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Chen B, Wang W, Hu M, Liang Y, Wang N, Li C, Li Y. "Photo-Thermo-Electric" Dental Implant for Anti-Infection and Enhanced Osteoimmunomodulation. ACS NANO 2024; 18:24968-24983. [PMID: 39192736 DOI: 10.1021/acsnano.4c05859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
The dental implant market has experienced explosive growth, owing to the widespread acceptance of implants as the core of oral rehabilitation. Clinically, achieving simultaneous anti-infective effects and rapid osseointegration is a crucial but challenging task for implants. The demand for implants with long-term broad-spectrum antibacterial and immune-osteogenic properties is growing. Existing methods are limited by a lack of safety, efficiency, short-lasting anti-infective ability, and inadequate consideration of the immunomodulatory effects on osteogenesis. Herein, a ZnO/black TiO2-x heterojunction surface structure was designed as a near-infrared (NIR) light-responsive nanofilm immobilized on a titanium (Ti) implant surface. This nanofilm introduces abundant oxygen vacancies and heterojunctions, which enhance the photothermal and photoelectric abilities of Ti implants under NIR illumination by narrowing the band gap and improving interfacial charge transfer. The "photo-thermo-electric" implant exhibits excellent broad-spectrum antibacterial efficacy against three dental pathogenic bacteria (Porphyromonas gingivalis, Fusobacterium nucleatum, and Staphylococcus aureus, >99.4%) by destroying the bacterial membrane and increasing the production of intracellular reactive oxygen species. Additionally, the implant can effectively eliminate mature multispecies biofilms and kill bacteria inside the biofilms under NIR irradiation. Meanwhile, this implant can also induce the pro-regenerative transformation of macrophages and promote osteoblast proliferation and differentiation. Moreover, in vivo results confirmed the superior antibacterial and osteoimmunomodulatory properties of this dental implant. RNA sequencing revealed that the underlying osteogenic mechanisms involve activation of the Wnt/β-catenin signaling pathway and bone development. Overall, this versatile "photo-thermo-electric" platform endows implants with anti-infection and bone integration performance simultaneously, which holds great potential for dental implants.
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Affiliation(s)
- Bo Chen
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Wanmeng Wang
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Meilin Hu
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Yunkai Liang
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Ning Wang
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Changyi Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
| | - Ying Li
- School of Dentistry, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, P. R. China
- Tianjin Key Laboratory of Oral Soft and Hard Tissues Restoration and Regeneration, Tianjin 300070, P. R. China
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Herrero-Climent F, Martínez-Rus F, Salido MP, Roldán D, Pradíes G. Comparative in vitro evaluation of microgap in titanium stock versus cobalt-chrome custom abutments on a conical connection implant: Effect of crown cementation and ceramic veneering. Clin Oral Implants Res 2024. [PMID: 38884385 DOI: 10.1111/clr.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/02/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To compare the implant-abutment connection microgap between computer-aided design and computer-aided manufacturing (CAD/CAM) milled or laser-sintered cobalt-chrome custom abutments with or without ceramic veneering and titanium stock abutments with or without crown cementation. MATERIAL AND METHODS Six groups of six abutments each were prepared: (1) CAD/CAM cobalt-chrome custom abutments: milled, milled with ceramic veneering, laser-sintered, and laser-sintered with ceramic veneering (four groups: MIL, MIL-C, SIN, and SIN-C, respectively) and (2) titanium stock abutments with or without zirconia crown cementation (two groups: STK and STK-Z, respectively). Abutments were screwed to the implants by applying 30 Ncm torque. All 36 samples were sectioned along their long axes. The implant-abutment connection microgap was measured using scanning electron microscopy on the right and left sides of the connection at the upper, middle, and lower levels. Data were analyzed using the Kruskal-Wallis test (p < .05). RESULTS Mean values (μm) of the microgap were 0.54 ± 0.44 (STK), 0.55 ± 0.48 (STK-Z), 1.53 ± 1.30 (MIL), 2.30 ± 2.2 (MIL-C), 1.53 ± 1.37 (SIN), and 1.87 ± 1.8 (SIN-C). Although significant differences were observed between the STK and STK-Z groups and the other groups (p < .05), none were observed between the milled and laser-sintered groups before or after ceramic veneering. The largest microgap was observed at the upper level in all groups. CONCLUSIONS Titanium stock abutments provided a closer fit than cobalt-chrome custom abutments. Neither crown cementation nor ceramic veneering resulted in significant changes in the implant-abutment connection microgap.
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Affiliation(s)
- Federico Herrero-Climent
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Francisco Martínez-Rus
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - María Paz Salido
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - David Roldán
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Guillermo Pradíes
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
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Sung CE, Chung KH, Lin FG, Huang RY, Cheng WC, Chen WL. Periodontal conditions of teeth adjacent to dental implants with or without peri-implantitis after non-surgical therapy in patients treated for periodontitis: A retrospective study. Clin Oral Implants Res 2024. [PMID: 38860518 DOI: 10.1111/clr.14316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 04/16/2024] [Accepted: 05/27/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES To retrospectively assess the periodontal conditions of teeth adjacent to and contralateral to implants presenting with or without peri-implantitis, following non-surgical periodontal and peri-implant mechanical therapy. MATERIALS AND METHODS One hundred and one patients with existing dental implants and chronic periodontitis, who underwent non-surgical periodontal and peri-implant mechanical therapy, were included. The periodontal clinical probing depth (PPD), gingival recession (GR), and bleeding on probing (BOP) were recorded at six sites around the adjacent (Adj-) teeth and the contralateral (CL-) teeth relative to the implant. The potential factors influencing the periodontal conditions of 316 teeth were analyzed by multivariate linear regression models with generalized estimating equation methods and α = .05. RESULTS The PPD of Adj-teeth was significantly different from that of CL-teeth before and after non-surgical therapy when the implant was diagnosed with peri-implantitis (PI) (p < .05). The PPD of teeth was shown to be affected by neighboring implants diagnosed with peri-implantitis (β = .825 mm, p < .001), teeth adjacent to implants (β = .245 mm, p = .004), a molar tooth type (β = .435 mm, p = .019), and non-surgical therapy (β = -.522 mm, p < .001). CONCLUSIONS Relatively compromised periodontal conditions at Adj-teeth after non-surgical PI therapy were detected. Therefore, clinicians should be aware that non-surgical therapy may be less successful at teeth adjacent to implants with PI.
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Affiliation(s)
- Cheng-En Sung
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Fu-Gong Lin
- Department of Optometry, Asia University, Taichung, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wan-Chien Cheng
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, and School of Medicine, National Defense Medical Center, Taipei, Taiwan
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Hamilton A, Negreiros WM, Jain S, Finkelman M, Gallucci GO. Influence of scanning protocol on the accuracy of complete-arch digital implant scans: An in vitro study. Clin Oral Implants Res 2024; 35:641-651. [PMID: 38567801 DOI: 10.1111/clr.14259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/20/2024] [Accepted: 03/14/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE This in-vitro study assessed the influence of two intraoral scanning (IOS) protocols on the accuracy (trueness and precision) of digital scans performed in edentulous arches. METHODS Twenty-two abutment-level master casts of edentulous arches with at least four implants were scanned repeatedly five times, each with two different scanning protocols. Protocol A (IOS-A) consisted of scanning the edentulous arch before inserting the implant scan bodies, followed by their insertion and its subsequent digital acquisition. Protocol B (IOS-B) consisted of scanning the edentulous arch with the scan bodies inserted from the outset. A reference scan from each edentulous cast was obtained using a laboratory scanner. Trueness and precision were calculated using the spatial fit analysis, cross-arch distance, and virtual Sheffield test. Statistical analysis was performed using generalized estimating equations (GEEs). Statistical significance was set at α = .05. RESULTS In the spatial fit test, the precision of average 3D distances was 45 μm (±23 μm) with protocol IOS-A and 25 μm (±10 μm) for IOS-B (p < .001), and the trueness of average 3D distances was 44 μm (±24 μm) with protocol IOS-A and 24 μm (±7 μm) for IOS-B (p < .001). Cross-arch distance precision was 59 μm (±53 μm) for IOS-A and 41 μm (±43 μm) for IOS-B (p = .0035), and trueness was 64 μm (±47 μm) for IOS-A and 50 μm (±40 μm) for IOS-B (p = .0021). Virtual Sheffield precision was 286 μm (±198 μm) for IOS-A and 146 μm (±92 μm) for IOS-B (p < .001), and trueness was 228 μm (±171 μm) for IOS-A and 139 μm (±92 μm) for IOS-B (p < .001). CONCLUSIONS The IOS-B protocol demonstrated significantly superior accuracy. Placement of scan bodies before scanning the edentulous arch is recommended to improve the accuracy of complete-arch intraoral scanning.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - William Matthew Negreiros
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shruti Jain
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Addy LD. An introduction to dental implants. Br Dent J 2024; 236:753-757. [PMID: 38789751 DOI: 10.1038/s41415-024-7430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
The use of implants to replace missing teeth is now commonplace and practised by clinicians worldwide in both general and specialist practice. There is an abundance of evidence on the general success of implant treatment. As well as reviewing the history of dental implants, this narrative review will discuss the merits and successful placement of tissue-level verses bone-level implants. Furthermore, the article will evaluate the concept and benefits of platform switching for implant treatment. Finally, with the increased placement of implants, this narrative paper will review how different titanium surfaces impact on the risk of peri-implantitis.
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Affiliation(s)
- Liam D Addy
- Consultant and Honorary Senior Lecturer in Restorative Dentistry, Cardiff Dental Hospital, Heath Park, Cardiff, CF14 4XY, UK.
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Quispe-López N, Gómez-Polo C, Zubizarreta-Macho Á, Montero J. How do the dimensions of peri-implant mucosa affect marginal bone loss in equicrestal and subcrestal position of implants? A 1-year clinical trial. Clin Implant Dent Relat Res 2024; 26:442-456. [PMID: 38282266 DOI: 10.1111/cid.13306] [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: 11/04/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION There is evidence that the apico-coronal implant position and the mucosal phenotype can affect the extent of peri-implant bone loss. This clinical trial analyzes the bone remodeling and marginal bone loss that occur around conical-connection implants placed equicrestally and subcrestally, assessing the effect of the peri-implant soft-tissue phenotype. METHODS Fifty-one patients received 56 implants of distinct diameters (3.5 mm Ø n = 6; 4.3 mm Ø n = 41; 5 mm Ø n = 9) in the posterior part of the maxilla or mandible. The implants were placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, depending on the initial supracrestal tissue height (STH). After 3 months of non-submerged healing, single metal-ceramic screw-retained implant-supported crowns were placed. Longitudinal measurements of STH, mucosal thickness and keratinized mucosa width (KMW) were made at the time of implant placement (T0), crown placement (T1), and after 3 (T2) and 6 months (T3) of prosthetic loading. At each of these points, a radiographic evaluation of bone remodeling and marginal bone loss was also performed. RESULTS STH was significantly greater for implants placed >1 mm subcrestally than for those placed 1 mm subcrestally. After 12 months of follow-up, a very significant (p < 0.001) loss of KMW was observed, in addition to a marginal bone loss of 0.08 ± 0.1, 0.15 ± 0.2, and 0.14 ± 0.2 mm in the groups placed equicrestally, 1 mm subcrestally and >1 mm subcrestally, respectively. After the multiple linear regression, marginal bone loss was found to depend primarily on KMW (β = -0.43), while also being affected by STH (β = 0.32) and implant diameter (β = -0.28). CONCLUSIONS Marginal bone loss may be influenced by the position with respect to the bone crest, as well as the KMW, STH, and implant diameter. However, more well-controlled studies are needed to verify these above-mentioned findings with different implant designs and connections.
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Affiliation(s)
- Norberto Quispe-López
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
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Güney Z, Karacaoglu F, Barıs E, Gezer KG, Akkaya MM. The relationship of peri-implant soft tissue wound healing with implant cover screw design: Cross-sectional study. Clin Implant Dent Relat Res 2024; 26:299-308. [PMID: 37712118 DOI: 10.1111/cid.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/18/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Dental implants are frequently preferred method for oral rehabilitation all over the world. The incidence of various complications such as incorrect prosthesis, peri-implant mucositis, and peri-implantitis is high; premature loss of implants is encountered due to osteointegration process not being completed for some unexplained reasons. However, there is no study in the literature examining the nonfunctional period of implants. Closure screws of different implant companies have different designs like surface properties, and areas, where closure screws sit, are important reservoirs for microorganism colonization. Our study aims to evaluate the inflammatory response, epithelial maturation, and epithelial-connective tissue interaction around closure screws. METHODS For this purpose, 52 implants belonging to five different implant companies were included in the study. Tissues removed over the cover screw during fitting of healing caps were used as biopsy material and for epithelial proliferation Ki-67, for epithelium-connective tissue interaction Syndecan-1, and for macrophage activation CD-68 expressions were evaluated by immunohistochemical analysis. Scanning electron microscopy (SEM) analyzes were performed to evaluate the presence of gap between the implant and the cover screw. RESULTS As a result of our study, intensity of subepithelial inflammation between groups wasn't statistically different. Differences in CD-68 and Syndecan-1 levels were obtained at the lamina propria level. H score of CD-68 was statistically significantly different in epithelium (p = 0.032), and H score of Syndecan-1 was different in lamina propria (p = 0.022). There wasn't a statistically significant difference between the groups for Ki-67 (p = 0.151). CONCLUSION Our study results indicate that in addition to the implant surface morphology, the design of the closure screws is important in the inflammatory response and epithelial maturation that develops during wound healing. Although the inflammatory response is required for healing, osteointegration, and implant survival, further investigation is needed to investigate the relationship between initial neck resorption and closure screws with radiographic and microbiological examinations.
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Affiliation(s)
- Zeliha Güney
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - Fatma Karacaoglu
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Emre Barıs
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - K Gökalp Gezer
- Güngören Oral and Dental Health Center, Istanbul, Turkey
| | - M Murat Akkaya
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Tajti P, Solyom E, Váncsa S, Mátrai P, Hegyi P, Varga G, Hermann P, Borbély J, Sculean A, Mikulás K. Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis. Periodontol 2000 2024; 94:627-638. [PMID: 37766634 DOI: 10.1111/prd.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing.
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Affiliation(s)
- Péter Tajti
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eleonora Solyom
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Mátrai
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Krisztina Mikulás
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Toia M, Parpaiola A, Stevanello N, Tattan M, Saleh MHA, Ravidà A. Clinical outcomes of implant- versus abutment-level connection in screw-retained fixed dental prostheses: A 5-year randomized controlled trial. Clin Oral Implants Res 2024; 35:230-241. [PMID: 38012845 DOI: 10.1111/clr.14217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/26/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
AIM The aim of the study was to evaluate the 5 years clinical outcomes associated with implant-level connection (IL) versus abutment-level connection (AL) for implants with an internal conical connection (ICC) supporting a screw-retained fixed partial denture. MATERIALS AND METHODS Fifty patients with 119 implants were randomly allocated to either the AL or IL group. Radiographic (Marginal bone loss) and clinical outcomes (Bleeding on Probing, probing pocket depth, plaque accumulation, incidence of peri-implantitis and peri-implant mucositis as well as prosthetic complications) were collected and compared at 1, 2, 3, and 5 years. A linear mixed model was used to evaluate the differences between groups. RESULTS Five years after treatment, the MBL change was not significantly different between the groups at any point. The MBL was 0.23 ± 0.64 mm (AL) and 0.23 ± 0.29 mm (IL). The bleeding on Probing was 44% (AL) and 45% (IL) (p = .89). The mean probing depth was 2.91 ± 1.01 mm (AL) and 3.51 ± 0.67 mm (IL). This difference between the groups was statistically significant but clinical insignificant. Presence of plaque was slightly higher (p = .06) in the IL group (34.4%) compared with the AL group (26.3%). The overall technical, biological, and prosthetic complication rates were similar between groups. None of the implants developed peri-implantitis during the entire follow-up period. CONCLUSION The results of this clinical trial indicated that all clinical and radiographical parameters were clinically comparable between the study groups.
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Affiliation(s)
- Marco Toia
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Andrea Parpaiola
- Department Clinic-Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
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Li D, Tan X, Zheng L, Tang H, Hu S, Zhai Q, Jing X, Liang P, Zhang Y, He Q, Jian G, Fan D, Ji P, Chen T, Zhang H. A Dual-Antioxidative Coating on Transmucosal Component of Implant to Repair Connective Tissue Barrier for Treatment of Peri-Implantitis. Adv Healthc Mater 2023; 12:e2301733. [PMID: 37660274 DOI: 10.1002/adhm.202301733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/10/2023] [Indexed: 09/04/2023]
Abstract
Since the microgap between implant and surrounding connective tissue creates the pass for pathogen invasion, sustained pathological stimuli can accelerate macrophage-mediated inflammation, therefore affecting peri-implant tissue regeneration and aggravate peri-implantitis. As the transmucosal component of implant, the abutment therefore needs to be biofunctionalized to repair the gingival barrier. Here, a mussel-bioinspired implant abutment coating containing tannic acid (TA), cerium and minocycline (TA-Ce-Mino) is reported. TA provides pyrogallol and catechol groups to promote cell adherence. Besides, Ce3+ /Ce4+ conversion exhibits enzyme-mimetic activity to remove reactive oxygen species while generating O2 , therefore promoting anti-inflammatory M2 macrophage polarization to help create a regenerative environment. Minocycline is involved on the TA surface to create local drug storage for responsive antibiosis. Moreover, the underlying therapeutic mechanism is revealed whereby the coating exhibits exogenous antioxidation from the inherent properties of Ce and TA and endogenous antioxidation through mitochondrial homeostasis maintenance and antioxidases promotion. In addition, it stimulates integrin to activate PI3K/Akt and RhoA/ROCK pathways to enhance VEGF-mediated angiogenesis and tissue regeneration. Combining the antibiosis and multidimensional orchestration, TA-Ce-Mino repairs soft tissue barriers and effector cell differentiation, thereby isolating the immune microenvironment from pathogen invasion. Consequently, this study provides critical insight into the design and biological mechanism of abutment surface modification to prevent peri-implantitis.
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Affiliation(s)
- Dize Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Xi Tan
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Liwen Zheng
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Han Tang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Shanshan Hu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Qiming Zhai
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Xuan Jing
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, P. R. China
| | - Panpan Liang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Yuxin Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Qingqing He
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Guangyu Jian
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Dongqi Fan
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Ping Ji
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
| | - Hongmei Zhang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, 401147, P. R. China
- Molecular Oncology Laboratory, Department of Orthopedic Surgery and Rehabilitation Medicine, The University of Chicago Medical Center, Chicago, IL, 60637, USA
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Al-Aali KA, Alzaid AA, Alsaloum M, Alanazi KK, Almujel SH. Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery. Photobiomodul Photomed Laser Surg 2023; 41:703-709. [PMID: 38011738 DOI: 10.1089/photob.2023.0076] [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: 11/29/2023] Open
Abstract
Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.
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Affiliation(s)
- Khulud A Al-Aali
- Prosthodontics, Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdulaziz A Alzaid
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammad Alsaloum
- Department of Restorative and Prosthetic Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khalid K Alanazi
- Department of Conservative Dental Science, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Saad Hamad Almujel
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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12
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Kensara A, Saito H, Mongodin EF, Masri R. Microbiological profile of peri-implantitis: Analyses of microbiome within dental implants. J Prosthodont 2023; 32:783-792. [PMID: 36691777 DOI: 10.1111/jopr.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To characterize the microbiome composition within dental implants of peri-implantitis subjects and healthy controls using 16S rRNA gene sequencing. MATERIALS AND METHODS Twenty-three subjects with healthy (n = 11 implants) and diseased (peri-implantitis, n = 21) implants were included in this controlled clinical cross-sectional study. Samples were obtained from internal surfaces of dental implants using sterile paper points for microbiological analysis. DNA was extracted, and the16S rRNA gene was amplified using universal primers targeting the V3-V4 regions. The resulting 16S polymerize chain reaction amplicons were sequenced on Illumina MiSeq, and the sequences were processed using DADA2 and the Human Oral Microbiome Database (HOMD) as references. Alpha and Beta diversity, as well as core microbiome and differential abundance analyses were then performed using the MicrobiomeAnalyst workflow. RESULTS A significant increase in microbial diversity was observed in the internal implant surface of healthy implants compared with the internal surfaces of peri-implantitis (Shannon p = 0.02). Bacterial community structure was significantly different among groups (p = 0.012). High levels of Gram-positive bacteria were detected inside implants with peri-implantitis compared to healthy implants, especially Enterococci. CONCLUSIONS There is a shift in bacterial diversity inside implants with peri-implantitis from the healthy control. The microbial colonization within that space might contribute to the etiology of peri-implant disease.
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Affiliation(s)
- Anmar Kensara
- Department of Restorative Dentistry, College of Dentistry, Umm Al Qura University, Makkah, Saudi Arabia
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Hanae Saito
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Emmanuel F Mongodin
- Institute for Genome Sciences, School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Radi Masri
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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13
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Molinero-Mourelle P, Peter L, Gaviria AS, Fonseca M, Schimmel M, Katsoulis J. Tactile misfit detection ability at the implant-abutment interface of internal connection dental implants: an in-vitro study. Acta Odontol Scand 2023; 81:591-596. [PMID: 37319413 DOI: 10.1080/00016357.2023.2223715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim of this in-vitro study was to investigate the tactile assessment ability at the implant impression-taking stage. METHODS Thirty clinicians (18 novices, 12 experts) were included for a tactile fit assessment by using a used/new probe (tip diameter 100 µm/20 µm). Six implant replicas and related impression copings of two internal connection implant systems were used, each with a perfect fit (0 µm) and defined vertical micro gaps of 8, 24, 55, 110 and 220 µm at the interface. Statistical analysis was performed using descriptive methods and non-parametric tests with a focus on specificity (ability to detect perfect fit), sensitivity (ability to detect misfit), and predictive values. P-values <5% were considered statistically significant. RESULTS The tactile assessment showed a mean total sensitivity for the Straumann and Nobel Biocare systems of 83% and 80% with a used probe, and 91% and 92% with a new probe, respectively. The mean total specificities were 33% and 20% with a used probe and 17% and 3% with a new probe, respectively. No statistical significance was observed between novice and expert clinicians concerning their tactile assessment ability. CONCLUSIONS The ability to detect a perfect fit (specificity) with a probe was very poor for both implant systems and impaired with the use of a new probe. The use of a new probe improved the gap detection ability (sensitivity) significantly at the expense of the specificity. A combination of additional chairside techniques with training and calibration could improve clinicians' ability to correctly assess the fit/misfit at the implant-abutment interface.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Conservative Dentistry and Orofacial Prosthodontics, Complutense University of Madrid, Madrid, Spain
| | - Lukas Peter
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ana Sol Gaviria
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Joannis Katsoulis
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Preventive and Restorative Sciences, Robert Schattner Center, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Cascos R, Celemín-Viñuela A, Mory-Rubiños N, Gómez-Polo C, Ortega R, Agustín-Panadero R, Gómez-Polo M. Influence of the Use of Transepithelial Abutments vs. Titanium Base Abutments on Microgap Formation at the Dental Implant-Abutment Interface: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6532. [PMID: 37834669 PMCID: PMC10573618 DOI: 10.3390/ma16196532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
This in vitro study aimed to assess the presence of microgaps at the implant-abutment interface in monolithic zirconia partial implant-supported fixed prostheses on transepithelial abutments versus Ti-base abutments. METHODS Sixty conical connection dental implants were divided into two groups (n = 30). The control group consisted of three-unit bridge monolithic zirconia connected to two implants by a transepithelial abutment. The test group consisted of monolithic zirconia three-unit restoration connected to two implants directly by a titanium base (Ti-base) abutment. The sample was subjected to thermocycling (10,000 cycles at 5 °C to 55 °C, dwelling time 50 s) and chewing simulation (300,000 cycles, under 200 N at frequencies of 2 Hz, at a 30° angle). The microgap was evaluated at six points (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) of each implant-abutment interface by using a scanning electron microscope (SEM). The data were analyzed using the Mann-Whitney U tests (p > 0.05). RESULTS The SEM analysis showed a smaller microgap at the implant-abutment interface in the control group (0.270 μm) than in the test group (3.902 μm). Statistically significant differences were observed between both groups (p < 0.05). CONCLUSIONS The use or not of transepithelial abutments affects the microgap size. The transepithelial abutments group presented lower microgap values at the interface with the implant than the Ti-base group in monolithic zirconia partial implant-supported fixed prostheses. However, both groups had microgap values within the clinically acceptable range.
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Affiliation(s)
- Rocío Cascos
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Alicia Celemín-Viñuela
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Nataly Mory-Rubiños
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain;
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
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15
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Kunrath MF, Gerhardt MDN. Trans-mucosal platforms for dental implants: Strategies to induce muco-integration and shield peri-implant diseases. Dent Mater 2023; 39:846-859. [PMID: 37537095 DOI: 10.1016/j.dental.2023.07.009] [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: 05/14/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This region promotes a challenging environment for the successfulness of dental components due to the transitional characteristics between soft and hard tissues, the presence of bacteria, and mechanical forces. This review explored the most current approaches to modify trans-mucosal components in terms of macro-design and surface properties. METHODS This critical review article revised intensely the literature until July 2023 to demonstrate, discuss, and summarize the current knowledge about marketable and innovative trans-mucosal components for dental implants. RESULTS A large number of dental implant brands have promoted the development of several implant-abutment designs in the clinical market. The progress of abutment designs shows an optimistic reduction of bacteria colonization underlying the implant-abutment gap, although, not completely inhibited. Fundamental and preclinical studies have demonstrated promising outcomes for altered-surface properties targeting antibacterial properties and soft tissue sealing. Nanotopographies, biomimetic coatings, and antibiotic-release properties have been shown to be able to modulate, align, orient soft tissue cells, and induce a reduction in biofilm formation, suggesting superior abilities compared to the current trans-mucosal platforms available on the market. SIGNIFICANCE Future clinical implant-abutments show the possibility to reduce peri-implant diseases and fortify soft tissue interaction with the implant-substrate, defending the implant system from bacteria invasion. However, the absence of technologies translated to commercial stages reveals the need for findings to "bridge the gap" between scientific evidences published and applied science in the industry.
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Affiliation(s)
- Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, P.O. Box 412, SE 405 30 Göteborg, Sweden; School of Health and Life Sciences, Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil; School of Technology, Post-Graduate Program in Materials Technology and Engineering, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Maurício do N Gerhardt
- School of Health and Life Sciences, Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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16
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Jervøe-Storm PM, Jepsen S, Marder M, Kraus D, Stoilov M, Enkling N. Prevention of internal bacterial colonization of dental implants: A comparative longitudinal observational study. Clin Oral Implants Res 2023; 34:979-986. [PMID: 37394702 DOI: 10.1111/clr.14124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/17/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES Previous studies have indicated a progressive internal bacterial colonization of implants and possible implications for peri-implant bone loss. The aim of this study was to evaluate a decontamination protocol, two disinfectants, and a sealant for their ability to prevent such a colonization. MATERIALS AND METHODS Bacterial samples were harvested from the peri-implant sulcus (external) and following abutment removal from the implant cavity (internal) during routine supportive peri-implant care in 30 edentulous patients 2 years after they had obtained two implants. In a split-mouth design, implants were randomly assigned to receive either internal decontamination alone (10% H2 O2 , brush) or additional placement of either sealant (GS), disinfectant agent (CHX-varnish) or disinfectant gel (1% CHX-gel), in the internal cavity before remounting of abutment/suprastructure. Twelve months later, internal and external sampling was repeated. Total bacterial counts (TBCs) were determined using real-time PCR in a total of 240 samples (eight per patient). RESULTS Total bacterial counts in the internal cavity significantly reduced overall treatment modalities 1 year after the treatments (4.0 [2.3-6.9]-fold reduction; p = .000). No significant differences between the four treatment types were found (p = .348). Comparison of internal and external sampling points revealed significant correlation (R2 = .366; p = .000) with systematically higher TBC counts in external samples. CONCLUSIONS Within the limitations of the present study, it can be concluded that the use of disinfectant agents or a sealant did not show an additional benefit in the prevention of internal bacterial colonization of implants compared to a decontamination protocol alone.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany
- Department of Reconstructive Dentistry & Gerodontology, University of Bern, Bern, Switzerland
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17
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Laleman I, Lambert F. Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review. Clin Implant Dent Relat Res 2023; 25:723-733. [PMID: 36825512 DOI: 10.1111/cid.13185] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023]
Abstract
Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis. With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, higher implants (≥2mm) with an emergence angle below 30° seem more favourable. It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice. [Correction added on 13 March 2023, after first online publication: 'longer implants (≥2mm)' was changed to 'higher implants (≥2mm)' in this version.].
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Affiliation(s)
- Isabelle Laleman
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
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Lin J, Cai P, Zhuo Y, Lin L, Zheng Z. Effect of abutment design on fracture resistance of resin-matrix ceramic crowns for dental implant restoration: an in vitro study. BMC Oral Health 2023; 23:410. [PMID: 37344826 DOI: 10.1186/s12903-023-03100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/01/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The purpose of this study is to investigate the performance and fracture resistance of different resin-matrix ceramic materials for use in implant-supported single crowns with respect to the abutment design (crown thickness: 1 mm, 2 and 3 mm). METHODS Forty-eight abutments and crowns were fabricated on implants in the right lower first molar. Two resin-matrix ceramic materials for dental crowns were selected for study: (1) a glass-ceramic in a resin interpenetrating matrix (Vita Enamic, Vita, Germany) and (2) a resin-based composite with nanoparticle ceramic filler (Lava Ultimate, 3 M ESPE, USA). Three types of abutments were designed: 1 mm thick crown + custom titanium abutment, 2 mm thick crown + custom titanium abutment and 3 mm thick crown + prefabricated titanium abutment. The experiment was divided into 6 groups (n = 8) according to the crown materials and abutment designs. After 10,000 thermocycles, fracture resistance was measured using a universal testing machine. The statistical significance of differences between various groups were analysed with ANOVA followed by a post hoc Tukey's honestly significant difference test. The surfaces of the fractured specimens were examined with scanning electron microscopy (SEM). RESULTS Two-way ANOVA revealed that the abutment design (F = 28.44, P = 1.52 × 10- 8<0.001) and the crown materials (F = 4.37, P = 0.043 < 0.05) had a significant effect on the fracture resistance of implant crown restoration. The Lava Ultimate-2 mm group showed the highest fracture resistance of 2222.74 ± 320.36 N, and the Vita Enamic-3 mm group showed the lowest fracture resistance of 1204.96 ± 130.50 N. Most of the 1 and 2 mm groups had partial crown fractures that could be repaired directly with resin, while the 3 mm group had longitudinal fracture of the crown, and the crowns were detached from the abutments. CONCLUSION Based on the in vitro data of this study, the fracture resistance of the 2 mm thick resin-matrix ceramic crown design was higher than that of the 1 and 3 mm groups. The 2 mm thick resin-matrix ceramic crown and personalized abutment are an option to replace zirconia for implant crown restoration.
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Affiliation(s)
- Jie Lin
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
- Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, 102-8159, Tokyo, Japan
- School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, 102-8159, Tokyo, Japan
| | - Pingping Cai
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Yingying Zhuo
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Ling Lin
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China
| | - Zhiqiang Zheng
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, 350002, Fuzhou, Fujian, PR China.
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Nie H, Tang Y, Yang Y, Wu W, Zhou W, Liu Z. Influence of a new abutment design concept on the biomechanics of peri-implant bone, implant components, and microgap formation: a finite element analysis. BMC Oral Health 2023; 23:277. [PMID: 37170117 PMCID: PMC10176806 DOI: 10.1186/s12903-023-02989-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND A new two-piece abutment design consisting of an upper prosthetic component and tissue-level base has been introduced; however, the biomechanical behavior of such a design has not been documented. This study aimed to investigate the effect of a two-piece abutment design on the stress in the implant components and surrounding bone, as well as its influence on microgap formation. METHODS To simulate the implant models in the mandibular left first molar area, we established nine experimental groups that included three bone qualities (type II, III, and IV) and three implant-abutment designs (internal bone level, tissue level, and a two-piece design). After the screw was preloaded, the maximum occlusal (600 N) and masticatory (225 N) forces were established. Finite element analysis was performed to analyze the maximum and minimum principal stresses on the peri-implant bone; the von Mises stresses in the implants, abutments, bases, and screws, and the microgaps at the implant-abutment, implant-base, and base-abutment interfaces. RESULTS For all three loading methods, the two-piece abutment design and bone-level connection exhibited similarities in the maximum and minimum principal stresses in the peri-implant bone. The von Mises stresses in both screws and bases were greater for the two-piece design than for the other connection types. The smallest microgap was detected in the tissue-level connection; the largest was observed at the implant-base interface in the two-piece design. CONCLUSIONS The present study found no evidence that the abutment design exerts a significant effect on peri-implant bone stress. However, the mechanical effects associated with the base and screws should be noted when using a two-piece abutment design. The two-piece abutment design also had no advantage in eliminating the microgap.
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Affiliation(s)
- Huimin Nie
- Department of Implant Dentistry, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 19, Beima Road, Zhifu District, Yantai, 264000, China
| | - Yantai Tang
- Department of Implant Dentistry, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 19, Beima Road, Zhifu District, Yantai, 264000, China
| | - Yan Yang
- Department of Implant Dentistry, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 19, Beima Road, Zhifu District, Yantai, 264000, China
| | - Weijie Wu
- University of Science and Technology Beijing, Beijing, 100000, China
| | - Wenjuan Zhou
- Department of Implant Dentistry, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 19, Beima Road, Zhifu District, Yantai, 264000, China.
| | - Zhonghao Liu
- Department of Implant Dentistry, Binzhou Medical University Affiliated Yantai Stomatological Hospital, No. 19, Beima Road, Zhifu District, Yantai, 264000, China
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20
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Fathi A, Rismanchian M, Dezaki SN. Effectiveness of Different Antimicrobial Agents on Malodor Prevention in Two-Stage Dental Implants: A Double-Blinded Randomized Clinical Trial. Eur J Dent 2023; 17:524-529. [PMID: 35820442 PMCID: PMC10329548 DOI: 10.1055/s-0042-1747954] [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: 10/17/2022] Open
Abstract
OBJECTIVE Opening of a healing abutment in two-stage implant systems is usually followed by a bad smell. Previous studies have found that presence of bacteria in microleakages of the implant-abutment interface results in further malodor. However, studies focusing on preventive treatments for this issue are scarce. Therefore, the aim of this study is to evaluate the effectiveness of two antimicrobial agents on prevention of malodor followed by opening the healing abutments. MATERIALS AND METHODS Current double-blinded randomized clinical trial was performed on 51 eligible patients who were referred for their exposure surgery. They were divided equally into three parallel groups. In two groups, either chlorhexidine or tetracycline was added to the internal surface of the fixtures before screwing the healing abutments. One group did not receive any intervention. Three to 4 weeks later malodor was scored by sniffing the healing abutments immediately after uncovering them (odorless = 0/odor = 1). The three groups were then compared regarding malodor scores. RESULTS Our findings showed that malodor was more frequent in the control group (58.82%) in comparison with groups of intervention (17.65 and 23.53%). There was a statistically significant difference between malodor in patients in whom antimicrobial agents (chlorhexidine and tetracycline) were used in their implants and the control group (p-value = 0.023). However, malodor in the chlorhexidine group and tetracycline group did not show any significant difference (p-value = 1). CONCLUSION Based upon the data from this study, it appears that local antimicrobial agents including chlorhexidine and tetracycline result in less malodor production within the implant-abutment interface. CLINICAL SIGNIFICANCE A specific type of malodor is commonly seen after opening the healing abutment of a two-stage dental implant. Not only this issue is noticed by the dentist, but also annoyed the patient. Using local antimicrobial agents in the fixtures is likely to be a simple, easily applicable solution that satisfies both patients and dentists, and eliminates the possibility of further inflammation.
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Affiliation(s)
- Amirhossein Fathi
- Dental Materials Research Center, Dental Prosthodontics Department, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Rismanchian
- Dental Implants Research Center, Dental Prosthodontics Department, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Nasrollahi Dezaki
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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21
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Carra MC, Blanc-Sylvestre N, Courtet A, Bouchard P. Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36807599 DOI: 10.1111/jcpe.13790] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
AIM This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). MATERIALS AND METHODS A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. RESULTS Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I2 : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I2 : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. CONCLUSIONS Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.
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Affiliation(s)
- Maria Clotilde Carra
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,Population-Based Epidemiologic Cohorts Unit, Inserm, UMS 11, Villejuif, France
| | - Nicolas Blanc-Sylvestre
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,URP 2496, Université Paris Cité, Paris, France
| | - Alexandre Courtet
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France
| | - Philippe Bouchard
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,URP 2496, Université Paris Cité, Paris, France
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22
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Revilla-León M, Yilmaz B, Kois JC, Att W. Prevention of peri-implant disease in edentulous patients with fixed implant rehabilitations. Clin Implant Dent Relat Res 2023. [PMID: 36707075 DOI: 10.1111/cid.13182] [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: 11/14/2022] [Accepted: 01/07/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics. METHODS A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed. CONCLUSIONS Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.
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Affiliation(s)
- Marta Revilla-León
- Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - Wael Att
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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23
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Rodrigues VVM, Faé DS, Rosa CDDRD, Bento VAA, Lacerda MFLS, Pellizzer EP, Lemos CAA. Is the clinical performance of internal conical connection better than internal non-conical connection for implant-supported restorations? A systematic review with meta-analysis of randomized controlled trials. J Prosthodont 2023. [PMID: 36700461 DOI: 10.1111/jopr.13655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/05/2023] [Accepted: 01/15/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To evaluate bone loss, prosthodontics and biological complications, and implant survival rates of internal conical connections (ICC) compared with internal non-conical connection (INCC) implants. METHODS The systematic review was registered on PROSPERO (CRD42021237170). Meta-analysis was performed using standardized mean difference (SMD) for bone loss and risk ratio (RR) for implant survival and complication rates. Risk of bias analysis was evaluated using RoB 2.0, whereas the GRADE tool was used to evaluate the certainty of evidence. A systematic search of the PubMed, Web of Science, Embase, Cochrane, and ProQuest databases was performed independently by two reviewers for articles published up to March 2022. The search criteria had no language or publication date restrictions. Handsearching analysis was performed in the reference list of potential articles. RESULTS Twelve randomized clinical trials, including 678 patients and 1006 implants (ICC [n = 476]; INCC [n = 530]), were included. Meta-analysis revealed that ICC demonstrated a lower risk for marginal bone loss (SMD: -0.80 mm; p = 0.004) and prosthodontics complications (RR: 0.16; p = 0.01) than INCC. However, both internal connections demonstrated no significant difference in implant survival rates (RR: 0.54; p = 0.10) and biological complications (RR: 0.90; p = 0.82). The overall risk of bias revealed some concerns and a low risk of bias for most of the included studies. However, the certainty of evidence of outcomes was considered low to moderate. CONCLUSION ICC may be considered a more favorable treatment option than INCC owing to greater preservation of peri-implant bone tissue and a lower probability of prosthodontics complications. However, well-conducted studies with long-term follow-up are warranted.
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Affiliation(s)
- Vitor Venâncio Moreira Rodrigues
- 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, São Paulo, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Mariane Floriano Lopes Santos Lacerda
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP-Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
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24
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [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: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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25
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Anitua E, Alkhraisat MH, Eguia A. On Peri-Implant Bone Loss Theories: Trying To Piece Together the Jigsaw. Cureus 2023; 15:e33237. [PMID: 36733558 PMCID: PMC9890078 DOI: 10.7759/cureus.33237] [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: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
This review aims to explore the plausibility of new theories on the etiopathogenesis of marginal bone loss (MBL) and peri-implantitis (PI) and to discuss possible underlying pathogenic mechanisms. The former concept of osteointegration of dental implants can now be conceptualized as a foreign body response histologically characterized by a bony demarcation in combination with chronic inflammation. Different risk factors can provoke additional inflammation and, therefore, pro-inflammatory cytokine release in soft tissues and bone, leading to an overpass of the threshold of peri-implant bone defensive and regenerative capacity. Progressive bone loss observed in MBL and PI is ultimately due to a localized imbalance in the receptor activator of nuclear factor kappaB ligand (RANKL)/Receptor activator of nuclear factor κ B (RANK)/osteoprotegerin (OPG) pathway in favor of increased catabolic activity. The genetic background and the severity and duration of the risk factors could explain differences between individuals in the threshold needed to reach an imbalanced scenario. MBL and PI pathogenesis could be better explained by the "inflammation-immunological balance" theory rather than a solely "infectious disease" conception. The link between the effect of biofilm and other risk factors leading to an imbalanced foreign body response lies in osteoclast differentiation and activation pathways (over)stimulation.
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Affiliation(s)
- Eduardo Anitua
- Regenerative Medicine Laboratory, Instituto Eduardo Anitua, Vitoria, ESP
| | | | - Asier Eguia
- Estomatology II, University of The Basque Country (Universidad del País Vasco, UPV/Euskal Herriko Unibertsitatea, EHU), Leioa, ESP
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26
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Qiu P, Feng L, Fu Q, Dai T, Liu M, Wang P, Lan Y. Dual-Functional Polyetheretherketone Surface with an Enhanced Osteogenic Capability and an Antibacterial Adhesion Property In Vitro by Chitosan Modification. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2022; 38:14712-14724. [PMID: 36420594 DOI: 10.1021/acs.langmuir.2c02267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A chitosan layer was covalently bonded to a polyetheretherketone (PEEK) surface using a simple facile self-assembly method to address inadequate biological activity and infection around the implant. The surface characterization, layer degradation, biological activity, and antibacterial adhesion properties of chitosan-modified PEEK (PEEK-CS) were studied. Through chitosan grafting, the surface morphology changed, the surface roughness increased, and the contact angle decreased significantly. PEEK-CS boosted cell adhesion, proliferation, increased alkaline phosphate activity, extracellular matrix mineralization, and expression of osteogenic genes. PEEK-CS demonstrated less adhesion to Porphyromonas gingivalis as well as less bacterial adhesion to P. gingivalis and Streptococcus mutans. According to our findings, chitosan modification significantly improved the osteogenic ability and antibacterial adhesion of PEEK in vitro.
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Affiliation(s)
- Peng Qiu
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Le Feng
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Qilin Fu
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Tao Dai
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Min Liu
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Pin Wang
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
| | - Yuyan Lan
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou646000, China
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27
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Clinical Outcomes of Dental Implants with Two Different Internal Connection Configurations—A RCT. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4040046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The aim of the present study was to highlight clinical and radiographical differences among implants sharing the same macro-geometry but with two different prosthodontic connections. Methods: Patients requiring at least 2 implants in the posterior area of the jaw were randomly divided into two groups (Conical (CS) and Internal Hexagonal (IH) connection). At implant surgery (T0), insertion torque, implant stability quotient (ISQ values recorded by resonance frequency analysis, RFA), and soft tissue thickness (STH) were assessed. A 1-abutment/1-time protocol was applied, and the prosthesis was realized following a fully digital workflow. At the 36-month follow-up periapical x-rays were taken. In order to statistically analyse differences among the two groups and the different variables, paired T-test was used. Linear regression analysis was conducted to analyze how marginal bone loss (MBL) was affected by other independent variables. A neural network created to predict the success (good or not good) of the implant itself was implemented. Results: 30 out of 33 patients (14 males, 16 females, mean age: 68.94 ± 13.01 years) (32 CS and 32 IH) were analyzed. No implants failed. Marginal bone loss at the 3-year time-point was 0.33 ± 0.34 mm and 0.43 ± 0.37 mm respectively for CS and IH with a significant difference between the two groups (p = 0.004). The presence of keratinized gingiva (p = 0.034) significantly influenced MBL. Conclusions: Both the implant connections investigated presented optimal clinical outcomes with minimal marginal bone loss; however, CS implants and implants with the presence of a greater width of keratinized tissue presented significantly lower MBL.
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28
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Soulami S, Slot DE, van der Weijden F. Implant‐abutment emergence angle and profile in relation to peri‐implantitis: A systematic review. Clin Exp Dent Res 2022; 8:795-806. [PMID: 35713938 PMCID: PMC9382038 DOI: 10.1002/cre2.594] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Statement The aim of this systematic review is to analyze literature regarding the relationship between the implant‐abutment emergence angle (EA) and implant emergence profile (EP) and the prevalence of peri‐implantitis. Methods PubMed and the Cochrane Library were searched for studies from initiation up to April 2022. Studies describing the EA and EP in association with peri‐implantitis were considered eligible for this review and selected for inclusion in this review if implant groups with wide and narrow EA and different EP types were described. Results Searches in PubMed and the Cochrane Library led to 1116 unique titles and the inclusion of three studies. These concerned 168–349 implants. Two studies presented the mean prevalence of peri‐implantitis which was 16.7% and 24.8% at the implant level. Both studies showed a significant relationship between peri‐implantitis in bone‐level implant groups with an EA above 30° compared to implants with an EA below 30°. A third study presented marginal bone loss which tended to be smaller when the EA was around 20°–40°. In one of the three included studies, the prevalence of peri‐implantitis was significantly higher if implants had a convex EP compared to a concave or straight EP. Another study showed a significantly higher prevalence of peri‐implantitis in implants with a convex EP compared to other EP types, if combined with an EA above 30°. Conclusions Three eligible studies were found. Reported associations should therefore be considered with caution. Synthesis suggests an association between a larger EA (>30°) and a higher prevalence of peri‐implantitis or marginal bone loss compared to a smaller EA (<30°). A convex EP may also be associated with a higher prevalence of peri‐implantitis. However, causality remains a question.
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Affiliation(s)
- Sara Soulami
- Master of Science Program of Dental Sciences Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Fridus van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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29
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Antimicrobial Efficacy and Permeability of Various Sealing Materials in Two Different Types of Implant–Abutment Connections. Int J Mol Sci 2022; 23:ijms23148031. [PMID: 35887378 PMCID: PMC9322952 DOI: 10.3390/ijms23148031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 12/10/2022] Open
Abstract
The presence of a microgap along an implant–abutment connection (IAC) is considered the main disadvantage of two-piece implant systems. Its existence may lead to mechanical and biological complications. Different IAC designs have been developed to minimise microleakage through the microgap and to increase the stability of prosthodontic abutments. Furthermore, different sealing materials have appeared on the market to seal the gap at the IAC. The purpose of this study was to evaluate the antimicrobial efficacy and permeability of different materials designed to seal the microgap, and their behaviour in conical and straight types of internal IACs. One hundred dental implants with original prosthodontic abutments were divided into two groups of fifty implants according to the type of IAC. Three different sealing materials (GapSeal, Flow.sil, and Oxysafe gel) were applied in the test subgroups. The contamination of implant–abutment assemblies was performed by a joint suspension containing Candida albicans and Staphylococcus aureus. It was concluded that the IAC type had no significant influence on microleakage regarding microbial infection. No significant difference was found between the various sealing agents. Only one sealing agent (GapSeal) was found to significantly prevent microleakage. A complete hermetic seal was not achieved with any of the sealing agents tested in this study.
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30
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Kim S, Lee JW, Kim JH, Truong VM, Park YS. The impact of Morse taper implant design on microleakage at implant-healing abutment interface. Dent Mater J 2022; 41:767-773. [PMID: 35858791 DOI: 10.4012/dmj.2022-022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The microbial leakage at the implant-abutment interface (IAI) is one cause of peri-implant infection that puts long-term implant stability at risk. The present study compared two types of Morse taper implants in terms of sealing performance at the implanthealing abutment interface. Three implant systems, one of which exhibited a partial face-contact design (TSO) and the other two a line-contact design (TSM and BLT), were analyzed in vitro using two quantitative implant leakage measuring techniques: air-injection pressure measurement test and microbial examination. An in-house-developed device was used to determine implant leakage by recording the initial drop in pressure while injecting air through the implant. The microbial examination measured the absorbances of culture mediums in which the inoculated implants were contained. Significant difference was found between the partial face- and line-contact groups (p<0.001). Both tests revealed that partial face-contact implants are more prone to leakage than line-contact implants.
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Affiliation(s)
- Soyeon Kim
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Joo Won Lee
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Jae-Heon Kim
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Van Mai Truong
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University
| | - Young-Seok Park
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University.,Center for Future Dentistry, School of Dentistry, Seoul National University
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Molinero-Mourelle P, Roccuzzo A, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Microleakage assessment of CAD-CAM Cobalt-Chrome and Zirconia abutments on a conical connection dental implant: A comparative in vitro study. Clin Oral Implants Res 2022; 33:945-952. [PMID: 35818785 PMCID: PMC9544167 DOI: 10.1111/clr.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
Objective To assess the marginal and bacterial microleakage in zirconia and CAD‐CAM or cast Co‐Cr implant abutments. Methods Sixty‐four conical connection implants with their respective abutments were divided into four groups (Co‐Cr (milled, laser‐sintered, and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs). Results Thirty (47%) implant‐abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co‐Cr milled, 14 Co‐Cr laser‐sintered and 14 cast). Seven specimens (1 Co‐Cr laser‐sintered and six cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co‐Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/ml). The Co‐Cr cast (9.39E+03 CFUs/ml) and laser‐sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co‐Cr cast and laser‐sintered resulted in a statistically significant differences in favor of Co‐CrCL (p < .05). Conclusions The abutment material and fabrication technique affected the implant‐abutment microleakage. Although the CAD‐CAM abutments presented favorable results, all tested groups presented microleakage.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Department of Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Edmond H N Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid
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Full Digital Model-Free Maxillary Prosthetic Rehabilitation by Means of One-Piece Implants: A Proof of Concept Clinical Report with Three-Years Follow Up. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4020020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Implant rehabilitation is a daily practice in dentistry, and patients often have heightened expectations regarding both the functional and the aesthetic outcome. Implant–abutment connection (IAC) is involved in the long-term aesthetic quality of the rehabilitation. The use of one-piece implants for fixing dentures may prevent the mechanical and biological implication of the implant–abutment interface, resulting in a better quality of hard and soft tissue maintenance. In this case report, we present a novel one-piece implant in a maxillary rehabilitation with a full model-free digital approach.
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Sealing Efficacy of the Original and Third-Party Custom-Made Abutments-Microbiological In Vitro Pilot Study. MATERIALS 2022; 15:ma15041597. [PMID: 35208136 PMCID: PMC8879410 DOI: 10.3390/ma15041597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 02/05/2023]
Abstract
Implant–abutment connection (IAC) is a key factor for the long-term success and stability of implant-supported prosthodontic restoration and its surrounding tissues. Misfit between prosthodontic abutment and implant at the IAC leads to technical and biological complications. Two kinds of prosthodontic abutments are currently available on the market: original and third-party abutments. The aim of this pilot study was to test and compare the internal fit (gap) at the implant–abutment interface depending on the abutment fabrication method based on microbial leakage in static conditions and the need for the use of gap sealing material. Two groups of 40 implants were formed on the basis of the type of abutment. In each of the groups of two implant systems, two subgroups of 10 implants were formed. The tested subgroups consisted of 10 implants with sealing material and a negative control subgroups consisting of 10 implants without any sealing material. The test material, GapSeal (Hager and Werken, Duisburg, Germany) was applied in the test subgroups. The implant–abutment assemblies were contaminated with a solution containing Staphylococcus aureus and Candida albicans for 14 days under aerobic conditions. Results showed that there was no statistically significant difference regarding the microbial leakage between the original and third-party custom-made abutments, regardless of the use of sealing material. It can be concluded that the abutment fabrication method has no significant influence on sealing efficacy regarding the bacterial and fungal leakage in static conditions.
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Malik R, Mayuri S, Ahamed Irfan KA, Raj R, Sen A, Bandgar S, Rangari P. Success of dental implant influenced by abutment types and loading protocol. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S1019-S1022. [PMID: 36110750 PMCID: PMC9469307 DOI: 10.4103/jpbs.jpbs_708_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Dental implants are considered better, latest, and most advanced technique of teeth replacement in present times with more teeth loss and increased related concerns. Aims: The present clinical trial was carried out to assess marginal bone loss and implant failure in immediate and delayed loading implants. The study also evaluated healing using Polymerase Chain Reaction (PCR) and the effect of risk factors on marginal bone loss. Materials and Methods: The 44 subjects were randomly divided into two groups with immediate loading and delayed loading protocols. Various soft-tissue parameters were seen clinically. Quantitative PCR was done to detect biomarkers. The collected data were subjected to statistical evaluation with a level of significance at P < 0.05 and the results were formulated. Results: Concerning marginal bone loss, it was seen that for delayed loading, the bone loss at the implant level was 1.52 ± 0.14, 0.19 ± 0.11, and 0.40 ± 0.12, respectively, at placement, 1 and 2 years. Plaque and mucosal bleeding scores were low at the time of placement with respective values of 0.96 ± 0.12 and 28.42 ± 3.15 for the delayed loading group and 0.98 ± 0.11 and 30.24 ± 3.15 for the immediate loading group. Tartrate-resistant acid phosphatase (TRAP) showing remodeling was high at 3 months in delayed loading (13.3 ± 8.5). Alkaline Phosphatase (ALP) was highest in delayed loading at 3 months (25.2 ± 7.7) and immediate loading at 2 days (32.6 ± 13). Conclusion: Both immediate loading and delayed loading implants show similar results in terms of bone loss, soft-tissue parameters, and biomarkers in sulcular fluids with relatively few and manageable complications.
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Galindo-Moreno P, Concha-Jeronimo A, Lopez-Chaichio L, Rodriguez-Alvarez R, Sanchez-Fernandez E, Padial-Molina M. Marginal Bone Loss around Implants with Internal Hexagonal and Internal Conical Connections: A 12-Month Randomized Pilot Study. J Clin Med 2021; 10:jcm10225427. [PMID: 34830709 PMCID: PMC8621760 DOI: 10.3390/jcm10225427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to analyze the differences in terms of the marginal bone level (MBL) around implants with either an internal conical or an internal hexagonal implant–prosthesis connection. A randomized clinical trial included patients in need of a single implant-supported restoration. The implant–prosthesis connection was either internal conical or internal hexagonal while maintaining the same type of implant macro- and microarchitecture. Clinical and radiographical variables were registered up to 12 months of follow-up, including MBL. A total of 30 patients were included in the study. The main outcome variable, MBL 12 months after prosthesis delivery, was statistically different in both groups: −0.25 (0.12) vs. −0.70 (0.43) (conical vs. hexagonal; p = 0.033). Differences were also observed at the 3- and 6-month follow-up visits as well as for the MBL change from prosthesis delivery to the 12-month follow-up (−0.15 (0.13) vs. −0.56 (0.44); conical vs. hexagonal; p = 0.023). Correlations between MBL around the implants and radiographic measurements on the adjacent teeth, buccal bone to implant, tissue thickness or keratinized tissue were not significant neither globally nor when analyzed independently by group. In view of such results, it can be concluded that single-unit restorations with internal hexagonal-connection implants induce higher marginal bone loss after 12 months of follow-up from prosthesis delivery than internal conical-connection implants.
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- Correspondence:
| | - Ada Concha-Jeronimo
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Lucia Lopez-Chaichio
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Roque Rodriguez-Alvarez
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Elena Sanchez-Fernandez
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
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Fernandes PF, Grenho L, Fernandes MH, Sampaio-Fernandes JC, Gomes PS. Microgap and bacterial microleakage during the osseointegration period: An in vitro assessment of the cover screw and healing abutment in a platform-switched implant system. J Prosthet Dent 2021:S0022-3913(21)00501-1. [PMID: 34711406 DOI: 10.1016/j.prosdent.2021.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Microgap and bacterial microleakage at the implant-prosthetic abutment interface are recognized concerns for implant-supported restorations, leading to inflammation of the peri-implant tissues, with deleterious consequences for crestal bone levels. However, little is known regarding the interface established between the implant and the healing abutment or cover screw placed for the osseointegration phase. PURPOSE The purpose of this in vitro study was to characterize the implant-cover screw and implant-healing abutment interfaces of a platform-switched implant system to determine the microgap and bacterial microleakage of the system and evaluate the biological response and functionality of an interface sealing agent. MATERIAL AND METHODS The interfacial microgaps of the implant-healing abutment and implant-cover screw interfaces were characterized by scanning electron microscopy (n=10), and bacterial microleakage was evaluated after colonization with Enterococcus faecalis in a 30-day follow-up (n=10). The sealing efficacy and irritation potential of a silicone-based sealer were determined by using the hen's egg test on chorioallantoic membrane assay. The 2-sample t test was performed to compare means between groups, and data presented with the Kaplan-Meier method were compared statistically by using the log-rank test (α=.05). RESULTS The interfacial microgap was less than 2.5 μm for both systems. Bacterial microleakage was noted in approximately 50% of the specimens, particularly at early time points, at both the healing abutment and cover screw interfaces. The silicone-based sealer prevented bacterial leakage in the experimental setting. CONCLUSIONS The implant-healing abutment and implant-cover screw interfaces of the tested system, despite the low microgap, allowed for bacterial microleakage after internal colonization. The use of a nonirritating silicone-based sealing agent effectively sealed the system.
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Affiliation(s)
- Pedro F Fernandes
- Graduate student, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Liliana Grenho
- Invited Assistant Professor, Oral Biosciences, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal
| | - Maria H Fernandes
- Full Professor, Oral Biosciences and Pharmacology, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal
| | - João C Sampaio-Fernandes
- Full Professor, Oral Rehabilitation, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Pedro S Gomes
- Associate Professor, Oral Biosciences, Faculty of Dental Medicine, University of Porto, Porto, Portugal; Researcher at LAQV/REQUIMTE, University of Porto, Porto, Portugal.
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Aslroosta H, Akbari S, Naddafpour N, Adnaninia ST, Khorsand A, Namadmalian Esfahani N. Effect of microthread design on the preservation of marginal bone around immediately placed implants: a 5-years prospective cohort study. BMC Oral Health 2021; 21:541. [PMID: 34670544 PMCID: PMC8529818 DOI: 10.1186/s12903-021-01881-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to evaluate the effect of the microthread design at the implant neck on the preservation of marginal bone around immediately-placed implants in a 5-year follow up. Methods Thirty patients received 41 immediately placed implants which were randomly assigned to treatment groups with microthreaded implants (test group, n = 22) or threaded implants (control group, n = 19). Clinical and radiographic analyses were carried out after 1 and5 years. Plaque index, bleeding on probing, suppuration, probing depth and marginal bone loss were subject to evaluations. The results were analyzed with the T-test, Fisher’s exact test and Mann–Whitney U test. Results No implants failed; thirty-five implants (in 27 patients); 21 microthreaded and 14 threaded implants; completed the 5 year follow up. The mean values of the marginal bone loss in microthreaded and threaded groups were 1.12 ± 0.95 mm and 0.87 ± 0.78 mm, respectively during an observation period of 70.9 ± 10.4 months; the differences in marginal bone loss and other pre-implant parameters were not significant between groups (P > 0.05). Conclusion Both implant designs showed acceptable results in terms of the clinical parameters and marginal bone level. Within the limitation of this study, the results did not demonstrate any superiority of the microthread design compared to threaded one in marginal bone preservation around immediately placed implants over 5 years of loading.
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Affiliation(s)
- Hoori Aslroosta
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
| | - Solmaz Akbari
- Periodontics Department, Dental Implant Research Center, Dentistry Research Institute, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nima Naddafpour
- Periodontics Department, Dental Faculty, Islamic Azad University, Tehran, Iran
| | | | - Afshin Khorsand
- Periodontics Department, Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran
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Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:181-202. [PMID: 34642979 DOI: 10.1111/clr.13823] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.
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Affiliation(s)
- Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aneesha Acharya
- Department of Periodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, India
| | - Stephanie Pekarski
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Meijndert CM, Raghoebar GM, Vissink A, Delli K, Meijer HJA. The effect of implant-abutment connections on peri-implant bone levels around single implants in the aesthetic zone: A systematic review and a meta-analysis. Clin Exp Dent Res 2021; 7:1025-1036. [PMID: 34418324 PMCID: PMC8638280 DOI: 10.1002/cre2.471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/04/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To systematically review literature about the effect of different implant‐abutment interface designs on peri‐implant bone level changes, implant loss and mid‐buccal mucosa changes around single implants in the anterior maxilla. Reviewing three connection configurations: Platform switched conical (PS‐conical); Platform switched parallel (PS‐parallel); Platform matched parallel (PM‐parallel). Methods A detailed search was carried out in Pubmed, EMBASE, Cochrane, Scopus, Open Gray and African journals Online (until December 1, 2020) and was restricted to clinical prospective studies of at least 1 year and with at least 10 human participants. A meta regression analysis was carried out primarily on the pooled peri‐implant bone level changes followed by implant loss and mid‐buccal mucosa level change. Risk of bias was assessed with RoB 2.0 and ROBINS‐I. The manuscript complied with the PRISMA guidelines and was registered in the PROSPERO database (ID: 225092). Results A total of 5513 hits gave 44 eligible articles for the analyses. Bone level change did not differ significantly between the two platform switched connections; their bone loss scores were significantly lower than PM‐connection. The PS‐conical connections have significantly lower implant losses than the PM connection. Mid‐buccal mucosa level change was comparable between the three connection configurations. Moderate to high risk of bias was detected in the included studies. Conclusions The performance of PS‐conical and PS‐parallel connection configurations both favored bone loss scores compared to the PM‐parallel connection configuration. All three demonstrated mid‐buccal mucosa changes that were small and did not differ significantly amongst the groups.
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Affiliation(s)
- Caroliene M Meijndert
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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40
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Wimmer L, Petrakakis P, El-Mahdy K, Herrmann S, Nolte D. Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design-retrospective analysis after a mean follow-up of 5 years. Int J Implant Dent 2021; 7:71. [PMID: 34318379 PMCID: PMC8316513 DOI: 10.1186/s40729-021-00353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. RESULTS Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = - 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. CONCLUSIONS Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.
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Affiliation(s)
- Lukas Wimmer
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany.,Private Dental Practice, St. Johann, Salzburg, Austria
| | | | - Karim El-Mahdy
- Department of Restorative Dentistry & Periodontology, Dental School, Ludwig Maximilian University, Munich, Germany
| | - Surian Herrmann
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany
| | - Dirk Nolte
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany. .,Ruhr University Bochum, Bochum, Germany.
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Kaczmarek K, Leniart A, Lapinska B, Skrzypek S, Lukomska-Szymanska M. Selected Spectroscopic Techniques for Surface Analysis of Dental Materials: A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2624. [PMID: 34067921 PMCID: PMC8156406 DOI: 10.3390/ma14102624] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022]
Abstract
The presented work focuses on the application of spectroscopic methods, such as Infrared Spectroscopy (IR), Fourier Transform Infrared Spectroscopy (FT-IR), Raman spectroscopy, Ultraviolet and Visible Spectroscopy (UV-Vis), X-ray spectroscopy, and Mass Spectrometry (MS), which are widely employed in the investigation of the surface properties of dental materials. Examples of the research of materials used as tooth fillings, surface preparation in dental prosthetics, cavity preparation methods and fractographic studies of dental implants are also presented. The cited studies show that the above techniques can be valuable tools as they are expanding the research capabilities of materials used in dentistry.
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Affiliation(s)
- Katarzyna Kaczmarek
- Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, 12 Tamka St., 91-403 Lodz, Poland; (A.L.); (S.S.)
| | - Andrzej Leniart
- Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, 12 Tamka St., 91-403 Lodz, Poland; (A.L.); (S.S.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland;
| | - Slawomira Skrzypek
- Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, 12 Tamka St., 91-403 Lodz, Poland; (A.L.); (S.S.)
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Molinero-Mourelle P, Cascos-Sanchez R, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt-Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study. MATERIALS 2021; 14:ma14092348. [PMID: 33946477 PMCID: PMC8125438 DOI: 10.3390/ma14092348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
The aim of this in vitro study was to investigate the microgaps at the implant-abutment interface when zirconia (Zr) and CAD/CAM or cast Co-Cr abutments were used. METHODS Sixty-four conical connection implants and their abutments were divided into four groups (Co-Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant-abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal-Wallis and pair-wise comparison were used to analyze the data (α = 0.05). RESULTS The SEM analysis revealed smaller microgaps with Co-Cr milled abutments (0.69-8.39 μm) followed by Zr abutments (0.12-6.57 μm), Co-Cr sintered (7.31-25.7 μm) and cast Co-Cr (1.68-85.97 μm). Statistically significant differences were found between milled and cast Co-Cr, milled and laser-sintered Co-Cr, and between Zr and cast and laser-sintered Co-Cr (p < 0.05). CONCLUSIONS The material and the abutment fabrication technique affected the implant-abutment microgap magnitude. The Zr and the milled Co-Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Correspondence: ; Tel.: +34-913941922
| | - Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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Kaur M, Abou-Arraj RV, Lin CP, Geisinger ML, Geurs NC. A 5-year retrospective analysis of biologic and prosthetic complications associated with single-tooth endosseous dental implants: Practical applications. Clin Adv Periodontics 2021; 11:225-232. [PMID: 33829671 DOI: 10.1002/cap.10155] [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: 02/27/2020] [Accepted: 02/28/2021] [Indexed: 11/11/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the key considerations of the incidence and timing for single-tooth implant complications, including early failure, biological complications, and prosthetic complications? SUMMARY Single-tooth dental implants have been shown to have a high overall survival rate, but implant complications affect patient satisfaction and may lead to costly and/or time-consuming repair and revision. Assessing the incidence and types of biologic and prosthetic complications and the timing of such complications is helpful so that the underlying causes can be addressed during the treatment planning process. Furthermore, identification of patient demographics, patient-, implant-, and site-specific factors associated with such complications may allow for more comprehensive risk assessment during treatment planning. CONCLUSIONS Overall, dental implants have a high survival rate. Identification of the incidence of both biologic and prosthetic complications and minimizing their impact in patients with dental implants is critical to overall implant success. Utilization of careful treatment planning and dental implant fixtures, surgical protocols, and prosthetic designs that reduce complication rates can improve patient acceptance and outcomes. Further research is necessary to fully assess complication rates and risk factors.
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Affiliation(s)
- Maninder Kaur
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ramzi V Abou-Arraj
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chee Paul Lin
- Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Gao J, Min J, Chen X, Yu P, Tan X, Zhang Q, Yu H. Effects of two fretting damage modes on the dental implant–abutment interface and the generation of metal wear debris: An in vitro study. FATIGUE & FRACTURE OF ENGINEERING MATERIALS & STRUCTURES 2020. [DOI: 10.1111/ffe.13399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jing Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Jie Min
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Xin Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Ping Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Xin Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Qianqian Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
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Immediate Placement and Restoration of a New Tapered Implant System in the Aesthetic Region: A Report of Three Cases. Case Rep Dent 2020; 2020:7632692. [PMID: 32802525 PMCID: PMC7411482 DOI: 10.1155/2020/7632692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To assess the clinical, radiographic, aesthetic, and patient-centred outcomes of a new implant system applied for an immediate implant placement and restoration approach in single tooth replacement of anterior maxillary teeth. Material and Method. Three cases were treated with a bone level tapered implant. All patients were treated with the same strategy involving flapless extraction and implant placement with simultaneous augmentation. Implants were provisionally restored with a screw-retained restoration at the day of surgery. Definitive restoration was fabricated after 3 months. Follow-up was one year after definitive restoration. Results At the 1-year follow-up, the implants were stable and no complications had occurred. Peri-implant bone levels had increased with a mean value of 0.24 ± 0.30 mm between definitive restoration placement and 1 year of follow-up. Clinical outcome scores showed healthy soft tissues. Mean Pink and White Esthetic scores were rated 7.0 and 7.3, respectively. Mean patient satisfaction had improved from 55.7 (pretreatment) to 90.0 (1-year follow-up) on a 0-100 VAS scale. Conclusion Immediate implant placement and restoration with the new tapered bone level implant system are accompanied by good initial clinical and radiographic results as well as high patient satisfaction.
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Fickl S, Stappert CFJ, Kohles SS. Crestal bone loss due to abutment manipulation and an internal silver deposition implant design in a canine model. Clin Oral Investig 2020; 25:515-523. [PMID: 32591870 DOI: 10.1007/s00784-020-03416-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/15/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The study aimed to evaluate the effect of internal silver coating as a countermeasure to crestal bone loss around implants with or without multiple abutment disconnections/reconnections. MATERIALS AND METHODS Following tooth extraction, 48 implants with connected healing abutments (24 implants internally coated with elemental silver) were placed in the mandible of eight beagle dogs. Two months after implant surgery one side of the mandible was randomly assigned to four abutment manipulations (disconnection/reconnection) on a weekly basis. At 4 months postoperative, biopsies were obtained and prepared for histomorphometric analysis. RESULTS Healing abutment manipulation increased crestal bone remodeling when compared to no abutment manipulation (1.28 mm versus 0.92 mm, respectively), although the difference was not statistically significant (p = 0.0836). Overall, an internal silver coating did not provide a statistically sufficient implant treatment characteristic as a countermeasure to crestal bone loss (p = 0.7801). CONCLUSIONS These findings indicate that the controlled variables explored here (abutment manipulation/internal silver coating) have a limited effect on initial crestal bone loss. CLINICAL RELEVANCE Abutment manipulation during prosthetic work does not seem to harm the peri-implant soft and hard tissues.
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Affiliation(s)
- Stefan Fickl
- Private Practice, Fürth, Germany
- Division of Periodontology, University of Würzburg, Würzburg, Germany
| | - Christian F J Stappert
- Private Practice, Zurich, Switzerland
- Department of Prosthodontics, Albert-Ludwigs University, Freiburg, Germany
| | - Sean S Kohles
- Kohles Bioengineering, 1731 SE 37th Avenue, Portland, OR, 97214-5135, USA.
- Division of Biomaterials & Biomechanics, School of Dentistry and Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
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Sanchez-Perez A, Nicolas-Silvente AI, Sanchez-Matas C, Cascales-Pina E, Macia-Manresa V, Romanos GE. Control of Peri-Implant Mucous Inflammation by Using Chlorhexidine or Ultraviolet C Radiation for Cleaning Healing Abutments. Double-Blind Randomized Clinical Trial. MATERIALS 2020; 13:ma13051124. [PMID: 32138236 PMCID: PMC7084961 DOI: 10.3390/ma13051124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/25/2023]
Abstract
Two-phase implants must be exposed to the external environment after the period of osteointegration has elapsed. For this purpose, a healing abutment is placed passing through the mucosa while forming the emergence profile. The continuous connection and disconnection can lead to an alteration in the tissue maturation, both because of the contact of bacterial plaque and because of the mechanical trauma that involves its manipulation, manifesting with different degrees of erythema or bleeding. To assess whether this epithelium disruption can be counteracted, a blinded study design was developed on 150 unitary implant patients divided into three groups (n = 50), applying chlorhexidine (group 1), ultraviolet C (UV-C) at a wavelength of 254 nm (group 2)and no treatment as a control group (group 3), during each of the disconnections and connections during the prosthodontic treatment (1 time per week for four weeks). All groups showed a better epithelium aspect at the end of the evaluation. Although there were no statistically significant differences in the degree of inflammation, the UV-C treated group had the lowest plaque accumulation, and the highest was for the chlorhexidine-treated group.
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Affiliation(s)
- Arturo Sanchez-Perez
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Ana I. Nicolas-Silvente
- D.D.S., Department of Restorative Dentistry, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain
- Correspondence: ; Tel.: +34-96824-7946
| | | | - Elena Cascales-Pina
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Vanesa Macia-Manresa
- D.D.S., Department of Periodontology, Medicine and Dentistry Faculty, Murcia University, 30008 Murcia, Spain; (A.S.-P.); (E.C.-P.); (V.M.-M.)
| | - Georgios E. Romanos
- D.D.S., Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794-8712, USA;
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