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Canullo L, Menini M, Pesce P, Iacono R, Sculean A, Del Fabbro M. Nano-superhydrophilic and bioactive surface in poor bone environment. Part 1: transition from primary to secondary stability. A controlled clinical trial : Bioactive implant surfaces in poor density bone. Clin Oral Investig 2024; 28:372. [PMID: 38872049 PMCID: PMC11176097 DOI: 10.1007/s00784-024-05747-7] [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: 10/21/2023] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Bioactive surfaces were designed to increase the interaction between the surface and the cells. This may speed up the biological stability and loading protocols. MATERIALS AND METHODS 36 patients with D3-D4 bone density were recruited and allocated into two groups. 30 bioactive (test group) and 30 traditional (control group) surfaced implants were placed. Insertion torque value (Ncm), insertion torque curve integral (cumulative torque, Ncm), torque density (Ncm/sec), implant stability quotient (ISQ) measured at three timepoints (baseline (T0), 30 (T30) and 45 (T45) days after surgery), and marginal bone loss (MBL) at 6 months of loading were assessed. RESULTS The mean ISQ and standard deviation at T0, T30, T45 were respectively 74.57 ± 7.85, 74.78 ± 7.31, 74.97 ± 6.34 in test group, and 77.12 ± 5.83, 73.33 ± 6.13, 73.44 ± 7.89 in control group, respectively. Data analysis showed significant differences between groups in ΔISQ at T0-T30 (p = 0.005) and T30-T45 (p = 0.012). Control group showed a significant decrease in ISQ at T30 (p = 0.01) and T45 (p = 0.03) compared to baseline, while no significant change was observed in test group. Due to the stability of the ISQ value ≥ 70, 26 test group and 23 control group implants were functionally loaded after 45 days. Conversely, due to the ISQ < 70 at T45, four test group implants and one control group implant were loaded after 90 days, and 6 control group implants were loaded after 180 days. Neither insertion torque nor ISQ at baseline were correlated with bone density (in Hounsfield units). There was no significant correlation between cumulative torque and ISQ at baseline. There was a significant positive slope in the correlation between torque density and ISQ at baseline, more accentuated in D3 than D4. This correlation remained significant for the test group in D3 bone at day 30 and 45 (p < 0.01 in both time frames), but not in D4 bone, and it was not significant in CG. CONCLUSIONS The bioactive surface showed better behavior in terms of implant stability in D3-D4 bone quality in the early stages of bone healing. Clinical relevance This study demonstrated that the transition from primary to secondary stability is improved using bioactive surface, especially in cases of poor bone environment (D3/D4 bone).
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Affiliation(s)
- Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, Genoa, 16132, Italy.
- Department of Periodontology, University of Bern, Bern, Switzerland.
| | - Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, Genoa, 16132, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, Genoa, 16132, Italy
| | - Roberta Iacono
- Department of Oral and Maxillo-facial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, 00161, Italy
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Park G, Matsuura T, Komatsu K, Ogawa T. Optimizing implant osseointegration, soft tissue responses, and bacterial inhibition: A comprehensive narrative review on the multifaceted approach of the UV photofunctionalization of titanium. J Prosthodont Res 2024:JPR_D_24_00086. [PMID: 38853001 DOI: 10.2186/jpr.jpr_d_24_00086] [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: 06/11/2024]
Abstract
Titanium implants have revolutionized restorative and reconstructive therapy, yet achieving optimal osseointegration and ensuring long-term implant success remain persistent challenges. In this review, we explore a cutting-edge approach to enhancing implant properties: ultraviolet (UV) photofunctionalization. By harnessing UV energy, photofunctionalization rejuvenates aging implants, leveraging and often surpassing the intrinsic potential of titanium materials. The primary aim of this narrative review is to offer an updated perspective on the advancements made in the field, providing a comprehensive overview of recent findings and exploring the relationship between UV-induced physicochemical alterations and cellular responses. There is now compelling evidence of significant transformations in titanium surface chemistry induced by photofunctionalization, transitioning from hydrocarbon-rich to carbon pellicle-free surfaces, generating superhydrophilic surfaces, and modulating the electrostatic properties. These changes are closely associated with improved cellular attachment, spreading, proliferation, differentiation, and, ultimately, osseointegration. Additionally, we discuss clinical studies demonstrating the efficacy of UV photofunctionalization in accelerating and enhancing the osseointegration of dental implants. Furthermore, we delve into recent advancements, including the development of one-minute vacuum UV (VUV) photofunctionalization, which addresses the limitations of conventional UV methods as well as the newly discovered functions of photofunctionalization in modulating soft tissue and bacterial interfaces. By elucidating the intricate relationship between surface science and biology, this body of research lays the groundwork for innovative strategies aimed at enhancing the clinical performance of titanium implants, marking a new era in implantology.
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Affiliation(s)
- Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
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Kido D, Komatsu K, Suzumura T, Matsuura T, Cheng J, Kim J, Park W, Ogawa T. Influence of Surface Contaminants and Hydrocarbon Pellicle on the Results of Wettability Measurements of Titanium. Int J Mol Sci 2023; 24:14688. [PMID: 37834133 PMCID: PMC10572547 DOI: 10.3390/ijms241914688] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Hydrophilicity/hydrophobicity-or wettability-is a key surface characterization metric for titanium used in dental and orthopedic implants. However, the effects of hydrophilicity/hydrophobicity on biological capability remain uncertain, and the relationships between surface wettability and other surface parameters, such as topography and chemistry, are poorly understood. The objective of this study was to identify determinants of surface wettability of titanium and establish the reliability and validity of the assessment. Wettability was evaluated as the contact angle of ddH2O. The age of titanium specimens significantly affected the contact angle, with acid-etched, microrough titanium surfaces becoming superhydrophilic immediately after surface processing, hydrophobic after 7 days, and hydrorepellent after 90 days. Similar age-related loss of hydrophilicity was also confirmed on sandblasted supra-micron rough surfaces so, regardless of surface topography, titanium surfaces eventually become hydrophobic or hydrorepellent with time. On age-standardized titanium, surface roughness increased the contact angle and hydrophobicity. UV treatment of titanium regenerated the superhydrophilicity regardless of age or surface roughness, with rougher surfaces becoming more superhydrophilic than machined surfaces after UV treatment. Conditioning titanium surfaces by autoclaving increased the hydrophobicity of already-hydrophobic surfaces, whereas conditioning with 70% alcohol and hydrating with water or saline attenuated pre-existing hydrophobicity. Conversely, when titanium surfaces were superhydrophilic like UV-treated ones, autoclaving and alcohol cleaning turned the surfaces hydrorepellent and hydrophobic, respectively. UV treatment recovered hydrophilicity without exception. In conclusion, surface roughness accentuates existing wettability and can either increase or decrease the contact angle. Titanium must be age-standardized when evaluating surface wettability. Surface conditioning techniques significantly but unpredictably affect existing wettability. These implied that titanium wettability is significantly influenced by the hydrocarbon pellicle and other contaminants inevitably accumulated. UV treatment may be an effective strategy to standardize wettability by making all titanium surfaces superhydrophilic, thereby allowing the characterization of individual surface topography and chemistry parameters in future studies.
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Affiliation(s)
- Daisuke Kido
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Diagnosis and General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Jeong Kim
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Wonhee Park
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Yadav TC, Bachhuka A. Tuning foreign body response with tailor-engineered nanoscale surface modifications: fundamentals to clinical applications. J Mater Chem B 2023; 11:7834-7854. [PMID: 37528807 DOI: 10.1039/d3tb01040f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Biomaterials are omnipresent in today's healthcare services and are employed in various applications, including implants, sensors, healthcare accessories, and drug delivery systems. Unfavorable host immunological responses frequently jeopardize the efficacy of biomaterials. As a result, surface modification has received much attention in controlling inflammatory responses since it helps camouflage the biomaterial from the host immune system, influencing the foreign body response (FBR) from protein adsorption to fibrous capsule formation. Surfaces with controlled nanotopography and chemistry, among other surface modification methodologies, have effectively altered the immune response to biomaterials. However, the field is still in its early stages, with only a few studies showing a synergistic effect of surface chemistry and nanotopography on inflammatory and wound healing pathways. Therefore, this review will concentrate on the individual and synergistic effects of surface chemistry and nanotopography on FBR modulation and the molecular processes known to modulate these responses. This review will also provide insights into crucial research gaps and advancements in various tactics for modulating FBR, opening new paths for future research. This will further aid in improving our understanding of the immune response to biomaterials, developing advanced surface modification techniques, designing immunomodulatory biomaterials, and translating discoveries into clinical applications.
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Affiliation(s)
- Tara Chand Yadav
- Department of Bioinformatics, Faculty of Engineering & Technology, Marwadi University, Gujarat, 360003, India
- Department of Electronics, Electric, and Automatic Engineering, Rovira I Virgili University (URV), Tarragona, 43003, Spain.
| | - Akash Bachhuka
- Department of Electronics, Electric, and Automatic Engineering, Rovira I Virgili University (URV), Tarragona, 43003, Spain.
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Zarazir R, Mrad S, Aoun G, Sleiman AA, Mousallem M, Bassil J. Comparison of Osseointegration in Novel Laser-Textured and SLA Implants. Acta Inform Med 2023; 31:137-140. [PMID: 37711484 PMCID: PMC10498373 DOI: 10.5455/aim.2023.31.137-140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/25/2023] [Indexed: 09/01/2023] Open
Abstract
Background Osseointegration is defined as the direct structural and functional connection between neo-formed bone and dental implants. Among the parameters suggested to predominantly influencing the establishment of a successful osseointegration is the quality of the implant surface, which may enhance the strength and speed of this biomechanical process. Objective The purpose of this study was to evaluate the ability of a novel laser-treated surface, compared to sandblasted, large-grit, acid-etched (SLA) surfaces, to enhance and accelerate implant integration in delayed implant placement.Methods: Thirty patients with two missing posterior teeth were enrolled in this study. Each patient received, at a randomly allocated site, an implant with a conventional SLA surface, and at a second site, an implant with laser-textured surface. A total of 60 tissue-level implants were subsequently placed. Implant stability (ISQ) was measured using resonance frequency analysis (RFA). ISQ was assessed at baseline (T0), 8 weeks (T1), and 12 weeks (T2) following implant placement. Results: There was a statistical difference in implant stability between laser-textured and SLA group at 12 weeks postoperatively. Implant stabilization showed a successful osseointegration with both surface types. Conclusion Both laser and SLA surface treatments had positive impacts on implant stabilization following delayed placement. Laser-treated surfaces presented higher values of osseointegration at 3 months postoperatively.
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Affiliation(s)
- Ralph Zarazir
- Attending Oral Surgeon, Military Medicine, Beirut, Lebanon
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Saint Joseph University of Beirut, Lebanon
| | - Stephanie Mrad
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Lebanon
| | - Georges Aoun
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | | | - Marianne Mousallem
- High Institute of Public Health, Saint Joseph University of Beirut, Lebanon
| | - Joseph Bassil
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Lebanon
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Teixeira JFL, de Souza JAC, Magalhães FAC, de Oliveira GJPL, de Santis JB, de Souza Costa CA, de Souza PPC. Laser-Modified Ti Surface Improves Paracrine Osteogenesis by Modulating the Expression of DKK1 in Osteoblasts. J Funct Biomater 2023; 14:jfb14040224. [PMID: 37103314 PMCID: PMC10145280 DOI: 10.3390/jfb14040224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
Titanium surface modifications are widely used to modulate cellular behavior by recognition of topographical cues. However, how those modifications affect the expression of mediators that will influence neighboring cells is still elusive. This study aimed to evaluate the effects of conditioned media from osteoblasts cultured on laser-modified titanium surfaces on the differentiation of bone marrow cells in a paracrine manner and to analyze the expression of Wnt pathway inhibitors. Mice calvarial osteoblasts were seeded on polished (P) and Yb:YAG laser-irradiated (L) Ti surfaces. Osteoblast culture media were collected and filtered on alternate days to stimulate mice BMCs. Resazurin assay was performed every other day for 20 days to check BMC viability and proliferation. After 7 and 14 days of BMCs maintained with osteoblasts P and L-conditioned media, alkaline phosphatase activity, Alizarin Red staining, and RT-qPCR were performed. ELISA of conditioned media was conducted to investigate the expression of Wnt inhibitors Dickkopf-1 (DKK1) and Sclerostin (SOST). BMCs showed increased mineralized nodule formation and alkaline phosphatase activity. The L-conditioned media enhanced the BMC mRNA expression of bone-related markers Bglap, Alpl, and Sp7. L-conditioned media decreased the expression of DKK1 compared with P-conditioned media. The contact of osteoblasts with Yb:YAG laser-modified Ti surfaces induces the regulation of the expression of mediators that affect the osteoblastic differentiation of neighboring cells. DKK1 is among these regulated mediators.
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Affiliation(s)
- Jorge Felipe Lima Teixeira
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | | | | | | | - José Bernardo de Santis
- Department of Basic and Oral Biology, Bone Research Lab, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | - Pedro Paulo Chaves de Souza
- Innovation in Biomaterials Laboratory (iBioM), School of Dentistry, Federal University of Goiás, Goiânia 74605-020, Brazil
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Pinotti FE, Aroni MAT, Oliveira GJPLD, Silva BLG, Marcantonio Junior E, Marcantonio RAC. Osseointegration of implants with superhydrophilic surfaces in rats with high serum levels of nicotine. Braz Dent J 2023; 34:105-112. [PMID: 37194848 DOI: 10.1590/0103-6440202305096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/15/2023] [Indexed: 05/18/2023] Open
Abstract
This study aimed to evaluate the effect of nicotine administration on the osseointegration of a superhydrophilic implants surface on rat tibiae. Thirty-two rats were used and divided into 2 groups according to the administration or not of nicotine: HH - Installation of implants with superhydrophilic surfaces in healthy animals; and HN - Installation of implants with superhydrophilic surfaces in animals subjected to nicotine administration. The animals were euthanized 15 and 45 days after implant placement (n = 8). Osseointegration was assessed by means of biomechanical analyses (removal torque), microcomputed tomography (volume of bone around the implants- %BV/TV), and histomorphometry (bone-implant contact -%BIC and the bone area between implant threads -%BBT). The animals subject to the nicotine administration presented lower removal torque than the control animals at the 45-day period (21.88 ± 2.80 Ncm vs. 17.88 ± 2.10 Ncm). The implants placed in the control rats presented higher %BIC (54.26 ± 6.59% vs. 39.25 ± 4.46%) and %BBT (50.57 ± 5.28% vs. 32.25 ± 5.24%) than the implants placed in nicotine animals at 15-day period. The nicotine administration reduces the osseointegration at 15 days, however, the superhydrophilic surface equalized the osseointegration in nicotine-exposed animals compared with healthy animals after 45 days of implant placement.
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Herrero F, de Souza RF, Feine JS, Alexander PP, Green AV, Oates TW. The impact of implant-retained overdentures on type-2 diabetic and non-diabetic edentulous patients: Satisfaction and quality of life in a prospective cohort study. J Dent 2022; 127:104357. [PMID: 36351489 PMCID: PMC9691604 DOI: 10.1016/j.jdent.2022.104357] [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: 05/31/2022] [Revised: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration. MATERIALS AND METHODS This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025). RESULTS At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups. CONCLUSIONS Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion. CLINICAL SIGNIFICANCE As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.
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Affiliation(s)
- Frances Herrero
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States
| | - Raphael F de Souza
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Peggy P Alexander
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Adriana Vargas Green
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Thomas W Oates
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States.
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Pinotti FE, Aron MAT, de Oliveira GJPL, Marcantonio E, Marcantonio RAC. Implants with hydrophilic surfaces equalize the osseointegration of implants in normo- and hyperglycaemic rats. Braz Dent J 2022; 33:71-77. [PMID: 36477967 PMCID: PMC9733365 DOI: 10.1590/0103-6440202204793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to evaluate the effect of a surface modified by blasting and acid attack and maintained in an isotonic solution compared to a machined surface on osseointegration in normo- and hyperglycaemic animals. Sixty-four animals were allocated into 4 groups with 16 animals each, and they were subdivided into two experimental periods (15 and 45 days), with 8 animals in each group. The groups were divided according to the type of implant that was installed in the animals' tibia and the animals' systemic condition: CM - Machined implants placed in Healthy animals; CH - Hydrophilic implants placed in Healthy animals, HM - Machined implants placed in animals with hyperglycaemia; HH- Hydrophilic implants installed in animals with hyperglycaemia. The following analyses were performed: biomechanical (removal torque), microtomographic (evaluation of the bone volume around the implants- BV/TV), and histomorphometric (evaluation of bone-implant contact BIC% and of the bone formation area between the threads BBT%). It was found that the implants with hydrophilic surfaces presented higher removal torques and quantities of BV/TV% and higher BIC% and BBT% values in normo- and hyperglycaemic animals. The results of this study indicated that the hydrophilic surface accelerates the osseointegration process (~ 15% BIC/BBT at 15-day period), especially in animals with hyperglycaemia. The hydrophilic surface equaled the osseointegration between normo- and hyperglycaemic animals, reversing the negative potential of hyperglycaemia on the osseointegration process.
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Affiliation(s)
- Felipe Eduardo Pinotti
- Department of Diagnosis and Surgery, São Paulo State University(Unesp), School of Dentistry, Araraquara, Brazil
| | | | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University(Unesp), School of Dentistry, Araraquara, Brazil
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Influence of the Surface Chemical Composition Differences between Zirconia and Titanium with the Similar Surface Structure and Roughness on Bone Formation. NANOMATERIALS 2022; 12:nano12142478. [PMID: 35889704 PMCID: PMC9324478 DOI: 10.3390/nano12142478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/05/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023]
Abstract
The osseointegration of zirconia (ZrO2) implants is still controversial. In this study, we aimed to make clear the influence of surface chemical composition, Ti or ZrO2, to osseointegration. First, a roughened Ti surface was prepared with a combination of large-grit sandblasting and acid treatment. Then, we applied molecular precursor solution containing Zr complex onto roughened Ti surface and can deposit thin ZrO2 film onto roughened Ti surface. We can change surface chemical composition from Ti to ZrO2 without changing the surface structure and roughness of roughened Ti. The tetragonal Zr was uniformly present on the ZrO2-coated Ti surface, and the surface of the ZrO2-coated Ti showed a higher apparent zeta potential than Ti. Ti and ZrO2-coated Ti rectangular plate implant was placed into the femur bone defect. After 2 and 4 weeks of implantation, histomorphometric observation revealed that the bone-to-implant contact ratio and the bone mass values for ZrO2-coated Ti implants inserted into the femur bone defects of the rats at 2 weeks were significantly higher than those for Ti implants (p < 0.05). It revealed that ZrO2 with a similar surface structure and roughness as that of roughened Ti promoted osteogenesis equivalent to or better than that of Ti in the early bone formation stage.
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Diehl D, Winkler M, Bilhan H, Friedmann A. Implant stability of narrow diameter implants in hyperglycemic patients-A 3-month case-control study. Clin Exp Dent Res 2022; 8:969-975. [PMID: 35578391 PMCID: PMC9382047 DOI: 10.1002/cre2.587] [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: 07/17/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this prospective case-control study was to compare the development of implant stability quotients of narrow diameter implants in patients with type 2 diabetes mellitus (T2DM) and healthy individuals within the first 3 months after implant insertion. METHODS Sixteen patients with T2DM (HbA1C > 6.5%) as test group and 16 nondiabetic patients (HbA1C < 5.9%) as the control group were evaluated. All patients received narrow-diameter tissue level implants in an edentulous area posterior to the canine. The implant stability was measured by means of resonance frequency analysis after 3 days, 7 days, 4 weeks, and 3 months postplacement. Statistical analysis of intergroup differences and correlation to HbA1c values and treated jaw was performed in PRISM 8. RESULTS The means for implant stability quotients showed a significant increase between Day 3 and 3-month assessment in both groups. No significant differences between study groups and no correlation of implant stability to HbA1c were found. CONCLUSION The present study shows encouraging clinical outcomes for narrow-diameter implants inserted in the posterior zone in patients with uncontrolled T2DM.
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Affiliation(s)
- Daniel Diehl
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany.,Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Marianna Winkler
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Nourah D, Aldahlawi S, Andreana S. Should the Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on Implant Survival. Curr Diabetes Rev 2022; 18:e060821195367. [PMID: 34365929 DOI: 10.2174/1573399817666210806120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used is as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. AIM This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less than optimal glycemic control. DISCUSSION Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. CONCLUSION In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.
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Affiliation(s)
- Dalia Nourah
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Friedmann A, Winkler M, Diehl D, Yildiz MS, Bilhan H. One-year performance of posterior narrow diameter implants in hyperglycemic and normo-glycemic patients-a pilot study. Clin Oral Investig 2021; 25:6707-6715. [PMID: 33939006 PMCID: PMC8602141 DOI: 10.1007/s00784-021-03957-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of the study was to compare the performance of narrow diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals during the first 12 months after implant loading. MATERIAL AND METHODS In 16 T2DM patients with HbA1C > 6.5% (test group) and 16 normo-glycemic patients (HbA1C < 6.0%; control group), one to two narrow diameter tissue level implants were placed in the posterior maxilla or mandible. After 3-month lasting integration period, implants were loaded by fixed dentures. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession and papilla bleeding index (PBI) were assessed manually at loading and after 12 months of function. The paired digital periapical radiographs were analyzed with regard to the change in marginal bone level (MBL) from baseline to 12 months' control. The mean values calculated for both patient groups were statistically analyzed. The technical complications were recorded. RESULTS The T2DM group accounted 13 patients due to 3 dropouts. The overall implant survival rate after 12 months was 100%. The differences in means for the clinical parameters and the MBL were statistically non-significant between the T2DM and normo-glycemic patients for the short period of loaded function reported here. No technical complications were recorded. CONCLUSIONS The study demonstrated an encouraging clinical outcome with narrow diameter implants in patients with uncontrolled T2DM compared to non-diabetics after 12 months post loading. For the short observation period, no biological and technical complications were reported regardless the glycemic status. CLINICAL RELEVANCE Patients with HbA1C > 6.5% may benefit from the treatment with narrow diameter implants by avoiding complex surgical interventions with augmentation procedures. TRIAL REGISTRATION Clinicaltrials.gov : NCT04630691.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Marianna Winkler
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Daniel Diehl
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Stockumer Straße 10, 58453 Witten, Germany
| | - Mehmet Selim Yildiz
- Department of Periodontology, Faculty of Dentistry, Altınbaş University, Zuhuratbaba, İncirli Cd. No:11-A, 34147 Bakırköy, Istanbul, Turkey
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
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Latimer JM, Roll KL, Daubert DM, Zhang H, Shalev T, Wolff LF, Kotsakis GA. Clinical performance of hydrophilic, titanium-zirconium dental implantsin patients with well-controlled and poorly-controlledtype 2 diabetes: One-Year results of a dual-centerprospectivecohort study. J Periodontol 2021; 93:745-757. [PMID: 34738235 DOI: 10.1002/jper.21-0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study assessed the clinical performance of hydrophilic dental implants in a patient cohort with type 2 diabetes mellitus (T2DM). METHODS Subjects with T2DM of ≥ 2-years duration were allocated to either the well-controlled (WC; HbA1c ≤ 7.0%,) or poorly-controlled (PC; 7.5 < HbA1c < 10%) groups in a dual-center, prospective cohort study. Each subject received a single, titanium-zirconium (Ti-Zr) dental implant with a chemically-modified, hydrophilic (modSLA) surface in a posterior mandibular site. Postoperatively, subjects were followed at 1, 2, 4, 8 and 12-week intervals. Post-loading, subjects were followed at 3, 6 and 12-months. Clinical and radiographic parameters of implant success, and dental patient-reported outcomes were collected. RESULTS Twenty-one dental patients (NWC = 11; NPC = 10; mean age: 66.8 ± 7.5 years) were enrolled and the 1-year implant success rate was 100%. Peri-implant bone levels were stable with 0.15 ± 0.06 mm mean marginal loss at one year without significant inter-group differences (p = 0.79). Postoperative pain was minimal at 1-week, and OHIP-5 scores decreased significantly over time as compared with preoperative levels (p < 0.001) suggesting significant improvement in patient-perceived oral health following implant therapy. CONCLUSIONS Elevated HbA1c levels> 7.5% did not compromise 1-year successrates, or oral health-related quality of lifein PC patients receiving modSLA, Ti-Zr implants. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jessica M Latimer
- Division of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA
| | | | - Diane M Daubert
- Department of Periodontics, University of Washington School of Dentistry, Seattle, WA
| | - Hai Zhang
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA
| | - Tamir Shalev
- Department of Periodontology and Oral Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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- Group Authorship; Study Collaborators are listed with their affiliations in the acknowledgements
| | - Larry F Wolff
- Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis, MN
| | - Georgios A Kotsakis
- Department of Periodontics, Director, Clinical and Translational Periodontal Research Lab., UTHealth San Antonio School of Dentistry, San Antonio, TX
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Bielemann AM, Schuster AJ, Possebon APDR, Schinestsck AR, Chagas-Junior OL, Faot F. Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2021; 33:21-32. [PMID: 34551146 DOI: 10.1111/clr.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year. MATERIALS AND METHODS In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates. RESULTS The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants. CONCLUSION Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.
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Affiliation(s)
- Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Otacílio Luiz Chagas-Junior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Li H, Wang Y, Zhang D, Chen T, Hu A, Han X. Glycemic fluctuation exacerbates inflammation and bone loss and alters microbiota profile around implants in diabetic mice with experimental peri-implantitis. Int J Implant Dent 2021; 7:79. [PMID: 34401982 PMCID: PMC8368769 DOI: 10.1186/s40729-021-00360-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of glycemic fluctuation under diabetic condition on peri-implantitis in diabetic patients remains unclear. We hypothesized that glycemic fluctuation has greater adverse effect on experimental peri-implantitis, compared with sustained high blood glucose in diabetes. RESULTS Maxillary left first and second molars of diabetic db/db mice were extracted and were replaced with one dental implant in the healed edentulous space. Glycemic control or fluctuation were managed by constant or interrupted oral administration of rosiglitazone to these mice. Meanwhile, experimental peri-implantitis was induced by ligation around implants. After 14 weeks, inflammatory responses, and peri-implant bone loss, together with oral microbiota profile were analyzed. Diabetic mice with glycemic fluctuation showed greater peri-implant bone loss, inflammatory cell infiltration, and osteoclastogenesis, compared with mice with sustained hyperglycemia. Compared to sustained hyperglycemia, glycemic fluctuation led to further increase in IL-1β, TNFα, RANKL, TLR2/4, IRAK1, and TRAF6 mRNA expression in peri-implant gingival tissues. Both rosiglitazone-induced glycemic control and glycemic fluctuation caused microbiota profile change in diabetic mice compared to that in uncontrolled hyperglycemic mice. CONCLUSIONS This study suggests that glycemic fluctuation may aggravate peri-implantitis inflammation and bone loss, which may be associated with a shift in peri-implant microbial profile towards dysbiotic changes and the activation of TLR2/4-IRAK1-TRAF6 signaling.
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Affiliation(s)
- Hao Li
- Department of Prosthodontics, the Affiliated Hospital of Stomatology, Guangxi Medical University, 10 Shuangyong Road, Nanning, 530021, People's Republic of China
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
| | - Yufeng Wang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Mucosal Diseases, Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Dong Zhang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Surgery, Qilu Hospital of Shandong University, Jinan, 250012, People's Republic of China
| | - Tsute Chen
- Department of Microbiology, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
- Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, 188 Longwood Avenue, Boston, 02115, USA
| | - Arthur Hu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA
| | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, 02142, USA.
- Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, 188 Longwood Avenue, Boston, 02115, USA.
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Histomorphometric analysis of implant osseointegration using hydrophilic implants in diabetic rats. Clin Oral Investig 2021; 25:5867-5878. [PMID: 33765194 DOI: 10.1007/s00784-021-03892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate peri-implant bone formation of titanium implants using an in vivo rat model with and without uncontrolled diabetes mellitus (DM) to evaluate osseointegration of hydrophobic (Neoporos®) and hydrophilic (Acqua®) surfaces. MATERIALS AND METHODS 54 rats were divided into two groups: DM group (DMG) (streptozotocin-induced diabetes) and a control group (CG). Implants with hydrophobic (Neoporos®) and hydrophilic surfaces (Acqua®) were placed in the left or right tibia of animals. Animals were further divided into three groups (n = 9) euthanized after 7, 14, or 28 days. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were assessed in total, cortical, and medullary areas. RESULTS The DMG group, after a 7-day healing period, yielded with the Acqua implants presented significantly higher total BIC (+37.9%; p=0.03) and trabecular BIC (%) (+46.3%; p=0.02) values in comparison to the Neoporos implants. After 28 days of healing, the CG yielded that the cortical BAFO of Acqua implants to be significantly, 14%, higher (p=0.04) than Neoporos implants. CONCLUSION The positive effects of the Acqua surface were able to counteract the adverse impact of uncontrolled DM at early osseointegration periods. After 28 days in vivo, the metabolic systemic impairment caused by DM overcame the surface treatment effect, leading to impaired osseointegration in both hydrophilic and hydrophobic implants. CLINICAL RELEVANCE The adverse effects of diabetes mellitus with respect to bone healing may be minimized by deploying implants with strategically modified surfaces. This study evaluated the effects of implants with Acqua® and Neoporos® surfaces in both diabetic and healthy animals. During the initial healing period in diabetic animals, the hydrophilic surface was demonstrated to have beneficial effect on osseointegration in comparison to the hydrophobic surface. The results provide an insight into early healing, but the authors suggest that a future short-term and long-term clinical study is needed to assess the possible benefit of the Acqua® implant as well as in increasing the predictability of implant osseointegration.
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Tallarico M, Baldini N, Gatti F, Martinolli M, Xhanari E, Meloni SM, Gabriele C, Immacolata LA. Role of New Hydrophilic Surfaces on Early Success Rate and Implant Stability: 1-Year Post-loading Results of a Multicenter, Split-Mouth, Randomized Controlled Trial. Eur J Dent 2020; 15:1-7. [PMID: 33242915 PMCID: PMC7902108 DOI: 10.1055/s-0040-1713952] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare early implant failure and implant stability of one-stage Hiossen ET III implants with its new hydrophilic (NH) surface, compared with Hiossen ET III implants with the sandblasted and acid-etched (SA) surface at 1-year follow-up. MATERIALS AND METHODS This study was designed as a split-mouth, multicenter randomized controlled trial aimed to compare SA surface implants (SA group) and NH surface, (NH group). Outcomes were implant and prosthetic survival rates, complications, the insertion torque at implant placement, and implant stability quotient (ISQ) values. RESULTS Twenty-nine patients (mean age 59.9 ± 11.3 years) were treated and followed up to 1 year after loading. No patient dropped out. Fifty-eight implants (29 SA group and 29 NH group) were placed. No implants or prostheses failed and no complications were experienced during follow-up. The mean insertion torque was 40.5 ± 3.23 (38.17-41.83) Ncm in the SA group and 40.48 ± 3.49 (38.02-41.98) Ncm in the NH group (p = 0.981). There was a statistically significant difference at the second week (T2) with higher values in the NH group (p = 0.041). Similar results were found in the maxilla (p = 0.045), but not in the mandible (p = 0.362). A positive correlation was found between initial insertion torque and ISQ with higher value in the NH group (0.73 vs. 0.66). CONCLUSIONS NH implants are a viable alternative to SA surface, as they seem to avoid the ISQ drop during the bone remodeling phase.
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Affiliation(s)
| | - Nicola Baldini
- Department of Periodontics and Implantology, University of Siena, Siena, Italy
| | - Fulvio Gatti
- Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Surgery, San Carlo and San Paolo Hospital, University of Milan, Milan, Italy
| | | | - Erta Xhanari
- School of Dentistry, University of Sassari, Sassari, Italy
| | - Silvio Mario Meloni
- Medical Surgical and Experimental Science Department, University of Sassari, Sassari, Italy
| | - Cervino Gabriele
- Department of BIOMORF, School of Dentistry, University of Messina, Messina, Italy
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Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The success rate of dental implants depends on primary and secondary stability. We investigate predictive factors for future risk stratification models. We retrospectively analyze 272 patients with a total of 582 implants. Implant stability is measured with resonance frequency analysis and evaluated based on the implant stability quotient (ISQ). A linear regression model with regression coefficients (reg. coeff.) and its 95% confidence interval (95% CI) is applied to assess predictive factors for implant stability. Implant diameter (reg. coeff.: 3.28; 95% CI: 1.89–4.66, p < 0.001), implant length (reg. coeff.: 0.67, 95% CI: 0.26–1.08, p < 0.001), and implant localization (maxillary vs. mandibular, reg. coeff.: −7.45, 95% CI: −8.70–(−6.20), p < 0.001) are significant prognostic factors for primary implant stability. An increase in ISQ between insertion and exposure is significantly correlated with healing time (reg. coeff.: 0.11, 95% CI: 0.04–0.19). Patients with maxillary implants have lower ISQ at insertion but show a higher increase in ISQ after insertion than patients with mandibular implants. We observe positive associations between primary implant stability and implant diameter, implant length, and localization (mandibular vs. maxillary). An increase in implant stability between insertion and exposure is significantly correlated with healing time and is higher for maxillary implants. These predictive factors should be further evaluated in prospective cohort studies to develop future preoperative risk-stratification models.
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Coating of a Sand-Blasted and Acid-Etched Implant Surface with a pH-Buffering Agent after Vacuum-UV Photofunctionalization. COATINGS 2020. [DOI: 10.3390/coatings10111040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ultraviolet (UV) photofunctionalization can reset the biological aging of titanium after the preparation and storage of dental implants by transforming hydrophobic titanium surfaces into superhydrophilic surfaces. Blood clot formation around the implant can initialize and promote the healing process at the bone–implant interface. The aim of this study is to evaluate and compare the capabilities of surface wettability and blood clotting of implants with a conventional sand-blasted and acid-etched surface (SA), a sand-blasted and acid-etched surface with vacuum-UV treatment (SA + VUV), and a sand-blasted and acid-etched surface coated with a pH-buffering agent after vacuum-UV treatment (SA + VUV + BS). Static and dynamic tests for surface wettability and blood clotting were performed in vitro for SA + VUV and SA + VUV + BS (n = 5), while hemostasis resulting from blood clotting was evaluated in vivo for SA, SA +VUV, and SA + VUV + BS (n = 4). A Kruskal–Wallis test showed statistically significant differences (p < 0.05) in all tests, with the exception of in vitro test of static blood clotting. VUV treatment is therefore effective at making an SA surface superhydrophilic as an alternative to routine UV-C radiation. The addition of a pH-buffering agent to SA + VUV also improved surface wettability and blood clotting, which are crucial for successful osseointegration.
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H H, G W, E H. The clinical significance of implant stability quotient (ISQ) measurements: A literature review. J Oral Biol Craniofac Res 2020; 10:629-638. [PMID: 32983857 DOI: 10.1016/j.jobcr.2020.07.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022] Open
Abstract
Implant stability quotients (ISQ values) are obtained in dental clinical practice on a non-invasive basis by resonance frequency measurement rapidly after surgical placement of implants. The ISQ-values are used as indicator for mechanical implant stability, and are believed to have predictive power for clinical outcome. It is the aim of this review to provide a synopsis of all factors described in the literature that influence ISQ measurements by performing an exhaustive literature review; moreover, this review aims at elucidating the key factors relevant for a rapid clinical predictive assessment. We searched systematically and exhaustively all major databases for publications relating to ISQ measurement methodology and for ISQ-influencing factor analyses. The reports identified were ordered in experimental (preclinical) studies and in clinical publications. We were able to identify 13 basic factors influencing ISQ-measurements. Among these, local bone quality, playing a key role in such measurements, was subdivided in four specific subfactors; thus a total of 17 individual factors was identified and reported to influence ISQ-measurements. A comprehensive list of these factors is provided in Table-form. A critical analysis points out that only 6 of these factors are of a sound predictive power useful for a rapid clinical assessment; and only two of these factors appear to have a well-documented scientific basis.
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Affiliation(s)
- Huang H
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan, 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands.,Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland
| | - Wu G
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Gustav Mahlerlaan, 3004, 1081LA Amsterdam, Nord-Holland, the Netherlands
| | - Hunziker E
- Department of Osteoporosis, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland.,Departments of Osteoporosis and Orthopaedic Surgery, Inselspital Bern University Hospital, Freiburgstrasse 3, CH-3010, Bern, Switzerland
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Almassri HNS, Ma Y, Dan Z, Ting Z, Cheng Y, Wu X. Implant stability and survival rates of a hydrophilic versus a conventional sandblasted, acid-etched implant surface: Systematic review and meta-analysis. J Am Dent Assoc 2020; 151:444-453. [PMID: 32450983 DOI: 10.1016/j.adaj.2020.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/27/2020] [Accepted: 03/05/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Modifying the implant surface via enhancing the wettability (hydrophilicity) improves osseointegration, reducing the healing period. In this study, the authors aimed to evaluate the stability and survival rates of implants with a hydrophilic surface compared with those with a sandblasted, acid-etched surface. TYPES OF STUDIES REVIEWED The included studies (randomized controlled trials) were identified through searches of PubMed, ScienceDirect, and Cochrane Library databases without date of publication restrictions. Quality assessment was performed using the Cochrane Collaboration tool. For primary outcome, confidence intervals were set at 95%; weighted means across the studies were calculated using a fixed-effects model or risk ratios and their 95% confidence intervals for secondary outcome. RESULTS The authors included 5 randomized controlled trials (246 dental implants) in the systematic review, which compared a hydrophilic with conventional sandblasted, acid-etched implant surface. The implant stability (primary outcome) was measured at baseline and 3, 6, and 8 weeks, and implant survival rates were measured as a secondary outcome. Overall, compared with the control groups, no clinically significant differences in implant stability or survival rates were identified for the hydrophilic surface groups. CONCLUSIONS AND PRACTICAL IMPLICATIONS The results did not show any clinically significant effect of a hydrophilic surface on improving implant stability or survival rates. However, these findings must be analyzed carefully owing to the limitations of this review, such as the small samples size and some differences among the included studies.
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Wang Q, Zhou P, Liu S, Attarilar S, Ma RLW, Zhong Y, Wang L. Multi-Scale Surface Treatments of Titanium Implants for Rapid Osseointegration: A Review. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1244. [PMID: 32604854 PMCID: PMC7353126 DOI: 10.3390/nano10061244] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/30/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
The propose of this review was to summarize the advances in multi-scale surface technology of titanium implants to accelerate the osseointegration process. The several multi-scaled methods used for improving wettability, roughness, and bioactivity of implant surfaces are reviewed. In addition, macro-scale methods (e.g., 3D printing (3DP) and laser surface texturing (LST)), micro-scale (e.g., grit-blasting, acid-etching, and Sand-blasted, Large-grit, and Acid-etching (SLA)) and nano-scale methods (e.g., plasma-spraying and anodization) are also discussed, and these surfaces are known to have favorable properties in clinical applications. Functionalized coatings with organic and non-organic loadings suggest good prospects for the future of modern biotechnology. Nevertheless, because of high cost and low clinical validation, these partial coatings have not been commercially available so far. A large number of in vitro and in vivo investigations are necessary in order to obtain in-depth exploration about the efficiency of functional implant surfaces. The prospective titanium implants should possess the optimum chemistry, bionic characteristics, and standardized modern topographies to achieve rapid osseointegration.
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Affiliation(s)
- Qingge Wang
- School of Metallurgical Engineering, Xi’an University of Architecture and Technology, No.13 Yanta Road, Xi’an 710055, China;
| | - Peng Zhou
- School of Aeronautical Materials Engineering, Xi’an Aeronautical Polytechnic Institute, Xi’an 710089, China;
| | - Shifeng Liu
- School of Metallurgical Engineering, Xi’an University of Architecture and Technology, No.13 Yanta Road, Xi’an 710055, China;
| | - Shokouh Attarilar
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Robin Lok-Wang Ma
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong 999077, China; (R.L.-W.M.); (Y.Z.)
| | - Yinsheng Zhong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong 999077, China; (R.L.-W.M.); (Y.Z.)
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China;
- National Engineering Research Center for Nanotechnology (NERCN), 28 East JiangChuan Road, Shanghai 200241, China
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Saito H, Aichelmann‐Reidy MB, Oates TW. Advances in implant therapy in North America: Improved outcomes and application in the compromised dentition. Periodontol 2000 2019; 82:225-237. [DOI: 10.1111/prd.12319] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hanae Saito
- Division of Periodontics Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
| | - Mary Beth Aichelmann‐Reidy
- Division of Periodontics Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
| | - Thomas W. Oates
- Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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Lagunov VL, Sun J, George R. Evaluation of biologic implant success parameters in type 2 diabetic glycemic control patients versus health patients: A meta-analysis. ACTA ACUST UNITED AC 2019; 10:e12478. [PMID: 31638347 DOI: 10.1111/jicd.12478] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/19/2019] [Accepted: 09/21/2019] [Indexed: 01/24/2023]
Abstract
AIM The aim of the present systematic literature review was to evaluate bleeding on probing (BOP), pocket depth (PD), and marginal bone loss (MBL) in type 2 diabetes mellitus (T2DM) control patients. METHODS An electronic literature search was conducted through PubMed, Web of Science, Cochrane, Embase, and ScienceDirect. The search included prospective human clinical studies that analyzed the success of dental implants in T2DM control patients. For inclusion, studies should have had a minimum of 1-year follow up and should have assessed the following parameters: MBL, BOP and PD. Prior to meta-analysis, all of the studies were assessed for quality, bias, and heterogeneity. RESULTS Risk of bias analysis indicated that all studies were of moderate quality. After a full-text evaluation, only seven studies met the inclusion criteria for this meta-analysis, with a combined total of 443 patients and 530 dental implants. The meta-analysis indicated a statistically significant difference between parameters of implants placed in the glycemic-controlled group and healthy group in MBL (P < .001), BOP (P < .04), and PD (P < .001). CONCLUSION The results of the present study indicated that, despite being glycemic controlled, patients with T2DM were associated with a higher risk of peri-implant disease.
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Affiliation(s)
- Victor L Lagunov
- School of Dentistry and Oral Health, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Roy George
- School of Dentistry and Oral Health, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
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ELsyad MA, Abdraboh AE, Aboelnagga MM, Ghali RM, Lebshtien IT. Effect of Low-Level Laser Irradiation on Stability and Marginal Bone of Narrow Implants Retaining Overdentures in Moderately Controlled Diabetic Patients. J ORAL IMPLANTOL 2019; 45:391-397. [PMID: 31389750 DOI: 10.1563/aaid-joi-d-18-00263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The researchers investigated the influence of low-level laser irradiation (LLLI) on implant stability and marginal bone of small-diameter implants retaining mandibular overdentures in patients with moderately controlled diabetes. Twenty patients (mean age = 59.32 ± 4.1 years) with moderately controlled diabetes mellitus (glycated hemoglobin A1c [HbA1c] = 8.1%-10.0 %) were rehabilitated by maxillary and mandibular conventional dentures. Two small-diameter implants (3 × 12 mm) were inserted in the canine areas of the mandible and immediately loaded by mandibular dentures. In a split-mouth design, LLLI was applied to 1 of the 2 implants in a random order (study group [SG]); the other implant was left as a control (control group [CG]). For each patient, gallium aluminum-arsenide diode low-level laser (940-nm wavelength, 0.50 ± 2 mW output power, 0.004 cm2 spot size; Epic, Biolase, Inc, San Clemente, Calif) was applied around each implant with total delivered energy of 90 J (equally divided by 6 irradiation points) in 3 sessions. The application was done immediately after implant insertion, 3 days and 1 week after surgery. Implant stability (measured by Periotest) and marginal bone loss (MBL; measured by cone beam computerized tomography) were evaluated at implant loading (T1), 6 months (T6), and 12 months (T12). One implant failed in the CG and no failures occurred in the SG, resulting in 95% and 100% survival rates, respectively. The SG recorded higher Periotest values than the CG at all observation times. However, the difference was significant (P = .039) at T6 only. The SG recorded lower MBL values than the CG. No difference in MBL was detected between groups or peri-implant sites (mesial, distal, buccal, and lingual) at T6 and T12. Within the limits of this study, LLLI had no effect on marginal bone around immediately loaded small-diameter implants retaining overdentures in patients with moderately controlled diabetes. However, it was beneficial in improving implant stability 6 months after overdenture insertion.
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Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, University of Mansoura, University of Delta, Eldakahlia, Egypt
| | | | - Mona M Aboelnagga
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
| | - Rami Maher Ghali
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
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Nano-scale modification of titanium implant surfaces to enhance osseointegration. Acta Biomater 2019; 94:112-131. [PMID: 31128320 DOI: 10.1016/j.actbio.2019.05.045] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 12/16/2022]
Abstract
The main aim of this review study was to report the state of art on the nano-scale technological advancements of titanium implant surfaces to enhance the osseointegration process. Several methods of surface modification are chronologically described bridging ordinary methods (e.g. grit blasting and etching) and advanced physicochemical approaches such as 3D-laser texturing and biomimetic modification. Functionalization procedures by using proteins, peptides, and bioactive ceramics have provided an enhancement in wettability and bioactivity of implant surfaces. Furthermore, recent findings have revealed a combined beneficial effect of micro- and nano-scale modification and biomimetic functionalization of titanium surfaces. However, some technological developments of implant surfaces are not commercially available yet due to costs and a lack of clinical validation for such recent surfaces. Further in vitro and in vivo studies are required to endorse the use of enhanced biomimetic implant surfaces. STATEMENT OF SIGNIFICANCE: Grit-blasting followed by acid-etching is currently used for titanium implant modifications, although recent technological biomimetic physicochemical methods have revealed enhanced osteoconductive and anti-microbial outcomes. An improvement in wettability and bioactivity of titanium implant surfaces has been accomplished by combining micro and nano-scale modification and functionalization with protein, peptides, and bioactive compounds. Such morphological and chemical modification of the titanium surfaces induce the migration and differentiation of osteogenic cells followed by an enhancement of the mineral matrix formation that accelerate the osseointegration process. Additionally, the incorporation of bioactive molecules into the nanostructured surfaces is a promising strategy to avoid early and late implant failures induced by the biofilm accumulation.
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Tallarico M, Baldini N, Martinolli M, Xhanari E, Kim YJ, Cervino G, Meloni SM. Do the New Hydrophilic Surface Have Any Influence on Early Success Rate and Implant Stability during Osseointegration Period? Four-Month Preliminary Results from a Split-Mouth, Randomized Controlled Trial. Eur J Dent 2019; 13:95-101. [PMID: 31170768 PMCID: PMC6635964 DOI: 10.1055/s-0039-1688737] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The objective of this study is to compare the implant stability of Hiossen ET III implants with its new hydrophilic (NH) surface and Hiossen ET III implants with the sandblasted and acid-etched (SA) surface. MATERIALS AND METHODS Patients required at least two teeth to be rehabilitated with a fixed, implant-supported restoration, consecutively enrolled. Patients randomly received SA surface implants (SA group) or SA implants with a newly developed bioabsorbable apatite nanocoating (NH group). Outcome measures were implant and prosthetic survival rate, complications, insertion torque, and implant stability quotient (ISQ) measured at implant placement and every week up to 8 weeks after implant placement. Comparison between groups was made by unpaired t-test, while the comparison between each follow-up will be made by paired t-tests to detect any change during the follow-up. Complications and failures were compared using Fisher's exact test. RESULTS A total of 14 patients were treated with 28 implants (14 SA and 14 NH). No implant and prosthesis failed 4 months after implant placement. No complications were experienced. At the 2nd week after implants placement, two implants in the SA group showed discontinuous measurements versus none in the NH group (p = 0.4815). Implants unscrewed during ISQ measurements and were rescrewed. Data recording stopped for 6 weeks. Both implants osseointegrated without any further complication. The NH implants did not show physiological ISQ decrease between 2nd and 4th week after implant placement, showing a more even pattern of ISQ values compared with SA implants (77.1 ± 4.6 vs. 72.9 ± 11.5; difference: 4.2 ± 12.1; p = 0.258). High ISQ values were found in both groups at each time point. CONCLUSIONS NH implants are a viable alternative to SA surface, as they seem to avoid the ISQ drop during the remodeling phase.
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Affiliation(s)
- Marco Tallarico
- Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania
| | - Nicola Baldini
- Department of Periodontics and Implantology, University of Siena, Siena, Italy
| | | | - Erta Xhanari
- Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania
| | - Yong-Jin Kim
- Department of Oral and Maxillofacial Surgery, Insan Apsun Dental Clinic, South Korea
| | - Gabriele Cervino
- Department BIOMORF, School of Dentistry, University of Messina, Messina, Italy
| | - Silvio Mario Meloni
- Department of Surgical, Microsurgical and Medical Science, University of Sassari, Sassari, Italy
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Pinotti FE, de Oliveira GJPL, Aroni MAT, Marcantonio RAC, Marcantonio E. Analysis of osseointegration of implants with hydrophilic surfaces in grafted areas: A Preclinical study. Clin Oral Implants Res 2018; 29:963-972. [DOI: 10.1111/clr.13361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 06/07/2018] [Accepted: 06/13/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Felipe E. Pinotti
- School of Dentistry; São Paulo State University (Unesp); Araraquara Brazil
| | | | | | | | - Elcio Marcantonio
- School of Dentistry; São Paulo State University (Unesp); Araraquara Brazil
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The Effects of Hierarchical Micro/Nano-Structured Titanium Surface on Osteoblast Proliferation and Differentiation Under Diabetic Conditions. IMPLANT DENT 2018; 26:263-269. [PMID: 28301384 DOI: 10.1097/id.0000000000000576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE The aim of the present study was to mimic the hierarchical structure of bone tissues by simple sandblasting/acid-etching and anodization to investigate the effects of such surface characteristics on proliferation and differentiation of osteoblasts in high glucose concentrations. By the way, the effects of high glucose levels on osteoblast functions were tested. METHODS MC3T3-E1 cells cultured on sand-blasted and acid-etched (SLA) surface and nano-modified SLA (NMSLA) surface were subjected to normal serum (NS) and diabetic serum (DS), respectively. The surface characteristics were evaluated by scanning electron microscopy. Cell proliferation was assessed using MTT assay. The levels of alkaline phosphatase (ALP) activity and mineralization were measured and compared. Real-time polymerase chain reaction was applied to detect the expression levels of osteogenic genes. RESULTS NMSLA significantly increased cell proliferation at time points ranging from 3 to 7 days under both serums. Cells cultured on NMSLA surfaces displayed significantly higher ALP activities and mineralization. The expression levels of Runx2 (indicates runt-related protein 2), collagen I (COL1), and osteocalcin (OCN) were notably increased on NMSLA surface compared with SLA surface. Moreover, we found that high glucose increased osteoblast proliferation but decreased differentiation of osteoblast slightly. CONCLUSION The hierarchical micro/nano-structured titanium surface has a favorable biocompatibility on simultaneously improving osteoblast proliferation and differentiation in diabetic serum.
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Chou WC, Wang RCC, Liu C, Yang CY, Lee TM. Surface Modification of Direct-Current and Radio-Frequency Oxygen Plasma Treatments Enhance Cell Biocompatibility. MATERIALS 2017; 10:ma10111223. [PMID: 29068417 PMCID: PMC5706170 DOI: 10.3390/ma10111223] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/22/2017] [Accepted: 10/23/2017] [Indexed: 12/28/2022]
Abstract
The sand-blasting and acid etching (SLA) method can fabricate a rough topography for mechanical fixation and long-term stability of titanium implant, but can not achieve early bone healing. This study used two kinds of plasma treatments (Direct-Current and Radio-Frequency plasma) to modify the SLA-treated surface. The modification of plasma treatments creates respective power range and different content functional OH groups. The results show that the plasma treatments do not change the micron scale topography, and plasma-treated specimens presented super hydrophilicity. The X-ray photoelectron spectroscopy (XPS)-examined result showed that the functional OH content of the RF plasma-treated group was higher than the control (SLA) and DC treatment groups. The biological responses (protein adsorption, cell attachment, cell proliferation, and differentiation) promoted after plasma treatments, and the cell responses, have correlated to the total content of amphoteric OH groups. The experimental results indicated that plasma treatments can create functional OH groups on SLA-treated specimens, and the RF plasma-treated SLA implant thus has potential for achievement of bone healing in early stage of implantation.
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Affiliation(s)
- Wan-Ching Chou
- Institute of Manufacturing Information and Systems, National Cheng Kung University, Tainan 701, Taiwan.
| | - Rex C-C Wang
- Institute of Manufacturing Information and Systems, National Cheng Kung University, Tainan 701, Taiwan.
| | - Cheng Liu
- Hyperbaric Oxygen Therapy Center and Division of Plastic Surgery, Chi Mei Medical Center, Tainan 710, Taiwan.
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan.
| | - Chyun-Yu Yang
- Department of Orthopedics, National Cheng Kung University Hospital, Tainan 704, Taiwan.
| | - Tzer-Min Lee
- Institute of Oral Medicine, National Cheng Kung University Medical College, Tainan 704, Taiwan.
- School of Dentistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
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Calciolari E, Mardas N, Dereka X, Anagnostopoulos AK, Tsangaris GT, Donos N. Protein expression during early stages of bone regeneration under hydrophobic and hydrophilic titanium domes. A pilot study. J Periodontal Res 2017; 53:174-187. [PMID: 29063586 DOI: 10.1111/jre.12498] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES There is significant evidence that, during the early stages of osseointegration, moderately rough hydrophilic (SLActive) surfaces can accelerate osteogenesis and increase bone-to-implant contact in comparison to hydrophobic (SLA) surfaces. However, very little is known regarding the molecular mechanisms behind the influence that surface chemistry modifications to increase hydrophilicity determine on bone healing. The aim of this study was to describe for the first time the proteins and related signalling pathways expressed during early osseous healing stages under SLA and SLActive titanium domes for guided bone regeneration. MATERIAL AND METHODS One SLA and 1 SLActive dome with an internal diameter of 5.0 mm and a height of 3.0 mm were secured to the parietal bones of nine 6-month-old male New Zealand rabbits. Three animals were randomly euthanized at 4, 7 and 14 days and the newly formed tissues retrieved under the domes were analysed with liquid chromatography-mass spectrometry/mass spectrometry. STRING and KEGG databases were applied for Gene Ontology and pathway analyses. RESULTS A different modulation of several pathways was detected between the 2 groups at all healing times. The main differences in the osseous healing response associated to the 2 surfaces were related to pathways involved in regulating the inflammatory response, differentiation of osteoblast precursors and skeletogenesis. At day 7, the highest number of proteins and the highest cellular activity were observed in both groups, although a more complex and articulated proteome in terms of cellular metabolism and signal transduction was observed in SLActive samples. CONCLUSION This is the first study describing the proteome expressed during early healing stages of guided bone regeneration and osseointegration. A combination of enhanced early osteogenic response and reduced inflammatory response were suggested for the hydrophilic group. Future studies are needed to corroborate these findings and explore the molecular effects of different titanium surfaces on the cascade of events taking place during bone formation.
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Affiliation(s)
- E Calciolari
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - N Mardas
- Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
| | - X Dereka
- Department of Periodontology, National and Kapodistrian University of Athens, Athens, Greece
| | - A K Anagnostopoulos
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - G T Tsangaris
- Proteomics Research Unit, Centre of Basic Research II, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - N Donos
- Centre for Clinical Oral Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts and The London School of Medicine and Dentistry, London, UK.,Centre for Oral Immunobiology and Regenerative Medicine, Queen Mary University of London (QMUL), Bart's & The London School of Dentistry & Medicine, London, UK
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Alzahrani AS, Abed HH. To what extent should dental implant placement be adopted as a standard for diabetic patients? Saudi Med J 2017; 37:1179-1183. [PMID: 27761554 PMCID: PMC5303793 DOI: 10.15537/smj.2016.11.15512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Diabetes mellitus (DM) is considered one of the major chronic diseases in the world. Long-term hyperglycemia considerably affects the body tissues, and consequently, can lead to morbidity and mortality. Moreover, many oral complications have been observed with DM but little consideration in relation to the placement of dental implants has been investigated. Dental research has analyzed the relation of dental implants and bone osseointegration in diabetic patients. Theoretically, an impaired immune system and delayed wound healing of these patients might decrease the success rate of implant placement; however, with noticeable advances in evidence-based dentistry and statistically significant results, successful implant treatment could be achieved significantly in well-controlled diabetic patients.
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Affiliation(s)
- Ahmed S Alzahrani
- Division of Periodontology, Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. E-mail.
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Eskow CC, Oates TW. Dental Implant Survival and Complication Rate over 2 Years for Individuals with Poorly Controlled Type 2 Diabetes Mellitus. Clin Implant Dent Relat Res 2017; 19:423-431. [PMID: 27990756 PMCID: PMC5453839 DOI: 10.1111/cid.12465] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Emerging evidence suggests that implant therapy may be a viable option for diabetic individuals with elevated glycemic levels. PURPOSE The purpose of this 2 year observational study was to evaluate survival and clinical complications of dental implants following placement in type 2 diabetes individuals having poor glycemic control. MATERIALS AND METHODS Adult participants (n = 24) with poorly controlled type 2 diabetes (8.0% ≤ HbA1c ≤ 12.0%) received two or more transgingival dental implants. Survival was evaluated after 1 (23 participants, 72 implants) and 2 (20 participants, 59 implants) years. Clinical complications were evaluated in 18 participants (52 implants) after 21-34 months. Relationships between complications and stratified HbA1c levels were assessed using Pearson's correlation test. RESULTS Survival rates were 98.6% (71/72 implants) after 1 year and 96.6% (57/59 implants) after 2 years. Complications were identified in 29% of participants with peri-implant mucositis, the most common event. Complications correlated directly with number of implants across HbA1c strata (0.42, R2 = 0.66). There was no correlation between HbA1c and the occurrences of complications or mucositis. CONCLUSIONS This 2-year evaluation supports the broader application of implant therapy in type 2 diabetes individuals with poor glycemic control in demonstrating high survival rates with limited complications.
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Affiliation(s)
- Caroline C Eskow
- Resident, Department of Comprehensive Dentistry, Graduate Prosthodontics, University of Texas Health Science Center at San Antonio; currently at private practice in Fairfax, VA, USA
| | - Thomas W Oates
- Professor and Chair, Department of Endodontics, Periodontics, and Prosthodontics University of Maryland, Baltimore, formerly Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Yamawaki I, Taguchi Y, Komasa S, Tanaka A, Umeda M. Effects of glucose concentration on osteogenic differentiation of type II diabetes mellitus rat bone marrow-derived mesenchymal stromal cells on a nano-scale modified titanium. J Periodontal Res 2017; 52:761-771. [PMID: 28321876 DOI: 10.1111/jre.12446] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus (DM) is a common disease worldwide. Patients with DM have an increased risk of losing their teeth compared with other individuals. Dental implants are a standard of care for treating partial or full edentulism, and various implant surface treatments have recently been developed to increase dental implant stability. However, some studies have reported that DM reduces osseointegration and the success rate of dental implants. The purpose of this study was to determine the effects of high glucose levels for hard tissue formation on a nano-scale modified titanium surface. MATERIAL AND METHODS Titanium disks were heated at 600°C for 1 h after treatment with or without 10 m NaOH solution. All disks were incubated with type II DM rat bone marrow-derived mesenchymal stromal cells before exposure to one of four concentrations of glucose (5.5, 8.0, 12.0 or 24.0 mm). The effect of different glucose concentrations on bone marrow-derived mesenchymal stromal cell osteogenesis and inflammatory cytokines on the nano-scale modified titanium surface was evaluated. RESULTS Alkaline phosphatase activity decreased with increasing glucose concentration. In contrast, osteocalcin production and calcium deposition were significantly decreased at 8.0 mm glucose, but increased with glucose concentrations over 8.0 mm. Differences in calcium/phosphate ratio associated with the various glucose concentrations were similar to osteocalcin production and calcium deposition. Inflammatory cytokines were expressed at high glucose concentrations, but the nano-scale modified titanium surface inhibited the effect of high glucose concentrations. CONCLUSION High glucose concentration increased hard tissue formation, but the quality of the mineralized tissue decreased. Furthermore, the nano-scale modified titanium surface increased mineralized tissue formation and anti-inflammation, but the quality of hard tissue was dependent on glucose concentration.
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Affiliation(s)
- I Yamawaki
- Department of Periodontology, Osaka Dental University, Osaka, Japan
| | - Y Taguchi
- Department of Periodontology, Osaka Dental University, Osaka, Japan
| | - S Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - A Tanaka
- Department of Oral Pathology, Osaka Dental University, Osaka, Japan
| | - M Umeda
- Department of Periodontology, Osaka Dental University, Osaka, Japan
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Factors Affecting Dental Implant Stability Measured Using the Ostell Mentor Device: A Systematic Review. IMPLANT DENT 2017; 24:565-77. [PMID: 26244855 DOI: 10.1097/id.0000000000000308] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to review the literature on factors that may affect dental implant stability as measured with the Ostell mentor device. MATERIALS AND METHODS A systematic search of the literature was performed in Pubmed, Scopus, and Cochrane databases using dental implants, stability, and resonance frequency analysis as key words. RESULTS The most relevant randomized controlled trials and clinical trials (n = 39) were selected from among 264 articles. CONCLUSIONS Many factors can affect dental implant stability as measured with the Ostell mentor device. This may be a useful instrument for deciding the timing of implant loading, but additional research is required to establish the reliability and predictability of resonance frequency analysis for the future osseointegration of dental implants, which remains controversial.
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38
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Guobis Z, Pacauskiene I, Astramskaite I. General Diseases Influence on Peri-Implantitis Development: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2016; 7:e5. [PMID: 27833730 PMCID: PMC5100645 DOI: 10.5037/jomr.2016.7305] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/22/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To systematically review the influence of systemic diseases or medications used in their treatment on the dental implant therapy success. MATERIAL AND METHODS The search strategy was implemented on the National Library of Medicine database (MEDLINE) (Ovid) and EMBASE electronic databases between January 2006 and January 2016. Human studies with available English articles analysing the relationship between dental implant therapy success and systemic diseases, such as diabetes mellitus, AIDS/HIV, rheumatoid arthritis, osteoporosis, Crohn's disease, cardiovascular diseases, scleroderma, Sjögren's syndrome, lichen planus, ectodermal dysplasia, post-transplantation status, were included in present review according to the PRISMA guidelines. The review protocol was registered on PROSPERO system with the code CRD42016033662. RESULTS Present review included forty one retrospective and prospective follow-up studies, case-control studies, case report series and cohort studies. Despite some limitations this study reveals positive results of implantation in most systemic conditions that should be interpreted with caution. Influence of cardiovascular diseases on the dental implantation success should be explored deeply, because of controversial results and likelihood of comorbidity expressed by a history of cardiovascular diseases and periodontitis. There is only a weak relationship with bone density in osteoporosis and implant failure. All the other diseases did not show significant effect on implantation success. CONCLUSIONS Recent studies with low strength of evidence and controversy show that systemic diseases may have potential effect on the success of implantation, but further detailed studies are needed to provide these findings.
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Affiliation(s)
- Zygimantas Guobis
- Department of Oral and Dental Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Ingrida Pacauskiene
- Department of Oral and Dental Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Inesa Astramskaite
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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Naujokat H, Kunzendorf B, Wiltfang J. Dental implants and diabetes mellitus-a systematic review. Int J Implant Dent 2016; 2:5. [PMID: 27747697 PMCID: PMC5005734 DOI: 10.1186/s40729-016-0038-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 02/05/2016] [Indexed: 11/10/2022] Open
Abstract
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially discussed. Because the number of patients suffering from diabetes increases, there are more diabetic patients demanding implant procedures. We aimed to answer the PICO question "Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?" by a systematic literature search based on the PRISMA statement. We identified 22 clinical studies and 20 publications of aggregated literature, which were quite heterogeneous concerning methods and results. We conclude that patients with poorly controlled diabetes suffer from impaired osseointegration, elevated risk of peri-implantitis, and higher level of implant failure. The influence of duration of the disease is not fully clear. The supportive administration of antibiotics and chlorhexidine seems to improve implant success. When diabetes is under well control, implant procedures are safe and predictable with a complication rate similar to that of healthy patients.
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Affiliation(s)
- Hendrik Naujokat
- Klinik für Mund- Kiefer- und Gesichtschirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Burkhard Kunzendorf
- Klinik für Mund- Kiefer- und Gesichtschirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jörg Wiltfang
- Klinik für Mund- Kiefer- und Gesichtschirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
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Conte A, Ghiraldini B, Casarin R, Casati M, Pimentel S, Cirano F, Duarte P, Ribeiro F. Impact of type 2 diabetes on the gene expression of bone-related factors at sites receiving dental implants. Int J Oral Maxillofac Surg 2015; 44:1302-8. [DOI: 10.1016/j.ijom.2015.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 12/11/2022]
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Erdogan Ö, Supachawaroj N, Soontornvipart K, Kheolamai P. Treatment of Peri-Implant Defects in the Rabbit's Tibia with Adipose or Bone Marrow-Derived Mesenchymal Stems Cells. Clin Implant Dent Relat Res 2015; 18:1003-1014. [PMID: 26402880 DOI: 10.1111/cid.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mesenchymal stem cell (MSC) treatment in conjunction with bone graft materials or space filler can be an alternative to autogenous bone grafts in the treatment of peri-implant bone defects. PURPOSE To evaluate the success of bone regeneration capacity of adipose-derived and bone marrow-derived MSCs for the treatment of peri-implant bone defects when applied with a beta-tricalcium phosphate/collagen-based scaffold. MATERIAL AND METHODS Forty implants were placed into the tibiae of 10 rabbits bilaterally. Surgical defects created around the implants were treated with one the following treatment modalities: 1) adipose-derived MSC transplanted scaffold + collagen membrane; 2) bone marrow-derived MSC transplanted scaffold + collagen membrane; 3) autogenous bone + collagen membrane; and 4) collagen membrane only. The bone regeneration capacity of each technique was determined by histomorphometry, micro-CT, and measuring the implant stability by resonance frequency analysis. RESULTS One limb of one rabbit was excluded because of fracture, and another limb was excluded because of infection. All parameters on 36 implants revealed that both sources of MSC can form equivalently new bone that is comparable with autogenous bone. The defects treated with membrane only had significantly less bone formation compared with other groups. CONCLUSION Both adipose-derived and bone marrow-derived MSC treatments are feasible alternatives to autogenous bone grafts in the treatment of peri-implant osseos defects.
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Affiliation(s)
- Özgür Erdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Rangsit University, Bangkok, Thailand.
| | - Nuttawut Supachawaroj
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Rangsit University, Bangkok, Thailand
| | - Kumpanart Soontornvipart
- Department of Surgery, Faculty of Veterinary Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pakpoom Kheolamai
- Center of Excellence in Stem Cell Research, Faculty of Medicine, Thammasat University, Pathumtani, Thailand
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Implant stability change and osseointegration speed of immediately loaded photofunctionalized implants. IMPLANT DENT 2015; 22:481-90. [PMID: 24021973 DOI: 10.1097/id.0b013e31829deb62] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study evaluated the degree and rate of implant stability development for photofunctionalized dental implants in humans. MATERIALS AND METHODS Thirty-three implants (7 patients) placed in the maxilla and immediate loaded were evaluated. Photofunctionalization was performed by treating implants with ultraviolet for 15 minutes immediately before placement. Implant stability was assessed by measuring the implant stability quotient (ISQ) weekly starting from implant placement up to 3 months. Osseointegration speed index (OSI), defined as ISQ increase per month, was also evaluated. RESULTS The average ISQ for photofunctionalized implants at week 6 was 78.0, which was considerably higher than the average ISQ of 66.1, reported in literature for various as-received implants after a longer healing time of 2 to 6 months. No stability dip was observed for photofunctionalized implants regardless of the initial ISQ values. The OSI for photofunctionalized implants was 6.3 and 3.1 when their initial ISQ was 65 to 70 and 71 to 75, respectively, whereas the OSI values for as-received implants calculated from literature ranged from -3.0 to 1.17 with an average of -0.10. CONCLUSIONS Photofunctionalization accelerated and enhanced osseointegration of dental implants, providing novel and practical avenues for further advancement in implant therapy.
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Ghiraldini B, Conte A, Casarin RC, Casati MZ, Pimentel SP, Cirano FR, Ribeiro FV. Influence of Glycemic Control on Peri-Implant Bone Healing: 12-Month Outcomes of Local Release of Bone-Related Factors and Implant Stabilization in Type 2 Diabetics. Clin Implant Dent Relat Res 2015; 18:801-9. [PMID: 25825337 DOI: 10.1111/cid.12339] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The poor glycemic status seems to be an important factor affecting implant complication rates, including peri-implant bone loss. PURPOSE This trial evaluated the influence of glycemic control of type 2 diabetes mellitus (T2DM) patients on implant stabilization and on the levels of bone markers in peri-implant fluid during the healing. MATERIALS AND METHODS Systemically healthy patients (SH,n = 19), better-controlled T2DM (BCDM,n = 16), and poorly controlled T2DM (PCDM,n = 16) indicated for implant therapy were recruited. The implant stability quotient (ISQ) was determined at implant placement, 3, 6, and 12 months. Levels of transforming growth factor- β (TGF-β), fibroblast growth factor (FGF), osteopontin (OPN), osteocalcin (OC), and osteoprotegerin (OPG) in the peri-implant fluid were quantified at 15 days, and 3, 6, and 12 months, using the Luminex assay. RESULTS OPG and OPN levels were higher in SH at 12 months than at15 days (p < .05), whereas OC and TGF-β were lower in PCDM at 12 months compared with the 15-day and 3-month follow-ups, respectively (p < .05). Inter-group analyses showed lower OPN levels in PCDM compared with SH at 12 months (p < .05). The ISQ was higher at 12 months when compared with baseline and 3 months in SH (p < .05), whereas no differences were observed during follow-up in diabetics, regardless of glycemic control (p > .05). No difference in ISQ was observed among groups over time (p > .05). CONCLUSION Poor glycemic control negatively modulated the bone factors during healing, although T2DM, regardless of glycemic status, had no effect on implant stabilization.
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Oates TW, Galloway P, Alexander P, Vargas Green A, Huynh-Ba G, Feine J, McMahan CA. The effects of elevated hemoglobin A(1c) in patients with type 2 diabetes mellitus on dental implants: Survival and stability at one year. J Am Dent Assoc 2014; 145:1218-26. [PMID: 25429035 PMCID: PMC4403726 DOI: 10.14219/jada.2014.93] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors conducted a prospective cohort study to determine whether poor glycemic control is a contraindication to implant therapy in patients with type 2 diabetes. METHODS The study sample consisted of 117 edentulous patients, each of whom received two mandibular implants, for a total of 234 implants. Implant-retained mandibular overdentures were loaded after a four-month healing period and followed up for an additional one year. The authors assessed implant survival and stability (by means of resonance frequency analysis) relative to glycated hemoglobin A1c (HbA1c) levels, with baseline levels up to 11.1 percent and levels as high as 13.3 percent over one year. RESULTS Implant survival rates for 110 of 117 patients who were followed up for one year after loading were 99.0 percent, 98.9 percent and 100 percent, respectively, for patients who did not have diabetes (n = 47), those with well-controlled diabetes (n = 44) and those with poorly controlled diabetes (n = 19). The authors considered the seven patients lost to follow-up as having had failed implants; consequently, their conservative estimates of survival rates in the three groups were 93.0 percent, 92.6 percent and 95.0 percent (P = .6510). Two implants failed at four weeks, one in the nondiabetes group and the other in the well-controlled diabetes group. Delays in implant stabilization were related directly to poor glycemic control. CONCLUSIONS The results of this study indicate that elevated HbA1c levels in patients with type 2 diabetes were not associated with altered implant survival one year after loading. However, alterations in early bone healing and implant stability were associated with hyperglycemia.
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Affiliation(s)
- Thomas W Oates
- Dr. Oates is a professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MCS 7888, San Antonio, Texas 78229-3900, e-mail . Address correspondence to Dr. Oates
| | - Patrick Galloway
- Dr. Galloway is a former resident, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio
| | - Peggy Alexander
- Dr. Alexander is a clinical professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio
| | - Adriana Vargas Green
- Dr. Vargas Green is an associate professor, Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio
| | - Guy Huynh-Ba
- Dr. Huynh-Ba is an associate professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio
| | - Jocelyn Feine
- Dr. Feine is a professor, Oral Health and Society Research Unit, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - C Alex McMahan
- Dr. McMahan is a professor, Department of Pathology, University of Texas Health Science Center at San Antonio
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Erdogan Ö, Uçar Y, Tatlı U, Sert M, Benlidayı ME, Evlice B. A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes. Clin Oral Implants Res 2014; 26:1267-75. [PMID: 25041273 DOI: 10.1111/clr.12450] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The objective of this prospective, controlled clinical study was to determine the outcomes of dental implant therapy with staged guided bone regeneration procedures in patients with type 2 diabetes. PATIENTS AND METHODS Twenty-four patients were included in the study. Half of the patients were diagnosed with type 2 diabetes mellitus (group 1) while the other half (group 2) of the patients consisted of patients without diabetes. The edentulous maxillary anterior/premolar regions with sufficient vertical height but inadequate horizontal width were treated with staged guided bone regeneration technique and with one or two implant-supported fixed restorations. The patients were followed up at least for 12 months. The parameters that were evaluated were radiographic evaluations on CBCT images and periapical radiographs, histomorphometric analysis, resonance frequency analysis (RFA) and wound-healing parameters. The data were analyzed statistically. RESULTS A total of 43 implants were placed in 24 patients (22 implants in group 1 and 21 implants in group 2). The survival rates of implants were 100% for both groups. The success rate of implants was 95% for group 1 and 100% for group 2. None of the parameters including CBCT findings, RFA values, success rates and wound-healing scores showed a significant difference between the two groups. CONCLUSION Staged guided bone regeneration is a feasible augmentation procedure for the treatment of horizontal bone deficiencies of the maxillary anterior/premolar regions in well-controlled type 2 diabetic patients.
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Affiliation(s)
- Özgür Erdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey.,Faculty of Dental Medicine, Rangsit University, Pathumthani, Bangkok, Thailand
| | - Yurdanur Uçar
- Department of Prosthodontics, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Ufuk Tatlı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Murat Sert
- Department of Endocrinology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Mehmet Emre Benlidayı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Burcu Evlice
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
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A review on the wettability of dental implant surfaces I: theoretical and experimental aspects. Acta Biomater 2014; 10:2894-906. [PMID: 24590162 DOI: 10.1016/j.actbio.2014.02.040] [Citation(s) in RCA: 215] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 02/14/2014] [Accepted: 02/21/2014] [Indexed: 01/31/2023]
Abstract
The surface wettability of biomaterials determines the biological cascade of events at the biomaterial/host interface. Wettability is modulated by surface characteristics, such as surface chemistry and surface topography. However, the design of current implant surfaces focuses mainly on specific micro- and nanotopographical features, and is still far from predicting the concomitant wetting behavior. There is an increasing interest in understanding the wetting mechanisms of implant surfaces and the role of wettability in the biological response at the implant/bone or implant/soft tissue interface. Fundamental knowledge related to the influence of surface roughness (i.e. a quantification of surface topography) on titanium and titanium alloy surface wettability, and the different associated wetting regimes, can improve our understanding of the role of wettability of rough implant surfaces on the biological outcome. Such an approach has been applied to biomaterial surfaces only in a limited way. Focusing on titanium dental and orthopaedic implants, the present study reviews the current knowledge on the wettability of biomaterial surfaces, encompassing basic and applied aspects that include measurement techniques, thermodynamic aspects of wetting and models predicting topographical and roughness effects on the wetting behavior.
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