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Xu W, Gao X, Zhang M, Jiang Z, Xu X, Huang L, Yao H, Zhang Y, Tong X, Li Y, Lin J, Wen C, Ding X. Electrospun polycaprolactone-chitosan nanofibers on a zinc mesh as biodegradable guided bone-regeneration membranes with enhanced mechanical, antibacterial, and osteogenic properties for alveolar bone-repair applications. Acta Biomater 2024; 187:434-450. [PMID: 39197567 DOI: 10.1016/j.actbio.2024.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/01/2024]
Abstract
Guided bone-regeneration membrane (GBRM) is commonly used in bone-repair surgery because it blocks fibroblast proliferation and provides spatial support in bone-defect spaces. However, the need for removal surgery and the lack of antibacterial properties of conventional GBRM limit its therapeutic applicability for alveolar bone defects. Here we developed a GBRM for alveolar bone-repair and -regeneration applications through double-sided electrospinning of polycaprolactone and chitosan layers on a Zn mesh surface (denoted DSZM). The DSZM showed a UTS of ∼25.6 MPa, elongation of ∼16.1%, strength-elongation product of ∼0.413 GPa%, and ultrahigh spatial maintenance ability, and the UTS was over 6 times higher than that of commercial Bio-Gide membrane. The DSZM exhibited a corrosion rate of ∼17 µm/y and a Zn ion concentration of ∼0.23 µg/ml after 1 month of immersion in Hanks' solution. The DSZM showed direct and indirect cytocompatibility with exceptional osteogenic differentiation and calcium deposition toward MC3T3-E1 cells. Further, the DSZM showed strongly sustained antibacterial activity against S. aureus and osteogenesis in a rat critical-sized maxillary defect model. Overall, the DSZM fits the requirements for alveolar bone-repair and -regeneration applications as a biodegradable GBRM material due to its spatial support, suitable degradability, cytocompatibility, and antibacterial and osteogenic capabilities. STATEMENT OF SIGNIFICANCE: This work reports the mechanical properties, antibacterial ability and osteogenic properties of electrospun PCL-CS nanofiber on Zn mesh as biodegradable guided bone-regeneration membrane for alveolar bone-repair applications. Our findings demonstrate that the DSZM prepared by double-sided electrospinning of PCL-CS layers on Zn mesh showed a UTS of ∼25.6 MPa, elongation of ∼16.1%, strength-elongation product of ∼0.413 GPa%, and ultrahigh spatial maintenance ability, and the UTS was over 6 times greater than that of commercial Bio-Gide® membrane. The DSZM showed direct and indirect cytocompatibility with exceptional osteogenic differentiation and calcium deposition toward MC3T3-E1 cells. Further, the DSZM showed strongly sustained antibacterial activity against S. aureus and osteogenesis in a rat critical-sized maxillary defect model.
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Affiliation(s)
- Wenjie Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China; Xiamen Susong Hospital, Xiamen 361000, China
| | - Xue Gao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Menghan Zhang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Zhengting Jiang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Xiaomin Xu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Liangfu Huang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Huiyu Yao
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Yitian Zhang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Xian Tong
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China.
| | - Yuncang Li
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia
| | - Jixing Lin
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China.
| | - Cuie Wen
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia.
| | - Xi Ding
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
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Hu C, Yang Q, Huang X, Wang F, Zhou H, Su X. Three-Dimensional Mechanical Microenvironment Rescued the Decline of Osteogenic Differentiation of Old Human Jaw Bone Marrow Mesenchymal Stem Cells. ACS Biomater Sci Eng 2024; 10:4496-4509. [PMID: 38860704 DOI: 10.1021/acsbiomaterials.4c00680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Resorption and atrophy of the alveolar bone, as two consequences of osteoporosis that remarkably complicate the orthodontic and prosthodontic treatments, contribute to the differentiated biological features and force-induced response of jaw bone marrow-derived mesenchymal stem cells (JBMSCs) in elderly patients. We isolated and cultured JBMSCs from adolescent and adult patients and then simulated the loading of orthodontic tension stress by constructing an in vitro three-dimensional (3D) stress loading model. The decline in osteogenic differentiation of aged JBMSCs was reversed by tensile stress stimulation. It is interesting to note that tension stimulation had a stronger effect on the osteogenic differentiation of elderly JBMSCs compared to the young ones, indicating a possible mechanism of aging rescue. High-throughput sequencing of microRNA (miRNAs) was subsequently performed before and after tension stimulation in all JBMSCs, followed by the comprehensive comparison of mechanically responsive miRNAs in the 3D strain microenvironment. The results suggested a significant reduction in the expression of miR-210-3p and miR-214-3p triggered by the 3D strain microenvironment in old-JBMSCs. Bioinformatic analysis indicated that both miRNAs participate in the regulation of critical pathways of aging and cellular senescence. Taken together, this study demonstrated that the 3D strain microenvironment efficiently rescued the cellular senescence of old-JBMSCs via modulating specific miRNAs, which provides a novel strategy for coordinating periodontal bone loss and regeneration of the elderly.
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Affiliation(s)
- Cheng Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
- Hospital of Stomatology & Guangdong Provincial Key Laboratory of Stomatology & Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Qiyuan Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaojun Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Fei Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Hong Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Xiaoxia Su
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
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Francis JR, Barber HD, Beals D, Siu T. The Relationship of Low-Serum Vitamin D and Early Dental Implant Failure. J ORAL IMPLANTOL 2024; 50:215-218. [PMID: 38530826 DOI: 10.1563/aaid-joi-d-23-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
The study is aimed to assess the effects of serum vitamin D levels and their relationship to early dental implant failures. A total of 174 implants in 109 patients were placed and serum vitamin D levels were noted on the day of implant placement. Implants were followed up until restoration, approximately 3-6 months later, and any implant failure was reported based on 50% or more bone loss or implant mobility. Eight individuals had an implant fail early and their vitamin D levels had a mean of 42.54 ng/mL compared with the successful patients' levels of 31.92 ng/mL. Although not statistically significant, there was no correlation between patients' low serum vitamin D levels and early implant failure.
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Affiliation(s)
- John R Francis
- Midwestern University, College of Dental Medicine-Arizona
| | | | - Douglas Beals
- Midwestern University, College of Dental Medicine-Arizona
| | - Trever Siu
- Midwestern University, College of Dental Medicine-Arizona
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Wang Y, Cao X, Shen Y, Zhong Q, Huang Y, Zhang Y, Huang Q, Xu C. Osteogenic effect of low-intensity pulsed ultrasound on peri-implant bone: A systematic review and meta-analysis. J Prosthodont Res 2024; 68:215-226. [PMID: 37518333 DOI: 10.2186/jpr.jpr_d_23_00068] [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] [Indexed: 08/01/2023]
Abstract
Purpose This study aimed to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on promoting osseointegration around dental implants.Study selection A comprehensive search was performed on two databases, including MEDLINE (PubMed) and Web of Science to identify relevant studies published before June 1, 2022. Randomized controlled trials that met the inclusion criteria were selected for the study. The year of publication, study design, animal species, number of animals, number of implants, implant position, implant size, intervention, follow-up time, bone volume ratio (BV/TV), bone-implant contact ratio (BIC), and implant removal torque value (RTV) measurements, including mean and SD, were extracted.Results Ten randomized trials were included in this meta-analysis. The results showed that LIPUS significantly promoted osteogenesis around dental implants. Furthermore, in animal models of pre-existing diseases such as osteoporosis and diabetes, LIPUS had the same effect. The included data were divided into subgroups to explore the effects of different follow-up time, acoustic intensities, and frequencies. Results showed that higher acoustic intensities and frequencies significantly improve the osteogenic effects of LIPUS. There was some degree of heterogeneity owing to bias in the included studies. More high-quality randomized controlled trials are necessary in the future.Conclusions LIPUS can promote bone healing around dental implants and is an attractive option for edentulous patients, especially those with pre-existing diseases. Further clinical trials on the use of LIPUS in implant dentistry are warranted. Furthermore, future studies must pay more attention to acoustic intensity and frequency.
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Affiliation(s)
- Yingying Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ximeng Cao
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yingyi Shen
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qi Zhong
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yujie Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yifan Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qingfeng Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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6
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Mulligan R, Suarez Durall P. Geriatric Phenotypes and Their Impact on Oral Health. Clin Geriatr Med 2023; 39:235-255. [PMID: 37045531 DOI: 10.1016/j.cger.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.
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Affiliation(s)
- Roseann Mulligan
- Herman Ostrow School of Dentistry of the University of Southern California, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA.
| | - Piedad Suarez Durall
- Herman Ostrow School of Dentistry of the University of Southern California, University Park Campus, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA
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Lemos CAA, de Oliveira AS, Faé DS, Oliveira HFFE, Del Rei Daltro Rosa CD, Bento VAA, Verri FR, Pellizzer EP. Do dental implants placed in patients with osteoporosis have higher risks of failure and marginal bone loss compared to those in healthy patients? A systematic review with meta-analysis. Clin Oral Investig 2023:10.1007/s00784-023-05005-2. [PMID: 37043030 DOI: 10.1007/s00784-023-05005-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to compare the dental implant survival rate and marginal bone loss between patients with and without osteoporosis. MATERIALS AND METHODS This systematic review was registered in PROSPERO (CRD42022356377). A systematic search was performed using five databases: MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to July 2022. Additional searches in ClinicalTrials.gov and the reference lists of included studies were performed. The eligibility criteria comprised observational studies with a direct comparison between patients with and without osteoporosis, with a minimum follow-up of 1 year and 10 implants placed in each group, which consider data analysis based on implant level, without restrictions on period or language of publication. The meta-analysis was performed using RevMan 5.4 program. Risk of bias analysis of the included studies was performed using the Newcastle-Ottawa scale (NOS). RESULTS Twelve studies met the eligibility criteria, totaling 1132 patients with a mean age range from 54 to 76.6 years. Most of the included patients were women (73.6%). A total of 3505 implants were evaluated-983 in patients with osteoporosis and 2522 in patients without osteoporosis. The meta-analysis indicated no difference in implant survival rates between patients with and without osteoporosis (OR, 1.78; 95% confidence interval [CI], 0.86-3.70; P = 0.12). However, significant bone loss was observed around dental implants placed in patients with osteoporosis (SMD, 0.71 mm; 95% CI, 0.06-0.87 mm). The NOS indicated a low risk of bias in the studies included. However, the certainty of the evidence was classified as very low and low for implant survival rates and bone loss, respectively. CONCLUSION According to the limitations of the present review, the data suggest that dental implants are a viable treatment option for the rehabilitation of patients with osteoporosis. However, clinical care by professionals is necessary to ensure the maintenance of peri-implant bone stability, as these patients may be susceptible to increased bone loss.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
| | - Andreza Soares de Oliveira
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | | | - Cleber Davi Del Rei Daltro Rosa
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, SP, Brazil
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Cheng YC, Ewers R, Morgan K, Hirayama M, Murcko L, Morgan J, Bergamo ETP, Bonfante EA. Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women. Clin Oral Investig 2022; 26:6569-6582. [PMID: 36001145 DOI: 10.1007/s00784-022-04609-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effects of antiresorptive treatment on the survival of plateau-root form dental implants. MATERIALS AND METHODS Patients undergoing antiresorptive therapy via oral or intravenous administration as well as patients not undergoing antiresorptive therapy and healthy control patients were included in this retrospective cohort study. In total, 1472 implants placed in 631 postmenopausal patients (M: 66.42 ± 9.10 years old), who were followed for a period of up to 20 years (8.78 ± 5.68 years). Kaplan-Meier survival analysis was performed, and univariate and multivariate Cox regression, clustered by each patient, was used to evaluate and study factors affecting the survival of their implants. RESULTS Implants placed in patients undergoing oral antiresorptive treatment presented significantly higher survival rates, than implants placed in the osteoporosis/osteopenia control cohort (p value < 0.001), and similar survival rates, when compared to healthy controls (p value = 0.03). Additionally, clustered univariate and multivariate Cox regression analysis also revealed higher implant survival when oral antiresorptive drugs (p value = 0.01 and 0.007, respectively) were used, and lower implant survival in the presence of untreated osteoporosis/osteopenia (p value = 0.002 and 0.005, respectively). Overall, the 20-year implant survival in osteoporotic patients undergoing antiresorptive therapy was 94%. For the failed implants, newly replaced implants in patients under antiresorptive treatment presented a 10-year survival of 89%. CONCLUSIONS Long-term plateau-root form implant survival in osteoporotic patients taking oral antiresorptives was similar to a healthy population and significantly higher than the untreated controls. CLINICAL RELEVANCE These results suggest that plateau-root form implants provide a robust solution for treating tooth loss in patients, who are undergoing antiresorptive therapy.
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Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rolf Ewers
- University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
| | | | | | | | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil
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9
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Stefos S, Kourtis S, Vrekoussis T, Augoulea A, Kalantaridou S. Quality of Life in Menopausal Women with Dental Restorations and Implants. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2203151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This multicenter study examined the relationship, possible interactions, and intermittent effects that dental implants and prostheses can have on menopausal women’s quality of life as well as provided information regarding the possible side effects of therapeutic regimens on menopause and osteoporosis or osteopenia.
Materials and Methods:
Questionnaires consisted of selected quality of life questions based on specific and additional medical and dental (mainly prosthodontic) questions, which were administered to 100 Greek menopausal/post-menopausal women (Age: Mean Value=63,62 years old) with osteopenia or with or without osteoporosis, with dental implants and implant restorations, or conventional prosthetic restorations visiting two University Hospitals. Menopausal/post-menopausal status was judged on the basis of either secondary, definitive amenorrhoea or based on follicular stimulation hormone (FSH) values, estradiol, and clinical risk factors.
Results:
Participants had a statistically significantly better “functional” and “psychological” feeling after prosthodontic rehabilitation with and without implants. Three out of four reported that their dentist informed them of the possible implant problems that might arise from osteoporosis and its treatment (medications). Moreover, osteopenia was found to be associated with a very lower problem percentage. The bisphosphonate treatment had the highest rate (80%) of reported implant problems than non-bisphosphonate treatment (30%). The hormone replacement therapy (HRT) for menopause was reported to be more associated with problems in implant placement (19%) than in those without treatment (27.3%).
Conclusion:
The questionnaires revealed a significant improvement concerning women’s life quality and well-documented information about the problems their dental implants and restorations may cause in association with menopause and/or osteoporosis.
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Aminoshariae A, Donaldson M, Horan M, Mackey SA, Kulild JC, Baur D. Emerging antiresorptive medications and their potential implications for dental surgeries. J Am Dent Assoc 2022; 153:649-658. [DOI: 10.1016/j.adaj.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/20/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022]
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Zhou Y, Hu Z, Ge M, Jin W, Tang R, Li Q, Xu W, Shi J, Xie Z. Intraosseous Injection of Calcium Phosphate Polymer-Induced Liquid Precursor Increases Bone Density and Improves Early Implant Osseointegration in Ovariectomized Rats. Int J Nanomedicine 2021; 16:6217-6229. [PMID: 34531654 PMCID: PMC8439716 DOI: 10.2147/ijn.s321882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Osteoporosis, due to bone loss and structural deterioration, is a risk factor for dental implant failure, as it impedes initial stability and osseointegration. We aim to assess the effects of calcium phosphate polymer-induced liquid precursor (CaP-PILP) treatment, which significantly increases bone density and improves early implant osseointegration in ovariectomized rats. METHODS In this study, CaP-PILP was synthesized and characterized through TEM, FTIR and XRD. A rat model of osteoporosis was generated by ovariectomy. CaP-PILP or hydroxyapatite (HAP, negative control) was injected into the tibia, and the resulting changes in bone quality were determined. Further, implants were installed in the treated tibias, and implantation characteristics were assessed after 4 weeks. RESULTS The CaP-PILP group had superior bone repair. Importantly, CaP-PILP had excellent properties, similar to those of normal bone, in terms of implant osseointegration. In vivo experiment displayed that CaP-PILP group had better bone contact rate (65.97±3.176) than HAP and OVX groups. Meanwhile, a mound of mature and continuous new bone formed. Moreover, the values of BIC and BA showed no significant difference between the CaP-PILP group and the sham group. CONCLUSION In summary, CaP-PILP is a promising material for application in poor-quality bones to improve implant success rates in patients with osteoporosis. This research provides new perspectives on the application of nano-apatite materials in bone repair.
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Affiliation(s)
- Yanyan Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Zihe Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Mingjie Ge
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Wenjing Jin
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Ruikang Tang
- Center for Biomaterials and Biopathways, Department of Chemistry, Zhejiang University, Hangzhou, 310027, People’s Republic of China
| | - Qi Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Weijian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Jue Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, People’s Republic of China
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12
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Texturized P(VDF-TrFE)/BT membrane enhances bone neoformation in calvaria defects regardless of the association with photobiomodulation therapy in ovariectomized rats. Clin Oral Investig 2021; 26:1053-1065. [PMID: 34370100 DOI: 10.1007/s00784-021-04089-y] [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: 05/01/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this investigation was to evaluate in vivo the response of bone tissue to photobiomodulation when associated with texturized P(VDF-TrFE)/BT in calvaria defects of ovariectomized rats. MATERIALS AND METHODS Wistar Hannover rats were submitted to ovariectomy/control surgery. Calvaria bone defects of 5-mm diameter were performed after 90 days of ovariectomy. The animals were divided into OVX (without laser (L) and membrane), OVX + P(VDF-TrFE)/BT, OVX + P(VDF-TrFE)/BT + L, and OVX + PTFE + L. It was utilized a low-intensity gallium-aluminum-arsenide laser (GaAlAs) with 780-nm wavelength and 30-J/cm2 energy density in 12 sessions (120 s). Thirty days after the bone defect the animals were euthanized for histological, microtomographic, and molecular evaluation. Quantitative analysis was analyzed by statistical software for p < 0.05. RESULTS Histological parameters showed bone tissue formation at the borders of all group defects. The association of photobiomodulation and texturized P(VDF-TrFE)/BT was not synergistic and did not show significant changes in morphometric analysis and biomarkers gene expression. Nevertheless, texturized P(VDF-TrFE)/BT membrane enhanced bone repair regardless of the association with photobiomodulation therapy, with an increase of connectivity density when compared to the OVX + PTFE + L group. The association of photobiomodulation therapy and PTFE was synergistic, increasing the expression of Runx2, Alp, Bsp, Bglap, Sp7, and Rankl, even though not enough to reflect significance in the morphometric parameters. CONCLUSIONS The utilization of texturized P (VDF-TrFE)/BT, regardless of the association with photobiomodulation therapy, enhanced bone repair in an experimental model of osteoporosis.
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Abstract
Older adults have multiple morbidities that can impact oral, systemic, and psychological health. Although each disorder requires consideration from the provider before treatment, by assessing the common phenotypic presentations of older adults, we can better understand, select, and coordinate treatment modifications that would need to be considered and implemented for dental care.
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Affiliation(s)
- Roseann Mulligan
- Herman Ostrow School of Dentistry of the University of Southern California, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA.
| | - Piedad Suarez Durall
- Herman Ostrow School of Dentistry of the University of Southern California, University Park Campus, DEN 4338, Mail Code: 0641, Los Angeles, CA 90089, USA
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14
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Sulijaya B, Takahashi N, Yamazaki K. Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation. Arch Oral Biol 2019; 105:72-80. [PMID: 31288144 DOI: 10.1016/j.archoralbio.2019.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/26/2019] [Accepted: 07/02/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed. DESIGN Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated. RESULT Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects. CONCLUSION Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.
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Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Naoki Takahashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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15
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Kim JW, Kim HY, Kim SY, Kim SJ. Impaired osseointegration of dental implants associated with orthognathic surgery: Possible regional acceleratory phenomenon. Clin Implant Dent Relat Res 2019; 21:531-537. [PMID: 30884115 DOI: 10.1111/cid.12745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 02/08/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Regional acceleratory phenomenon (RAP) is demonstrated to decrease regional bone mineral density and accelerate bone turnover. Hypothesizing that RAP can negatively affect the osseointegration of biomaterials, this study aimed to investigate the possible influence of the RAP on dental implant osseointegration. MATERIALS AND METHODS Orthognathic surgery, one of the major surgeries on oral and maxillofacial region was set as intervention for RAP. Considering that RAP exerts its physiologic effects until 4 months after noxious stimuli, patients were classified according to the time interval between orthognathic surgery and dental implant installation; group I was designated to patients who had implant installation within 4 months from orthognathic surgery. Group II were those with installation after 4-12 months and group III was longer than 12 months. Radiographic and clinical evaluations of dental implants including peri-implant marginal bone changes (MBR), implant stability, cumulative survival rates were analyzed. RESULTS A total of 54 patients with 106 implants (mean follow-up of 72.6 months) were included in the study. MBR was significantly higher in group I (2.62 ± 0.91 mm) and II (2.25 ± 0.95 mm) compared to that of group III (0.94 ± 0.90 mm) at last follow up (P < 0.05) and this group difference over time was also significant (P < 0.001). Compared to group III, groups I and II exhibited lower ISQ values and higher biological complications including peri-implantitis and peri-implant gingivitis (P < 0.05). Group I showed significantly low-cumulative survival rate (89.2%; implant-level) compared to groups II and III. CONCLUSIONS In this study, impaired osseointegration of dental implants was demonstrated associated with orthognathic surgery. Micro-environmental changes of hard tissue induced by major surgery on the jaw showed deteriorating effects on integrity of biomaterial osseointegration. Special considerations should be addressed for ideal treatment results and prognosis.
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Affiliation(s)
- Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, South Korea.,Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, South Korea
| | - Heon-Young Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, South Korea
| | - Seon-Yeong Kim
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, South Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, South Korea.,Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, South Korea
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16
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Arioka M, Zhang X, Li Z, Tulu US, Liu Y, Wang L, Yuan X, Helms JA. Osteoporotic Changes in the Periodontium Impair Alveolar Bone Healing. J Dent Res 2019; 98:450-458. [PMID: 30626268 DOI: 10.1177/0022034518818456] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of this study was to determine the extent to which osteoporosis affects the jaw skeleton and then to evaluate possible mechanisms whereby an osteoporotic phenotype might affect the rate of alveolar bone healing following tooth extraction. Using an ovariectomized mouse model coupled with micro-computed tomographic imaging, histologic, molecular, and cellular assays, we first demonstrated that the appendicular and jaw skeletons both develop osteoporotic phenotypes. Next, we demonstrated that osteoporotic mice exhibit atrophy of the periodontal ligament (PDL) and that this atrophy was accompanied by a reduction in the pool of osteoprogenitor cells in the PDL. The paucity of PDL-derived osteoprogenitor cells in osteoporotic mice was associated with significantly slower extraction socket healing. Collectively, these analyses demonstrate that the jaw skeleton is susceptible to the untoward effects of osteoporosis that manifest as thinner, more porous alveolar bone, PDL thinning, and slower bone repair. These findings have potential clinical significance for older osteopenic patients undergoing reconstructive procedures.
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Affiliation(s)
- M Arioka
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,2 Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - X Zhang
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,3 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Z Li
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,4 Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - U S Tulu
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - Y Liu
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,3 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - L Wang
- 3 State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Yuan
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - J A Helms
- 1 Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
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17
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Dereka X, Calciolari E, Donos N, Mardas N. Osseointegration in osteoporotic-like condition: A systematic review of preclinical studies. J Periodontal Res 2018; 53:933-940. [PMID: 29845622 DOI: 10.1111/jre.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 12/11/2022]
Abstract
Osteoporosis is one of the most common skeletal disorders affecting a significant percentage of people worldwide. Research data suggested that systemic diseases such as osteoporosis could act as risk factors for osseointegration, jeopardizing the healing process and thus the predictability of dental implant success on compromised patients. It is well accepted that preclinical studies in animal models reproducing the osteoporotic condition are one of the most important stages in the research of new biomaterials and therapeutic modalities. The aim of this systematic review was to investigate whether osteoporosis compromises dental implant osseointegration in experimental osteoporotic-like conditions. A 3-stage systematic literature research was conducted in MEDLINE via OVID and EMBASE up to and including March 2017. Experimental studies reporting on dental implant osseointegration on different osteoporotic animal models were assessed. The studies had to report on the percentage of bone-to-implant contact (%BIC) as the primary outcome. ARRIVE guidelines for reporting on animal research were applied to evaluate the methodological quality and risk of bias of the studies. Fifty-seven studies met the inclusion criteria and were assessed qualitatively. The most adopted animal model was the rat. A variability of %BIC values was observed, ranging from 30% to 99% and from 26% to 94% for the healthy and osteoporotic group, respectively. The great majority (47) of the included studies concluded that estrogen deficiency significantly affects BIC values, 9 studies stated that it was not possible to observe statistical differences in BIC between ovariectomized and healthy groups and 1 study did not provide a comparison between the healthy and osteoporotic group. Owing to the great heterogeneity in implant surface, study design, observation time-points, site of implant placement and reported outcomes, a meta-analysis could not be performed. An overall high risk of bias was observed, owing to the limited information on animal housing and husbandry, baseline characteristics and health status, ethical statement and allocation to the experimental groups provided. Although the available studies seem to suggest a lower osseointegration in osteoporotic-like conditions, no robust conclusions can be drawn due to the great heterogeneity and overall low quality of the available studies. Future studies with emphasis on minimizing the possible sources of bias and evaluating osseointegration of dental implants placed into jawbones instead of long bones are warranted.
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Affiliation(s)
- X Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - E Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Donos
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Centre for Clinical Oral Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - N Mardas
- Centre for Oral Immunobiology & Regenerative Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
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18
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Kim JW, Lee H, Lim HK, Kim JW, Byun SH, Choi YJ, Lee UL. Orthognathic surgery Deteriorates the osseointegration of dental implants: A propensity-matched multicentre cohort study. J Oral Rehabil 2018; 45:967-973. [PMID: 30125391 DOI: 10.1111/joor.12705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/24/2018] [Accepted: 08/15/2018] [Indexed: 12/22/2022]
Abstract
This study aimed to investigate the possible influence of the regional acceleratory phenomenon (RAP) on dental implant osseointegration. Orthognathic surgery was set as an intervention for RAP, and a multicentre cohort study of two groups was undertaken. Group O included patients with single implant placement at least 4 months after orthognathic surgery and functional loading for more than 1 year, while controls (Group C) were without any major surgery. Clinical and radiographic assessments of implants, including changes in marginal bone levels, were analysed at baseline, 6- and 12-month follow-up. Bivariate analysis of two groups with propensity score matching was performed. After propensity score matching, all 10 confounding variables had acceptable standardised difference scores (<20%), indicating that the matching procedure had efficiently balanced the two groups. Following the propensity score adjustment, the marginal bone loss was significantly higher in Group O than the control at 6 months (1.66 ± 1.05 mm vs 0.59 ± 0.64 mm, P < 0.001) and 12 months (2.30 ± 1.27 mm vs 0.82 ± 0.78 mm, P < 0.001). Compared to Group C, subjects in Group O had a higher incidence of peri-implant mucositis and implantitis (11.8% vs 1.5%, P = 0.033). Impaired osseointegration of dental implants was associated with orthognathic surgery. Special considerations for peri-implant soft and hard tissue stability should be addressed to obtain ideal treatment results and prognosis for patients who have had prior orthognathic surgery.
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Affiliation(s)
- Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea.,Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea
| | - Ho Lee
- Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ho-Kyung Lim
- Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital, Seoul, Korea
| | - Ju-Won Kim
- Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Pyeong-chon Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, Korea
| | - Soo-Hwan Byun
- Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, Korea
| | - Young-Jun Choi
- Department of Oral and Maxillofacial Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ui-Lyong Lee
- Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital, Seoul, Korea
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19
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Barngkgei I, Khattab R. Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: The
OSTEOSYR
project. ACTA ACUST UNITED AC 2018; 9:e12332. [DOI: 10.1111/jicd.12332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Imad Barngkgei
- Department of Oral MedicineFaculty of DentistrySyrian Private University Damascus Syria
- Department of Oral MedicineFaculty of DentistryDamascus University Damascus Syria
| | - Razan Khattab
- Department of PeriodontologyFaculty of DentistryDamascus University Damascus Syria
- Department of PeriodontologyFaculty of DentistryAlsham Private University Damascus Syria
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20
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21
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Sturrock A, Preshaw PM, Hayes C, Wilkes S. Attitudes and perceptions of GPs and community pharmacists towards their role in the prevention of bisphosphonate-related osteonecrosis of the jaw: a qualitative study in the North East of England. BMJ Open 2017; 7:e016047. [PMID: 28965092 PMCID: PMC5640123 DOI: 10.1136/bmjopen-2017-016047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare, yet significant, adverse effect of bisphosphonate therapy. A multidisciplinary approach to the prevention of BRONJ is recommended due to the significant morbidity and difficulty treating the condition. Current evidence suggests that both general practitioners (GPs) and community pharmacists have limited knowledge relating to BRONJ and that preventative strategies are rarely implemented. OBJECTIVE To explore the attitudes and perceptions of GPs and community pharmacists on the risks and preventative strategies for the development of BRONJ. DESIGN Interpretivist methodological approach using qualitative semistructured interviews. PARTICIPANTS 9 community pharmacists and 8 GPs. SETTING Primary Care in North East England and Cumbria, UK. METHODS Using a Grounded Theory methodology and integrating a process of constant comparison in the iterative enrichment of data sets, semistructured interviews were undertaken, transcribed and analysed using framework analysis. Salient themes were identified and related back to extant literature in the field. RESULTS Four salient and inter-related themes emerged: (1) uncertain knowledge, indicating limited exposure of respondents to BRONJ, and limited awareness of the implications of its diagnosis, risk factors and preventative strategies; (2) patient specific, referring to the complexity of patients, patient education and prioritising aspects of care; (3) wider context, indicating a lack of interdisciplinary communication and referral processes between professions, workload pressures, access and patient receptivity to dental services; and (4) professional, reflecting professional roles and responsibilities, authority and educational initiatives CONCLUSIONS: Effective communication or collaborative care between GPs and community pharmacists for the prevention of BRONJ is not apparent. Interventions to mitigate against the risk of developing BRONJ and clarity of GP and community pharmacy roles are required.
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Affiliation(s)
- Andrew Sturrock
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Philip M Preshaw
- Centre for Oral Health Research and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Catherine Hayes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Scott Wilkes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
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22
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de-Freitas NR, Lima LB, de-Moura MB, Veloso-Guedes CCF, Simamoto-Júnior PC, de-Magalhães D. Bisphosphonate treatment and dental implants: A systematic review. Med Oral Patol Oral Cir Bucal 2016; 21:e644-51. [PMID: 27475681 PMCID: PMC5005105 DOI: 10.4317/medoral.20920] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 03/01/2016] [Indexed: 12/02/2022] Open
Abstract
Background To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. Material and Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in “PICO” format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. Results The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. Conclusions Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed. Key words:Bisphosphonates, diphosphonates, dental implants, osteonecrosis.
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Affiliation(s)
- N-R de-Freitas
- Area of Oral & Maxillofacial Surgery, and Implantology, School of Dentistry, Federal University of Uberlândia, Avenida Pará, 1720, bloco 4T, CEP 38405-900 Uberlândia, Minas Gerais, Brazil,
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23
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Jonasson G, Rythén M. Alveolar bone loss in osteoporosis: a loaded and cellular affair? Clin Cosmet Investig Dent 2016; 8:95-103. [PMID: 27471408 PMCID: PMC4948717 DOI: 10.2147/ccide.s92774] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Maxillary and mandibular bone mirror skeletal bone conditions. Bone remodeling happens at endosteal surfaces where the osteoclasts and osteoblasts are situated. More surfaces means more cells and remodeling. The bone turnover rate in the mandibular alveolar process is probably the fastest in the body; thus, the first signs of osteoporosis may be revealed here. Hormones, osteoporosis, and aging influence the alveolar process and the skeletal bones similarly, but differences in loading between loaded, half-loaded, and unloaded bones are important to consider. Bone mass is redistributed from one location to another where strength is needed. A sparse trabeculation in the mandibular premolar region (large intertrabecular spaces and thin trabeculae) is a reliable sign of osteopenia and a high skeletal fracture risk. Having dense trabeculation (small intertrabecular spaces and well-mineralized trabeculae) is generally advantageous to the individual because of the low fracture risk, but may imply some problems for the clinician.
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Affiliation(s)
- Grethe Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg
- Research and Development Centre, Borås
| | - Marianne Rythén
- Research and Development Centre, Borås
- Specialist Clinic for Pediatric Dentistry, Public Dental Service, Mölndal, Sweden
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Temmerman A, Rasmusson L, Kübler A, Thor A, Quirynen M. An open, prospective, non-randomized, controlled, multicentre study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 1-year results. Clin Oral Implants Res 2016; 28:95-102. [DOI: 10.1111/clr.12766] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Andy Temmerman
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery; University of Wuerzburg; Würzburg Germany
| | - Andreas Thor
- Department of Oral and Maxillofacial Surgery; Institute of Surgical Sciences; Uppsala University; Uppsala Sweden
| | - Marc Quirynen
- Section of Periodontology; Department of Oral Health Sciences; KU Leuven & Dentistry; University Hospitals; KU Leuven; Leuven Belgium
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25
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Jonasson G. Five-year alveolar bone level changes in women of varying skeletal bone mineral density and bone trabeculation. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:86-93. [PMID: 26093684 DOI: 10.1016/j.oooo.2015.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 03/29/2015] [Accepted: 04/14/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To investigate alveolar bone level changes in women with varying skeletal bone mineral density (BMD) and bone trabeculation. STUDY DESIGN In a prospective, longitudinal study of 128 women (22-75 years of age), BMD (dual x-ray absorptiometry), and periapical radiography were performed in 1996 and 2001. The mandibular trabecular bone was assessed as dense, mixed, or sparse. Mandibular alveolar bone level was measured with a Schei ruler and related to BMD (osteoporotic, osteopenic, or normal) and trabeculation. RESULTS After 5 years, the total bone level score was significantly decreased (P = .001). No significant differences were found in the total bone level scores between the different BMD groups. The greatest decreased total bone level score in 1996 was found in the group with dense trabeculation (0.71 in the dense group vs. 0.31 in the nondense group, P = .005), and similarly in 2001 (0.75 in the dense group vs. 0.39 in the nondense group, P = .020). Five-year changes in the total bone level scores did not differ between trabeculation groups (P = .37). CONCLUSIONS The small group of women with dense mandibular trabecular bone seems to suffer a greater decrease in alveolar bone height compared with other women, including women with osteoporosis.
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Affiliation(s)
- Grethe Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research and Development Centre, Sven Eriksonplatsen 4, 50338 Borås, Sweden.
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Spyropoulou A, Karamesinis K, Basdra EK. Mechanotransduction pathways in bone pathobiology. Biochim Biophys Acta Mol Basis Dis 2015; 1852:1700-8. [PMID: 26004394 DOI: 10.1016/j.bbadis.2015.05.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/12/2015] [Accepted: 05/14/2015] [Indexed: 12/16/2022]
Abstract
The skeleton is subject to dynamic changes throughout life and bone remodeling is essential for maintenance of bone functionality. The cell populations which predominantly participate in bone and cartilage remodeling, namely osteocytes, osteoblasts, osteoclasts and chondrocytes sense and respond to external mechanical signals and via a series of molecular cascades control bone metabolism and turnover rate. The aforementioned process, known as mechanotransduction, is the underlying mechanism that controls bone homeostasis and function. A wide array of cross-talking signaling pathways has been found to play an important role in the preservation of bone and cartilage tissue health. Moreover, alterations in bone mechanotransduction pathways, due to genetic, hormonal and biomechanical factors, are considered responsible for the pathogenesis of bone and cartilage diseases. Extensive research has been conducted and demonstrated that aberrations in mechanotransduction pathways result in disease-like effects, however only few signaling pathways have actually been engaged in the development of bone disease. The aim of the present review is to present these signaling molecules and cascades that have been found to be mechano-responsive and implicated in bone disease development, as revealed by research in the last five years. In addition, the role of these molecules as prognostic or diagnostic disease markers and their potential as therapeutic targets are also discussed.
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Affiliation(s)
- Anastasia Spyropoulou
- Department of Biological Chemistry, Cellular and Molecular Biomechanics Unit, University of Athens Medical School, 11527 Athens, Greece
| | - Konstantinos Karamesinis
- Department of Biological Chemistry, Cellular and Molecular Biomechanics Unit, University of Athens Medical School, 11527 Athens, Greece
| | - Efthimia K Basdra
- Department of Biological Chemistry, Cellular and Molecular Biomechanics Unit, University of Athens Medical School, 11527 Athens, Greece.
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Lim WH, Liu B, Mah SJ, Yin X, Helms JA. Alveolar Bone Turnover and Periodontal Ligament Width Are Controlled by Wnt. J Periodontol 2015; 86:319-26. [DOI: 10.1902/jop.2014.140286] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Paulsson-Björnsson L, Adams J, Bondemark L, Devlin H, Horner K, Lindh C. The impact of premature birth on the mandibular cortical bone of children. Osteoporos Int 2015; 26:637-44. [PMID: 25266484 DOI: 10.1007/s00198-014-2898-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 09/08/2014] [Indexed: 11/27/2022]
Abstract
SUMMARY Children born prematurely often have reduced skeletal mineralization. The aim in this study was to compare the cortical thickness of the lower jaw on radiographs of 8- to 10-year-old children with histories of preterm or full term births. There were no significant differences in cortical thickness between full term and preterm children at this age. INTRODUCTION The purpose of this study was to compare the cortical thickness of the mandible on panoramic radiographs of 8- to 10-year-old children with histories of preterm or full term births. METHODS Panoramic radiography was performed on 36 extremely preterm, 38 very preterm and 42 full term children at the age of 8 to 10 years. Five observers independently measured the mandibular cortical width on the panoramic radiographs at four defined sites bilaterally. Altogether, 928 sites were available. Measurements were performed twice on a random 24% of the sites by four observers. One-way analysis of variance with Tukey's post hoc test was used to test differences between groups. Intraclass correlation coefficient (ICC) was calculated for interobserver agreement while intra-observer agreement was expressed as measurement precision. RESULTS Significant differences of mandibular cortical width were found between extremely preterm and very preterm children for five of the eight measurement sites with the very preterm showing the highest value. No significant differences were found between full term and either very preterm or extremely preterm except for one measurement site, with the extremely preterm showing the lowest value. ICC varied between 0.30 and 0.83 for the different sites (mean 0.62). The precision of a single measurement varied between 0.11 and 0.45 mm (mean 0.25 mm). CONCLUSIONS From the evidence that very preterm children had significantly thicker mandibular cortices than extremely preterm children, we suggest that these findings may reflect the effect of mineral supplementation provided to premature infants, causing a 'shifting up' of bone mineral status relative to the full term peer group while maintaining the difference between very preterm and extremely preterm born children.
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Zhou Y, Guan X, Liu T, Wang X, Yu M, Yang G, Wang H. Whole body vibration improves osseointegration by up-regulating osteoblastic activity but down-regulating osteoblast-mediated osteoclastogenesis via ERK1/2 pathway. Bone 2015; 71:17-24. [PMID: 25304090 DOI: 10.1016/j.bone.2014.09.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/25/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
Due to the reduction in bone mass and deterioration in bone microarchitecture, osteoporosis is an important risk factor for impairing implant osseointegration. Recently, low-magnitude, high-frequency (LMHF) vibration (LM: <1×g; HF: 20-90Hz) has been shown to exhibit anabolic, but anti-resorptive effects on skeletal homeostasis. Therefore, we hypothesized that LMHF loading, in terms of whole body vibration (WBV), may improve implant fixation under osteoporotic status. In the in vivo study, WBV treatment (magnitude: 0.3g, frequency: 40Hz, time: 30min/12h, 5days/week) was applied after hydroxyapatite-coated titanium implants were inserted in the bilateral tibiae of ovariectomized rats. The bone mass and the osteospecific gene expressions were measured at 12weeks post implantation. In the in vitro study, the cellular and molecular mechanisms underlying osteoblastic and osteoclastic activities were fully investigated using various experimental assays. Micro-CT examination showed that WBV could enhance osseointegration by improving microstructure parameters surrounding implants. WBV-regulated gene levels in favor of bone formation over resorption may be the reason for the favorable adaptive bone remolding on bone-implant surface. The in vitro study showed that vibration (magnitude: 0.3g, frequency: 40Hz, time: 30min/12h) up-regulated osteoblast differentiation, matrix synthesis and mineralization. However, mechanically regulated osteoclastic activity was mainly through the effect on osteoblastic cells producing osteoclastogenesis-associated key soluble factors, including RANKL and M-CSF. Osteoblasts were therefore the direct target cells during the mechanotransduction process. The ERK1/2 pathway was demonstrated to play an essential role in vibration-induced enhancement of bone formation and decreased bone resorption. Our data suggests that WBV was a helpful non-pharmacological intervention for improving osseointegration under osteoporosis.
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Affiliation(s)
- Yi Zhou
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Xiaoxu Guan
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Tie Liu
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Xinhua Wang
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Mengfei Yu
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Guoli Yang
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China
| | - Huiming Wang
- Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Yan'an Road 395, Hangzhou 310000, People's Republic of China.
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Li Y, Fu Q, Qi Y, Shen M, Niu Q, Hu K, Kong L. Effect of a hierarchical hybrid micro/nanorough strontium-loaded surface on osseointegration in osteoporosis. RSC Adv 2015. [DOI: 10.1039/c5ra04914h] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the effect of a hierarchical hybrid micro/nanorough titanium strontium-loaded (MNT-Sr) surface on osseointegration under osteoporotic conditions.
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Affiliation(s)
- Yongfeng Li
- State Key Laboratory of Military Stomatology
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Fourth Military Medical University
- Xi'an 710032
| | - Qian Fu
- State Key Laboratory of Military Stomatology
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Fourth Military Medical University
- Xi'an 710032
| | - Yaping Qi
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Second Hospital of Hebei Medical University
- Shijiazhuang 050000
- PR China
| | - Mingming Shen
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Second Hospital of Hebei Medical University
- Shijiazhuang 050000
- PR China
| | - Qiang Niu
- State Key Laboratory of Military Stomatology
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Fourth Military Medical University
- Xi'an 710032
| | - Kaijin Hu
- State Key Laboratory of Military Stomatology
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Fourth Military Medical University
- Xi'an 710032
| | - Liang Kong
- State Key Laboratory of Military Stomatology
- Department of Oral and Maxillofacial Surgery
- School of Stomatology
- The Fourth Military Medical University
- Xi'an 710032
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Abstract
Dental implants are an indispensible tool for the restoration of missing teeth. Their use has elevated the practice of dentistry by improving both our technical ability to rehabilitate patients and general quality of life. To routinely achieve the associated high expectations, diligent attention to details must be observed and addressed from the outset. Of central concern is the attainment of osseointegration and the location of implants to ideally support the intended restoration. The pivotal point in treatment planning for dental implants occurs when the location of bone is viewed radiographically in the context of the planned prosthesis. This most often requires diagnostic waxing or tooth arrangement using mounted diagnostic casts.
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Abstract
Periodontitis is a common, chronic, inflammatory disease in which the supporting apparatus of the teeth is gradually destroyed, resulting in tooth mobility and tooth loss. Susceptibility to periodontitis is increased approximately three-fold in people with diabetes. Hyperglycemia leads to exacerbated tissue destruction and the clinical signs of periodontitis. There is evidence to support a two-way relationship between periodontitis and diabetes; not only does diabetes increase the risk for periodontitis, but periodontitis is associated with compromised glycemic control. Cooperation between health care teams would benefit the treatment of patients with diabetes and periodontitis.
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Affiliation(s)
- Philip M Preshaw
- School of Dental Sciences, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4BW, UK.
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Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: chronic periodontitis and systemic health. J Evid Based Dent Pract 2013; 12:20-8. [PMID: 23040337 DOI: 10.1016/s1532-3382(12)70006-4] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. Currently, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm low birth weight babies, respiratory diseases, and rheumatoid arthritis. EVIDENCE ACQUISITION Evidence was taken from systematic reviews, clinical trials, and mechanistic studies retrieved in searches of the PubMed electronic database. The available data provide the basis for applied practical clinical recommendations. EVIDENCE SYNTHESIS Evidence is summarized and critically reviewed from systematic reviews, primary clinical trials, and mechanistic studies CONCLUSIONS Surrogate markers for chronic periodontitis, such as tooth loss, show relatively consistent but weak associations with multiple systemic conditions. Despite biological plausibility, shorter-term interventional trials have generally not supported unambiguous cause-and-effect relationships. Nevertheless, the effective treatment of periodontal infections is important to achieve oral health goals, as well as to reduce the systemic risks of chronic local inflammation and bacteremias. Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. With pregnancy as a possible exception, the local and systemic effects of periodontal infections and inflammation are usually exerted for many years, typically among those who are middle-aged or older. It follows that numerous epidemiological associations linking chronic periodontitis to age-associated and biologically complex conditions such as diabetes, cardiovascular disease, osteoporosis, respiratory diseases, rheumatoid arthritis, certain cancers, erectile dysfunction, kidney disease and dementia, have been reported. In the coming years, it seems likely that additional associations will be reported, despite adjustments for known genetic, behavioral and environmental confounders. Determining cause-and-effect mechanisms is more complicated, especially in circumstances where systemic effects may be subtle. Currently, however, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm/low birth weight babies, respiratory diseases, and rheumatoid arthritis.
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Affiliation(s)
- Joan Otomo-Corgel
- UCLA School of Dentistry, Department of Periodontics, Faculty, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA 90017-4002, USA.
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Diz P, Scully C, Sanz M. Dental implants in the medically compromised patient. J Dent 2013; 41:195-206. [PMID: 23313715 DOI: 10.1016/j.jdent.2012.12.008] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 12/03/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE It has been suggested that some local and systemic factors could be contraindications to dental implant treatment. The objective of this paper was to evaluate whether success and survival rates of dental implants are reduced in the medically compromised patient. DATA/SOURCES An extensive literature search was conducted using PubMed/Medline, Scopus, Scirus and Cochrane databases up to November 8, 2012. CONCLUSIONS There are very few absolute medical contraindications to dental implant treatment, although a number of conditions may increase the risk of treatment failure or complications. The degree of systemic disease-control may be far more important that the nature of the disorder itself, and individualized medical control should be established prior to implant therapy, since in many of these patients the quality of life and functional benefits from dental implants may outweigh any risks.
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Affiliation(s)
- Pedro Diz
- Grupo de Investigación en Odontología Médico-Quirúrgica (OMEQUI), School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
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Abstract
As periodontal researchers and clinicians, we are challenged every day to make decisions relating to the clinical management of our patients and about how best to conduct clinical periodontal research. This volume of Periodontology 2000 addresses some of the critical issues in contemporary clinical periodontics and periodontal research that are of direct relevance to clinicians, researchers, teachers and students. The 11 review articles in this volume of Periodontology 2000 focus on aspects of periodontal research methodology and clinical periodontology. In terms of research methodology, the articles aim to inform the reader on topics relating to randomized controlled trials in periodontal research, evidence-based dentistry, calibration of clinical examiners and statistics relevant to periodontal research. The clinical periodontology articles address issues relating to decisions on retaining periodontally compromised teeth or replacing them with implants, periodontal management in the patient with osteoporosis, surgical approaches for root coverage and the emerging science of advanced regenerative technologies, including the use of stem cells, for periodontal regeneration. It is hoped that these critical reviews will address many of the dilemmas that confront us on a regular basis and provide practical guidance to those engaged in both clinical periodontology and clinical periodontal research.
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