation errors of the Lava COS and the working cast were not significantly different in trueness and precision. Therefore, distance errors of the optical impression were slightly greater than those of conventional impression. Moreover, the trueness and precision of angulation error could be improved in the optical impression using longer healing abutments. In the near future, the development of information technology could enable improvement in the accuracy of the optical impression with intraoral scanners.
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Affiliation(s)
- Hitoshi Ajioka
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan
| | - Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan
| | - Chikayuki Odaira
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan
| | - Takuya Kobayashi
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Morioka, Iwate, Japan
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Schepke U, Meijer HJA, Kerdijk W, Raghoebar GM, Cune M. Stock Versus CAD/CAM Customized Zirconia Implant Abutments - Clinical and Patient-Based Outcomes in a Randomized Controlled Clinical Trial. Clin Implant Dent Relat Res 2016; 19:74-84. [PMID: 27476829 PMCID: PMC5297995 DOI: 10.1111/cid.12440] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 07/04/2016] [Indexed: 12/24/2022]
Abstract
Background Single‐tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient‐based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri‐implant bone level (primary outcome), Plaque‐index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment.
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Affiliation(s)
- Ulf Schepke
- Associate professor, Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Professor, Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wouter Kerdijk
- Associate professor, Department of Public and Individual Oral Health, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marco Cune
- Professor, Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, The Netherlands
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42
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Kuhn K, Rudolph H, Graf M, Moldan M, Zhou S, Udart M, Böhmler A, Luthardt RG. Interaction of titanium, zirconia and lithium disilicate with peri-implant soft tissue: study protocol for a randomized controlled trial. Trials 2015; 16:467. [PMID: 26470711 PMCID: PMC4608119 DOI: 10.1186/s13063-015-0979-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 09/28/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Against the background of increasing use of dental implants, and thus an increasing prevalence of implant-associated complications, a deeper understanding of the biomolecular mechanisms in the peri-implant tissue is needed. Peri-implant soft tissue is in direct contact with transmucosal dental implant abutments. The aim of this trial is to distinguish the biomolecular and histological interactions of various dental abutment materials with peri-implant soft tissue. METHODS/DESIGN The study is designed as a prospective, randomized, investigator-initiated clinical pilot trial with blinded assessment. We will ultimately include 24 eligible patients who opt for implant treatment to replace a single missing posterior tooth. Three months after implantation (submerged procedure), the study begins with the second-stage surgery. Each of the 24 patients will be given three different transmucosal abutments (zirconia, lithium disilicate, titanium) consecutively. The sequence in which the three materials are used is randomized. Peri-implant crevicular fluid is sampled weekly around the respective abutment for biomolecular analyses. After one month of wearing time, the stamping press from the second-stage surgery is used to gain a narrow gingival ring biopsy around the abutment for immunohistochemical analyses. The next abutment is then inserted. The same procedure is used for all three abutments. After sampling is completed, the patients will receive a definitive crown. The primary outcome measure of the trial is biomolecular detection of specific markers in the peri-implant crevicular fluid: matrix metalloproteinase 8, interleukin- 1β, polymorphonuclear elastase, and myeloid-related protein MRP8/14 (calprotectin). Secondary outcome measures include immunohistochemical analyses and clinical parameters. DISCUSSION The study design will allow us to perform correlation analyses between the clinical indices with biomarkers' expression in the interface of the transmucosal abutments and the peri-implant soft tissue. A deeper understanding of the three abutment materials' interactions with peri-implant soft tissue will help us understand the formation mechanisms of implant-associated complications and then develop prevention strategies. TRIAL REGISTRATION The trial is registered at the German Clinical Trial Register and the International Clinical Trials Registry Platform by the WHO under DRKS00006555 (Registered on 27 October 2014).
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Affiliation(s)
- Katharina Kuhn
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Michael Graf
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Matthias Moldan
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Shaoxia Zhou
- Department of Clinical Chemistry, Ulm University, Ulm, Germany.
| | - Martin Udart
- Institut für Lasertechnologien in der Medizin und Messtechnik, Ulm University, Ulm, Germany.
| | - Andrea Böhmler
- Institut für Lasertechnologien in der Medizin und Messtechnik, Ulm University, Ulm, Germany.
| | - Ralph G Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
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Implant Supported Fixed Dental Prostheses Using a New Monotype Zirconia Implant-A Case Report. Dent J (Basel) 2015; 3:79-92. [PMID: 29567928 PMCID: PMC5851168 DOI: 10.3390/dj3030079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/04/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022] Open
Abstract
Currently, titanium or specific titanium alloys are the most often used materials for the fabrication of dental implants. Many studies have confirmed the osseointegrative capacity and clinical long-term performance of moderately rough titanium implants. However, disadvantages have also been reported with regard to peri-implant infections and the titanium metal properties. Tooth colored ceramic implants have attracted the interest of clinicians since the end of the 1960s. Initially, alumina was used for the fabrication of ceramic implants; however, due to the poor biomechanical properties, alumina implants are not commercially available any more. Since end of the 1990s, zirconia has been established in dentistry due to its superior biomechanical properties compared to other oxide ceramics such as alumina. Currently, zirconia is the material of choice for the fabrication of ceramic implants. Zirconia implants show superior biocompatibility compared to titanium and other metals. Additionally, it has been reported that zirconia implants with a micro-rough surface topography show at least a comparable osseointegrative capacity and similar clinical survival rates to moderately rough titanium implants. The present case reports a fixed implant-supported reconstruction of a large edentulous space with compromised local bone conditions using new monotype zirconia dental implants with a micro-rough surface topography.
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Apratim A, Eachempati P, Krishnappa Salian KK, Singh V, Chhabra S, Shah S. Zirconia in dental implantology: A review. J Int Soc Prev Community Dent 2015; 5:147-56. [PMID: 26236672 PMCID: PMC4515795 DOI: 10.4103/2231-0762.158014] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Titanium has been the most popular material of choice for dental implantology over the past few decades. Its properties have been found to be most suitable for the success of implant treatment. But recently, zirconia is slowly emerging as one of the materials which might replace the gold standard of dental implant, i.e., titanium. Materials and Methods: Literature was searched to retrieve information about zirconia dental implant and studies were critically analyzed. PubMed database was searched for information about zirconia dental implant regarding mechanical properties, osseointegration, surface roughness, biocompatibility, and soft tissue health around it. The literature search was limited to English language articles published from 1975 to 2015. Results: A total of 45 papers met the inclusion criteria for this review, among the relevant search in the database. Conclusion: Literature search showed that some of the properties of zirconia seem to be suitable for making it an ideal dental implant, such as biocompatibility, osseointegration, favourable soft tissue response and aesthetics due to light transmission and its color. At the same time, some studies also point out its drawbacks. It was also found that most of the studies on zirconia dental implants are short-term studies and there is a need for more long-term clinical trials to prove that zirconia is worth enough to replace titanium as a biomaterial in dental implantology.
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Affiliation(s)
- Abhishek Apratim
- Department of Prosthodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | | | | | - Vijendra Singh
- Department of Periodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | - Saurabh Chhabra
- Department of Dentistry, New Delhi Municipal Council (NDMC), New Delhi, India
| | - Sanket Shah
- Department of Prosthodontics, Vaidik Dental College, Daman, Gujarat, India, India
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Gehrke P, Tabellion A, Fischer C. Microscopical and chemical surface characterization of CAD/CAM zircona abutments after different cleaning procedures. A qualitative analysis. J Adv Prosthodont 2015; 7:151-9. [PMID: 25932314 PMCID: PMC4414946 DOI: 10.4047/jap.2015.7.2.151] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/19/2014] [Accepted: 02/04/2015] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non-quantitatively. RESULTS All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.
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Osman RB, Swain MV. A Critical Review of Dental Implant Materials with an Emphasis on Titanium versus Zirconia. MATERIALS 2015; 8:932-958. [PMID: 28787980 PMCID: PMC5455450 DOI: 10.3390/ma8030932] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/20/2015] [Accepted: 02/12/2015] [Indexed: 01/21/2023]
Abstract
The goal of the current publication is to provide a comprehensive literature review on the topic of dental implant materials. The following paper focuses on conventional titanium implants and more recently introduced and increasingly popular zirconia implants. Major subtopics include the material science and the clinical considerations involving both implant materials and the influence of their physical properties on the treatment outcome. Titanium remains the gold standard for the fabrication of oral implants, even though sensitivity does occur, though its clinical relevance is not yet clear. Zirconia implants may prove to be promising in the future; however, further in vitro and well-designed in vivo clinical studies are needed before such a recommendation can be made. Special considerations and technical experience are needed when dealing with zirconia implants to minimize the incidence of mechanical failure.
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Affiliation(s)
- Reham B Osman
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centrum of Dentistry Amsterdam (ACTA), 1081 LA Amsterdam, The Netherlands.
- Department of Removable Prosthodontics, Cairo University, Giza 11553, Egypt.
| | - Michael V Swain
- Biomaterials Laboratory, Sydney Dental Hospital, the University of Sydney, Surry Hills, NSW 2010, Australia.
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Kwon YD, Choi HJ, Lee H, Lee JW, Weber HP, Pae A. Cellular viability and genetic expression of human gingival fibroblasts to zirconia with enamel matrix derivative (Emdogain®). J Adv Prosthodont 2014; 6:406-14. [PMID: 25352963 PMCID: PMC4211057 DOI: 10.4047/jap.2014.6.5.406] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/20/2014] [Accepted: 07/07/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The objective of this study was to investigate the biologic effects of enamel matrix derivative (EMD) with different concentrations on cell viability and the genetic expression of human gingival fibroblasts (HGF) to zirconia surfaces. MATERIALS AND METHODS Immortalized human gingival fibroblasts (HGF) were cultured (1) without EMD, (2) with EMD 25 µg/mL, and (3) with EMD 100 µg/mL on zirconia discs. MTT assay was performed to evaluate the cell proliferation activity and SEM was carried out to examine the cellular morphology and attachment. The mRNA expression of collagen type I, osteopontin, fibronectin, and TGF-β1 was evaluated with the real-time polymerase chain reaction (RT-PCR). RESULTS From MTT assay, HGF showed more proliferation in EMD 25 µg/mL group than control and EMD 100 µg/mL group (P<.05). HGFs showed more flattened cellular morphology on the experimental groups than on the control group after 4h culture and more cellular attachments were observed on EMD 25 µg/mL group and EMD 100 µg/mL group after 24h culture. After 48h of culture, cellular attachment was similar in all groups. The mRNA expression of type I collagen increased in a concentration dependent manner. The genetic expression of osteopontin, fibronectin, and TGF-β1 was increased at EMD 100 µg/mL. However, the mRNA expression of proteins associated with cellular attachment was decreased at EMD 25 µg/mL. CONCLUSION Through this short term culture of HGF on zirconium discs, we conclude that EMD affects the proliferation, attachment, and cell morphology of HGF cells. Also, EMD stimulates production of extracellular matrix collagen, osteopontin, and TGF-β1 in high concentration levels. CLINICAL RELEVANCE With the use of EMD, protective barrier between attached gingiva and transmucosal zirconia abutment may be enhanced leading to final esthetic results with implants.
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Affiliation(s)
- Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Hyun-Jung Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Heesu Lee
- Department of Oral Anatomy, Dental School, Kangnung-Wonju National University, Kangnung, Republic of Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Hans-Peter Weber
- Department of Prosthodontics and Operative Dentistry, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Ahran Pae
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants. J Clin Periodontol 2014; 41 Suppl 15:S6-22. [DOI: 10.1111/jcpe.12206] [Citation(s) in RCA: 211] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Anton Sculean
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Reinhard Gruber
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Laboratory of Oral Cell Biology; School of Dental Medicine; University of Bern; Bern Switzerland
| | - Dieter D. Bosshardt
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
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Canullo L, Penarrocha-Oltra D, Marchionni S, Bagán L, Peñarrocha-Diago MA, Micarelli C. Soft tissue cell adhesion to titanium abutments after different cleaning procedures: preliminary results of a randomized clinical trial. Med Oral Patol Oral Cir Bucal 2014; 19:e177-83. [PMID: 24121917 PMCID: PMC4015045 DOI: 10.4317/medoral.19329] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 05/22/2013] [Indexed: 02/04/2023] Open
Abstract
Objectives: A randomized controlled trial was performed to assess soft tissue cell adhesion to implant titanium abutments subjected to different cleaning procedures and test if plasma cleaning can enhance cell adhesion at an early healing time.
Study Design: Eighteen patients with osseointegrated and submerged implants were included. Before re-opening, 18 abutments were divided in 3 groups corresponding to different clinical conditions with different cleaning processes: no treatment (G1), laboratory customization and cleaning by steam (G2), cleaning by plasma of Argon (G3). Abutments were removed after 1 week and scanning electron microscopy was used to analyze cell adhesion to the abutment surface quantitatively (percentage of area occupied by cells) and qualitatively (aspect of adhered cells and presence of contaminants).
Results: Mean percentages of area occupied by cells were 17.6 ± 22.7%, 16.5 ± 12.9% and 46.3 ± 27.9% for G1, G2 and G3 respectively. Differences were statistically significant between G1 and G3 (p=0.030), close to significance between G2 and G3 (p=0.056), and non-significant between G1 and G2 (p=0.530). The proportion of samples presenting adhered cells was homogeneous among the 3 groups (p-valor = 1.000). In all cases cells presented a flattened aspect; in 2 cases cells were less efficiently adhered and in 1 case cells presented filipodia. Three cases showed contamination with cocobacteria.
Conclusions: Within the limits of the present study, plasma of Argon may enhance cell adhesion to titanium abutments, even at the early stage of soft tissue healing. Further studies with greater samples are necessary to confirm these findings.
Key words:Connective tissue, dental abutments, randomized controlled trial, clinical research, glow discharged abutment, plasma cleaning.
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Affiliation(s)
- L Canullo
- Cirugía Bucal, Clínicas Odontológicas, Gascó Oliag 1, 46021- Valencia, Spain,
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Saridag S, Tak O, Alniacik G. Basic properties and types of zirconia: An overview. World J Stomatol 2013; 2:40-47. [DOI: 10.5321/wjs.v2.i3.40] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 02/14/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
This paper describes types and characteristics of zirconia materials in relation to their applications in dentistry. The zirconia material typically used today by most manufacturers is a tetragonal polycrystalline zirconia, partially stabilized with yttrium oxide. The mechanical properties of zirconia have been extensively investigated in the scientific literature and zirconia clearly measures up to any other equivalent manufactured material. The biocompatibility of zirconia has also been extensively evaluated and no local or systemic adverse reactions or cytotoxic effects have been found in relation to it. However, ceramic bonding, ageing, light transmission and manufacturing processes are all factors that need to be further evaluated in order to guide the successful use of zirconia as a prosthetic restorative material. Milling zirconia to full-contour might be an alternative to traditionally veneered restorations. A potential adhesion mechanism appears to be the combination of air abrasion with aluminum oxide particles (silanated or not), followed by sintering with materials containing special reactive monomers. Changes in zirconia properties before and after the sintering process have also been investigated. It was found that after sintering, surface roughness was greater, and micro hardness was slightly reduced; however, accurate precision of fit was not affected by the sintering process. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labeled as its main clinical setback. As zirconia has demonstrated good mechanical and biological performance, future technology is attempting to improve esthetics and minimize veneer fracture, aiming to create confidence in the dental community towards this all-ceramic system. Milling zirconia to full-contour might be an alternative to traditionally veneered restorations. Finally, implications are drawn for manufacturing, machining, and widespread use of these materials.
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