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Bhagawati SB, Jain SR, Debnath P, Riyaz K, Patil R, Ansari J. Patients' Perceptions Regarding Acceptance of Dental Implants as an Option for the Replacement of Missing Teeth: An Observational Study. Cureus 2024; 16:e57232. [PMID: 38686275 PMCID: PMC11056823 DOI: 10.7759/cureus.57232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Dental implants enhance the self-assurance and overall well-being of individuals by providing oral comfort during mastication and a notable degree of contentment. The objectives of the present study were to assess patients' perception of opting or non-opting for dental implants as a replacement for missing teeth and to determine the correlation between various factors and perceived demand for dental implant treatment. MATERIALS AND METHODS A cross-sectional observational study was conducted on 214 partially edentulous individuals aged between 21 and 50 years. These patients sought treatment to replace their missing teeth. The participants were provided with detailed information regarding various options for replacing their missing teeth, including removable prostheses, fixed partial dentures, and dental implants. The researchers recorded and evaluated the reasons behind the patients' decision to opt for or decline dental implant treatment using the chi-squared test. Categorical variables were summarized as percentages (n %). The association between variables and binary data was examined using point biserial correlation, whereas, for continuous data, the Pearson correlation coefficient was employed. RESULTS About 65 (30.4%) patients opted for dental implant treatment and 149 (69.6%) patients did not opt for dental implant treatment. Missing teeth were found in 120 women (56.08%) and 94 men (43.92%). The main reason for seeking dental implant treatment was the need for improvement in functions such as chewing in 65 (100%) patients, followed by the need for improvement in oral health in 57 (88%), aesthetics in 54 (83%), need for bone and adjacent teeth preservation in 52 (80%), and durability of dental implants in 46 (71%) patients. The main reasons for not seeking dental implant treatment and opting for fixed prostheses other than dental implants or removable prostheses cost 149 (100%), fear of surgery 132 (91%), underlying health issues 121 (81%), lack of knowledge about dental implants 120 (80.5%), and time management issues 92 (62%). Gender, age, and number of missing teeth showed a negative correlation, whereas level of education, social status, and oral health awareness showed a positive correlation with the perceived need for dental implant treatment. CONCLUSION Dental implant treatment was preferred by 30.4% of patients, which was influenced by gender, sex, level of education, social status, awareness of oral health, and number of missing teeth. Cost, fear of surgery, underlying medical conditions, lack of knowledge, and time management are some reasons for not opting for dental implant treatment.
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Affiliation(s)
- Sharanamma B Bhagawati
- Department of Periodontics, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, IND
| | - Saurabh R Jain
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
| | - Puja Debnath
- Department of Periodontics, Agartala Government Dental College & IGM Hospital, Agartala, IND
| | - Khadeer Riyaz
- Department of Orthodontics, The Oxford Dental College and Research Centre, Bengaluru, IND
| | - Rohit Patil
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
| | - Jaweria Ansari
- Department of Prosthodontics, Jawahar Medical Foundation's Annasaheb Chudaman Patil Memorial Dental College, Dhule, IND
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Chatzopoulos GS, Wolff LF. Retrospective analysis of 50,333 implants on implant failure and associated patient-related factors. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101555. [PMID: 37437663 DOI: 10.1016/j.jormas.2023.101555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/10/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE The aim of this investigation was to retrospectively evaluate the long-term implant loss rates and to identify associations between implant failure and patient-related factors in a sample of patients who had consecutively received implant therapy in ten dental universities in the United States using a large database. METHODS Dental records of adult patients who had attended the dental clinics of the universities contributing data to the BigMouth network between 2011 and 2022 seeking dental therapy were evaluated. Information regarding patients' characteristics including age, gender, ethnicity, race, tobacco use and systemic medical conditions were extracted from patients' files. RESULTS A total of 20,842 patients who received 50,333 dental implants over a 12-year period (2011-2022) were included. The mean age of the cohort was 57.50±14.27 years which consisted of 51.8% females, 91.1% non-Hispanic, 66.3% white individuals and 8% tobacco users. In the univariate analysis, ethnicity, race and marijuana use were significantly associated with implant treatment outcome. Race and ethnicity were significantly associated with implant loss in the multivariate analysis. The implant failure rate was estimated to be 2.7% at the patient level and 1.4% at the implant level. CONCLUSION Within the limitations of this retrospective study that utilized records of 50,333 dental implants placed in ten institutions contributing data to the BigMouth network, the implant failure rate was estimated to be 2.7% at patient level and 1.4% at implant level. Ethnicity and race were significantly associated with implant failure, while none of the examined systemic conditions were associated with implant loss.
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Affiliation(s)
- Georgios S Chatzopoulos
- Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry, University of Minnesota, 515 Delaware Street SE, Minneapolis, MN,55455, USA; Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Larry F Wolff
- Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry, University of Minnesota, 515 Delaware Street SE, Minneapolis, MN,55455, USA
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Gulati K, Chopra D, Kocak-Oztug NA, Verron E. Fit and forget: The future of dental implant therapy via nanotechnology. Adv Drug Deliv Rev 2023; 199:114900. [PMID: 37263543 DOI: 10.1016/j.addr.2023.114900] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak-Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, 34116 Istanbul, Turkey
| | - Elise Verron
- Nantes Université, CNRS, CEISAM, UMR 6230, 44000 Nantes, France
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Wang N, Wang Z, Hu C, Yang Y, He G, Shao L, You J. Effect of perioperative cognitive behavioral interventions on pain, anxiety, and sleep quality in elderly patients after sinus floor elevation and immediate implantation: A randomized controlled trial. Technol Health Care 2023; 31:323-332. [PMID: 37066933 DOI: 10.3233/thc-236028] [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: 04/18/2023]
Abstract
BACKGROUND Sinus floor elevation and immediate dental implantation are commonly performed to treat dentition defects in elderly patients. Targeted cognitive behavioral interventions (CBI) during the perioperative period can reduce pain and anxiety as well as improve sleep quality. This can lead to improvements in patient cooperation during follow-up treatment and enhance the overall efficacy of the surgery. OBJECTIVE The study aimed to investigate the impact of a cognitive behavioral intervention method on perioperative pain, anxiety, and sleep quality in elderly patients undergoing sinus floor elevation and immediate dental implantation. METHODS Forty patients who required the treatment at the Stomatology Clinic in our hospital between December 2018 and December 2022 were enrolled in this randomized controlled trial. The patients were randomly divided into two groups: a control group (n= 20), which received conventional treatment and care during the perioperative period, and an intervention group (n= 20), which received comprehensive behavioral intervention in addition to the conventional treatment and care during the perioperative period. The perioperative anxiety, pain, and sleep quality of the patients in both groups were evaluated. Anxiety was assessed using the Self-Rating Anxiety Scale (SAS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pain was measured using the visual analog scale (VAS). RESULTS No statistically significant differences in SAS and PSQI were observed between the two groups at the initial visit; the values were significantly higher than those measured postoperatively. The SAS scores and PSQI of patients on days 0 and 7 post-surgery in the intervention group were significantly lower than those in the control group (P< 0.05). CONCLUSION Perioperative cognitive behavioral intervention can effectively improve anxiety, postoperative pain and sleep quality in elderly patients who have undergone sinus floor elevation and immediate dental implantation, thereby reducing the incidence of complications.
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Affiliation(s)
- Ning Wang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Zou Wang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Hu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yujun Yang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Guixin He
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Longquan Shao
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie You
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Tian Z. Ageing-Associated Transcriptomic Alterations in Peri-Implantitis Pathology: A Bioinformatic Study. DISEASE MARKERS 2022; 2022:8456968. [PMID: 36267464 PMCID: PMC9578877 DOI: 10.1155/2022/8456968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
Abstract
Background Ageing is associated with increased incidence of peri-implantitis but the roles of ageing-associated biological mechanisms in the occurrence of peri-implantitis are not known. This study is aimed at performing integrative bioinformatic analysis of publically available datasets to uncover molecular mechanisms related to ageing and peri-implantitis. Methods Gene expression datasets related to ageing and peri-implantitis (PI) were sought, and differentially expressed genes (DEGs) were analysed. Ageing-related genes were also identified from the "Aging Atlas" database. Using intersection analysis, an age-related-PI gene set was identified. Functional enrichment analysis for enriched GO biological process and KEGG pathways, protein-protein interaction (PPI) network analysis, correlation analysis, and immune cell infiltration analysis to determine high-abundance immune cells were performed. Least absolute shrinkage and selection operator (LASSO) logistic regression identified key age-related-PI genes. Transcription factor-gene and drug-gene interactions and enriched KEGG pathways for the key age-related-PI genes were determined. Results A total of 52 genes were identified as age-related-PI genes and found enriched in several inflammation-associated processes including myeloid leukocyte activation, acute inflammatory response, mononuclear cell differentiation, B cell activation, NF-kappa B signalling, IL-17 signalling, and TNF signalling. LYN, CDKN2A, MAPT, BTK, and PRKCB were hub genes in the PPI network. Immune cell infiltration analysis showed activated dendritic cells, central memory CD4 T cells, immature dendritic cells, and plasmacytoid dendritic cells were highly abundant in PI and ageing. 7 key age-related PI genes including ALOX5AP, EAF2, FAM46C, GZMK, MAPT, RGS1, and SOSTDC1 were identified using LASSO with high predictive values and found to be enriched in multiple neurodegeneration-associated pathways, MAPK signalling, and Fc epsilon RI signalling. MAPT and ALOX5AP were associated with multiple drugs and transcription factors and interacted with other age-related genes to regulate multiple biological pathways. Conclusion A suite of bioinformatics analysis identified a 7-signature gene set highly relevant to cooccurrence of ageing and peri-implantitis and highlighted the role of neurodegeneration, autoimmune, and inflammation related pathways. MAPT and ALOX5AP were identified as key candidate target genes for clinical translation.
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Affiliation(s)
- Zhaojun Tian
- College of Dentistry, I.M. Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, No. 2с4, Moscow 119435, Russia
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Sociodemographic Factors and Implant Consideration by Patients Attending Removable Prosthodontics Clinics. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8466979. [PMID: 35860798 PMCID: PMC9293525 DOI: 10.1155/2022/8466979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 05/29/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022]
Abstract
Objective. This study is aimed at investigating the treatment options offered to and chosen by patients attending a student prosthodontics clinic and to investigate the effect of the sociodemographic background of participants on implant consideration. Material and Methods. A cross-sectional descriptive study was conducted on 200 participants including their socioeconomic background, treatment options presented, treatment preferences, and implant consideration. Bivariate tests (unpaired
-test, chi-square, and Mann–Whitney test) and Spearman correlation were used for comparison of different socioeconomic groups according to treatment preferences (implant consideration versus conventional removable prosthesis). Results. Treatment options presented by dental students include 63.5% complete denture, 32% implants/removable dentures, and partial denture 4.5%. Conventional removable prostheses were mostly chosen due to low income. Implants were only considered by 26% of participants. Age and implant consideration had a significant negative correlation. No significant difference in gender and residency area on implant consideration was found. The chi-square test showed a significant difference between implant consideration and conventional removable prostheses in the various occupation groups. Conclusions. Low income is the main factor prohibiting patients from considering dental implants. Age and educational level may play a considerable role in considering dental implants. There should be more emphasis on dental students’ treatment planning education to include and explain dental implants as a treatment option for their patients in the prosthodontics clinic.
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Wu X, Ye M, Sun J, Yan Q, Shi B, Xia H. Patient-reported outcome measures following surgeries in implant dentistry and associated factors: a cross-sectional study. BMJ Open 2022; 12:e059730. [PMID: 35710257 PMCID: PMC9207936 DOI: 10.1136/bmjopen-2021-059730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the patient-reported outcome measures (PROMs) of dental implant surgeries and analyse the associated indicators. DESIGN A cross-sectional study design was used. SETTING Department of Oral Implantology, Hospital of Stomatology, Wuhan University (May 2020-April 2021). PARTICIPANTS Participants with missing teeth in need of implant-supported rehabilitation. INTERVENTIONS Dental implant placement and/or bone augmentation procedures. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was discomfort on postoperative day 1, measured using a numerical rating scale (NRS). Secondary outcomes included pain and anxiety during surgery; discomfort on postoperative days 3, 7 and 14; and post-surgical complications. RESULTS A total of 366 participants were included, of which 288 (78.7%) and 328 (89.7%) reported no to mild pain and anxiety (NRS 0-3) during surgery, respectively. The proportion of patients reporting discomfort decreased from postoperative day 1 (57.7%) to day 3 (36.1%) and day 7 (17.5%). The most frequent postoperative adverse events were pain and swelling. Patient-related factors (age, sex, smoking, alcohol consumption, history of periodontitis, and pain and anxiety during surgery) and surgery-related factors (type and extent of surgical procedure) were analysed. The factors associated with the severity of discomfort after surgery included alcohol consumption, pain perception during surgery, bone augmentation procedures and age (p<0.05). Similarly, the factors associated with the duration of discomfort included alcohol consumption, pain perception during surgery and age (p<0.05). CONCLUSIONS PROMs related to dental implant surgeries can be predicted using certain risk indicators. Alcohol consumption, pain during surgery and age were associated with discomfort following dental implant surgery.
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Affiliation(s)
- Xinyu Wu
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Mengjie Ye
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jiahui Sun
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Malm MO, Jemt T, Stenport VF. Patient factors related to early implant failures in the edentulous jaw: A large retrospective case-control study. Clin Implant Dent Relat Res 2021; 23:466-476. [PMID: 33999522 DOI: 10.1111/cid.13009] [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: 02/22/2021] [Revised: 04/14/2021] [Accepted: 04/29/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dental implants provide anchorage for dental prostheses to restore functions for individuals with edentulous jaws. During the healing phase, proper osseointegration is required to prevent early implant failure. More knowledge is needed regarding factors related to early failure of dental implants. PURPOSE The aim of the present study was to identify possible risk factors for early implant failure, with respect to anamnestic and clinical parameters. MATERIALS AND METHODS All patients with edentulous jaws with early implant failure (n = 408) from one referral clinic were compared with a matched control group (n = 408) with no implant failure. Early implant failure was identified during the first year of prosthetic function. Matching was performed on age, gender, year of surgery, type of jaw, and type of implant surface. In addition, data on anamnestic and clinical parameters were collected. The data were analyzed with a multivariable logistic regression model using early implant failure as the binary outcome. RESULTS Five anamnestic factors were statistically significant with respect to higher probability for early implant failure: systemic disease, allergies in general, food allergies, smoking, and intake of analgesic medication. Four clinical conditions (i.e., implants in the opposing jaw, low primary stability, reduced bone volume, and healing complications) were also related to higher probability for early implant failure. CONCLUSIONS This study identified nine factors associated with early implant failure, several related to patient's general health. Further investigations are needed to fully understand the causality between the obtained variables and early implant failure.
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Affiliation(s)
- Malin Olsson Malm
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Torsten Jemt
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Victoria Franke Stenport
- Brånemark Clinic, Public Dental Service, Region of Västra Götaland, Gothenburg, Sweden.,Department of Prosthodontics and Dental Material Science, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Etöz O, Bertl K, Kukla E, Ulm C, Ozmeric N, Stavropoulos A. How old is old for implant therapy in terms of implant survival and marginal bone levels after 5-11 years? Clin Oral Implants Res 2021; 32:337-348. [PMID: 33368735 PMCID: PMC7986728 DOI: 10.1111/clr.13704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 09/25/2020] [Accepted: 11/24/2020] [Indexed: 01/26/2023]
Abstract
Aim To evaluate implant survival and marginal bone levels (MBLevel) at least 5 years after implant installation in patients ≥65 years old. Methods Patient records were screened retrospectively for the following inclusion criteria: (1) ≥65 years of age at the time of implant installation, and (2) ≥5‐year radiographic follow‐up or registered implant loss. Association between patient‐ and implant‐related data with radiographically assessed data [i.e. implant survival, mean MBLevel (i.e. average of mesial and distal level) and maximum marginal bone loss (i.e. either mesial or distal loss; maximum MBLoss)] were statistically evaluated by mixed effects multi‐level regression models. Results Two‐hundred‐eighteen implants in 74 patients were included with a mean follow‐up of 6.2 years (range: 5 to 10.7 years); four early and six late implant losses have been registered (implant survival rate: 95.4%). Mean MBLevel and maximum MBLoss was 1.24 ± 0.9 mm and 1.48 ± 1.0 mm, respectively. Maximum MBLoss < 2 mm, 2 to 5 mm and ≥5 mm was found in 70.7, 28.8 and 0.5% of the implants, respectively. For both, mean MBLevel and maximum MBLoss, age presented a slightly protective effect (mean MBLevel: Coef. −0.041, p = .016; maximum MBLoss: Coef. −0.045, p = .014). Conclusion The high implant survival rate (95.4%), low mean MBLevel (1.24 mm) and low frequency of maximum MBLoss ≥ 5 mm (0.5%) observed herein after 5 to 11 years follow‐up suggest that older age should not be considered as a limiting factor for implant treatment.
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Affiliation(s)
- Onur Etöz
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Department of Periodontology, Gazi University, Ankara, Turkey
| | - Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Edmund Kukla
- Comprehensive Center Unit, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Nurdan Ozmeric
- Department of Periodontology, Gazi University, Ankara, Turkey
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
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Liu W, Zhou L, Xue H, Li H, Yuan Q. Growth differentiation factor 11 impairs titanium implant healing in the femur and leads to mandibular bone loss. J Periodontol 2020; 91:1203-1212. [PMID: 31983062 DOI: 10.1002/jper.19-0247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Growth differentiation factor 11 (GDF11), a secreted member of the transforming growth factor-β superfamily, has recently been suggested as an anti-aging factor that declines with age in the bloodstream, and restoration of the youthful level by administration of its recombinant protein could reverse age-related dysfunctions. However, its effects on titanium implant osseointegration and mandibular bone during aging remain unknown. METHODS Two-month-old and 18-month-old C57BL male mice were given daily intraperitoneal injections of recombinant GDF11 (rGDF11) or vehicle for 6 weeks. Experimental titanium implants were inserted into femurs on the fourth week. Inhibition of GDF11 function was achieved by GDF11 antibody. Implant-bearing femurs were subjected to histomorphometric analysis and biomechanical evaluation. Mandibles were scanned with micro-CT and decalcified for histological measurements. RESULTS In both young adult and aged mice, supraphysiologic GDF11 leads to a significantly decreased bone-to-implant contact ratio (BIC) and peri-implant bone volume/total volume (BV/TV) at the histologic level and reduced resistance at the biomechanical level, indicating weakened implant fixation. Moreover, rGDF11 administration resulted in less trabecular bone volume and thinner cortical thickness in the mandible, which was further compromised in the old animals. In contrast, inhibition of GDF11 improved peri-implant bone healing in old mice. CONCLUSIONS Rather than functioning as a rejuvenating factor, exogenous GDF11 negatively affects not only titanium implant healing but also mandibular bone in both young and old mice. In contrast, neutralization of endogenous GDF11 has positive effects on implant fixation in aged mice.
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Affiliation(s)
- Weiqing Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Liyan Zhou
- Dept. of Implant, Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hanxiao Xue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hanshi Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Quan Yuan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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11
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Bertl K, Ebner M, Knibbe M, Pandis N, Kuchler U, Ulm C, Stavropoulos A. How old is old for implant therapy in terms of early implant losses? J Clin Periodontol 2019; 46:1282-1293. [PMID: 31529723 PMCID: PMC6899847 DOI: 10.1111/jcpe.13199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/21/2019] [Accepted: 09/09/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age. METHODS All patients ≥65 years old at implant installation, in an university setting over a time-period of 11.5 years, with complete anamnestic data and follow-up until prosthetic restoration were included, and any early implant loss (EIL; i.e. lack of osseointegration prior to or at the time-point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients, was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on (a) gender, (b) implant region, (c) smoking status and (d) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group was statistically assessed. RESULTS Four hundred forty-four patients ≥65 years old (range 65.1-91.3; 56.8% female) receiving 1,517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into four age groups [65-69.9 (n = 213), 70-74.9 (n = 111), 75-79.9 (n = 80) and ≥80 (n = 40)], EIL was on the implant level 0.41, 0.83, 0.34 and 2.26%, respectively, (p = .102) and on the patient level 1.41, 2.70, 1.25 and 7.50%, respectively, (p = .104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = .090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p = .280). EIL could not be associated with any systemic condition or medication intake. CONCLUSIONS Elderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, ageing does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Maria Ebner
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Comprehensive Center Unit, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Marianne Knibbe
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ulrike Kuchler
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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12
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Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:287-306. [DOI: 10.1111/jcpe.13052] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/09/2018] [Accepted: 12/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Hyun-Chang Lim
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
- Department of Periodontology; Periodontal-Implant Clinical Research Institute; School of Dentistry; Kyung Hee University; Seoul Republic of Korea
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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13
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Schimmel M, Srinivasan M, McKenna G, Müller F. Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:311-330. [DOI: 10.1111/clr.13288] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Martin Schimmel
- Division of GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Gerald McKenna
- Centre for Public HealthQueen's University Belfast Institute of Clinical Sciences Belfast UK
| | - Frauke Müller
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
- Department of Internal Medicine, Rehabilitation and GeriatricsUniversity Hospitals of Geneva Thônex Switzerland
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14
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Stigler RG, Becker K, Kloss FR, Gassner R, Lepperdinger G. Long-lived murine osteocytes are embodied by craniofacial skeleton in young and old animals whereas they decrease in number in postcranial skeletons at older ages. Gerodontology 2018; 35:391-397. [PMID: 30052290 DOI: 10.1111/ger.12362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Osteocytes are engaged in life-enduring processes such as bone remodelling, fracture healing or osseointegration of implants. Over age, ossification processes and regenerative capacity can greatly differ in mandible and femur. OBJECTIVE Mesenchymal stem cells from cranial and postcranial bones are of different embryologic origin. This may be the reason why the regenerative capacity differs between cranial and postcranial bones in old patients. It was hypothesised that different ageing patterns, reflected by osteocyte density, lacunar density and osteoid formation, exist between murine mandibles and femurs. MATERIAL AND METHODS Mandible and femur of young (4 months) and old (34-36 months old) male C57Bl/6 mice were histologically investigated to determine the number of lacunae occupied with osteocytes. Osteoid formation was revealed by Masson-Goldner staining, and the spatial distribution of BMP-2 synthesis was examined. RESULTS Over lifetime, the number of lacunae occupied with osteocytes only showed a modest decrease in mandibular bone (old 85.63%/young 91.12%) while greatly diverging in the femur (old 55.99%/young 93.28%). In equal measure, old femur exhibited less osteoid formation and decreased BMP-2 expression. CONCLUSION Tissue-specific conduct of bone ageing is moulded by osteocytic activities, which was found to vary between postcranial and craniofacial skeleton. The latter harbours long-lived osteocytes also in old animals which assures lifelong bone integrity. Preliminary concurring findings from a human cadaver, also presented in this contribution, provided a rationale for recommending the translatability to humans.
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Affiliation(s)
- Robert G Stigler
- Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frank R Kloss
- Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Robert Gassner
- Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Günter Lepperdinger
- Division of Genetics, Department of Cell Biology and Physiology, Faculty of Natural Sciences, University Salzburg, Salzburg, Austria
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Abstract
This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.
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Lamster IB. Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession. Periodontol 2000 2018; 72:7-12. [PMID: 27501487 DOI: 10.1111/prd.12157] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 12/31/2022]
Abstract
The world's population is aging, and it has been estimated that by 2050, the number of people 65 years of age and older will reach 1.5 billion. The aging population will be affected by noncommunicable chronic diseases, including diabetes mellitus, cardiovascular disease and cognitive impairment. This important demographic shift includes a reduction in tooth loss/edentulism, particularly in older adults of the developed countries in North America, western Europe and north-east Asia. Therefore, in the future, dental providers will be required to care for an expanded number of older adults who have retained teeth and are medically complex. As the linkage of oral disease and systemic disease has focused on the relationship of periodontitis and noncommunicable chronic diseases, a broad review of 'geriatric periodontology' is both timely and important. This volume of Periodontology 2000 covers a range of subjects under this heading. Included are the demographics of an aging world; the effect of aging on stem cell function in the periodontium; the periodontal microbiota associated with aging; the host response in the periodontium of aging individuals; an analysis of the prevalence of periodontitis in the USA on a national, state-wide and community basis; differentiation of physiologic oral aging from disease; treatment of periodontal disease in older adults; implant therapy for older patients; oral disease and the frailty syndrome; the relationship of tooth loss to longevity and life expectancy; and the relationship of periodontal disease to noncommunicable chronic diseases. Although 'geriatric dentistry' is not a recognized specialty in dentistry, and 'geriatric periodontology' is a descriptive title, the subject of this volume of Periodontology 2000 is critical to the future of clinical dentistry, dental public health and dental research. Any comprehensive focus on older patients can only be accomplished with an emphasis on interprofessional education and practice. If embraced, this shift will allow the dental profession to be more closely aligned with the larger health-care environment, and can improve both oral health and health outcomes for patients seen in the dental office.
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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