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Liu X, Deng S, Li X, Liu H, Li Z, Wu Y, Luo P, Zhong X, Huang R, Liu R, Wu X, Huang B, Chen Z, Chen Z, Chen S. A Standardized Rat Model to Study Peri-implantitis of Transmucosal Osseointegrated Implants. Biomater Res 2024; 28:0021. [PMID: 38828365 PMCID: PMC11142924 DOI: 10.34133/bmr.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/19/2024] [Indexed: 06/05/2024] Open
Abstract
With the high incidence rate, distinctive implant characteristic and unique infection pattern, peri-implantitis (PI) requires a specially designed implant animal model for the researches on the pathogenesis and treatments. Previous small-animal PI models exhibit variability in implant site selection, design, and surgical procedures resulting in unnecessary tissue damage and less effectivity. Herein, a quantitative-analysis-based standardized rat model for transmucosal PI-related research was proposed. After dissecting the anatomic structures of the rat maxilla, we determined that placing the implant anterior to the molars in the rat maxilla streamlined the experimental period and enhanced animal welfare. We standardized the model by controlling the rat strain, gender, and size. The customized implant and a series of matched surgical instruments were appropriately designed. A clear, step-by-step surgical process was established. These designs ensured the success rate, stability, and replicability of the model. Each validation method confirmed the successful construction of the model. This study proposed a quantitative-analysis-based standardized transmucosal PI rat model with improved animal welfare and reliable procedures. This model could provide efficient in vivo insights to study the pathogenesis and treatments of PI and preliminary screening data for further large-animal and clinical trials.
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Affiliation(s)
- Xingchen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shudan Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiyan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Zhixin Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - You Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Pu Luo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xinyi Zhong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Ruoxuan Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Runheng Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiayi Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Baoxin Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shoucheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
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Ren H, Wang P, Huang H, Huang J, Lu Y, Wu Y, Xie Z, Tang Y, Cai Z, Shen H. N-Halaminated spermidine-containing polymeric coating enables titanium to achieve dual functions of antibacterial and osseointegration. Biomater Sci 2024; 12:2648-2659. [PMID: 38573023 DOI: 10.1039/d4bm00061g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Titanium (Ti) and its alloys have been widely employed in the treatment of orthopedics and other hard tissue diseases. However, Ti-based implants are bioinert and suffer from bacterial infections and poor osseointegration in clinical applications. Herein, we successfully modified Ti with a porous N-halaminated spermidine-containing polymeric coating (Ti-SPD-Cl) through alkali-heat treatment, surface grafting and chlorination, and it has both excellent antibacterial and osteogenic abilities to significantly enhance osseointegration. The as-obtained Ti-SPD-Cl contains abundant N-Cl groups and demonstrates effective antibacterial ability against S. aureus and E. coli. Meanwhile, due to the presence of the spermidine component and construction of a porous hydrophilic surface, Ti-SPD-Cl is also beneficial for maintaining cell membrane homeostasis and promoting cell adhesion, exhibiting good biocompatibility and osteogenic ability. The rat osteomyelitis model demonstrates that Ti-SPD-Cl can effectively suppress bacterial infection and enhance bone-implant integration. Thus, Ti-SPD-Cl shows promising clinical applicability in the prevention of orthopedic implant infections and poor osseointegration.
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Affiliation(s)
- Hang Ren
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Peng Wang
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Hanwen Huang
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Junshen Huang
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Yuheng Lu
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Yanfeng Wu
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Zhongyu Xie
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Youchen Tang
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Zhaopeng Cai
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
| | - Huiyong Shen
- The Eighth Affiliated Hospital Sun Yat-sen University Shenzhen 518033, P.R. China.
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Zhang L, Zhou C, Jiang J, Chen X, Wang Y, Xu A, He F. Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study. J Clin Periodontol 2024; 51:652-664. [PMID: 38246602 DOI: 10.1111/jcpe.13947] [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: 04/08/2023] [Revised: 12/11/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
AIM To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival. MATERIALS AND METHODS This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded. RESULTS Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication. CONCLUSIONS Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.
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Affiliation(s)
- Liefen Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Chuan Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yaoqiong Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Antian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Ramesh R, Sasi A, Mohamed SC, Joseph SP. "Compression Necrosis" - A Cause of Concern for Early Implant Failure? Case Report and Review of Literature. Clin Cosmet Investig Dent 2024; 16:43-52. [PMID: 38469322 PMCID: PMC10926919 DOI: 10.2147/ccide.s453798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose Compression necrosis refers to bone tissue damage that can occur when excessive pressure or force is applied to surrounding bone during implant placement. This pressure can compromise blood supply to the bone, leading to necrosis. Compression necrosis is a concern, because it can affect the stability and long-term success of dental implant. Patients and Methods This case report highlights a case of early bone loss and implant failure possibly due to compression necrosis. Clinical data, photographs, radiographs, blood examination report and histology were presented to document the early failure of an implant placed in the mandibular left posterior region of a 33-year-old female patient. Results Radiograph taken six weeks after implant placement showed severe angular defect. Therefore, the implant was surgically removed. Histological examination of the area showed bony trabeculae with an absence of osteoblastic riming, suggestive of necrotic bone. Conclusion Using excessive torque values when placing implants in dense bones can increase the risk of implant failure due to bone over compression. Dental professionals must follow the manufacturer's instructions and employ quality surgical techniques during implant placement into dense cortical bone to minimise risks.
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Affiliation(s)
- Roshni Ramesh
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Anoop Sasi
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Shahana C Mohamed
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Sonia P Joseph
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
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Talib EQ, Taha GI. Involvement of interlukin-17A (IL-17A) gene polymorphism and interlukin-23 (IL-23) level in the development of peri-implantitis. BDJ Open 2024; 10:12. [PMID: 38413570 PMCID: PMC10899656 DOI: 10.1038/s41405-024-00193-9] [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: 11/09/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Dental implantation has been practiced since ancient times and has gone through several stages. Dentists use dental implants to support dental prostheses such as crowns, bridges, dentures, face prostheses, or as an orthodontic anchor. Thus, the purpose of this study is to detect the role of the immune-genetic variation of IL-17A and related inflammatory cytokine (IL-23) in the initiation and progress of peri implantitis. MATERIAL AND METHODS This cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants, and 30 healthy controls); their mean age was (43.91 ± 11.33) years. Blood samples and Peri-implant sulcus fluid (PISF) were collected from all subjects (patients with peri-implantitis, successful implants, and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital, Baghdad University, Baghdad, Iraq. The blood sample detects gene polymorphisms in interleukin-17A by a polymerase chain reaction (PCR). An enzyme-linked immunosorbent assay (ELISA) was carried out to estimate the Peri-implant sulcus fluid (PISF) levels of interleukin-23. RESULT The current study revealed an obvious significant elevation in the mean level of interleukin-23 in the peri-implantitis patient's group more than its level in the successful implant and control groups (P < 0.05). In addition, the result showed that A/A genotype is associated significantly with peri-implantitis OR (95%confidence interval) =6.9 (1.7121 to 27.4638) folds increase risk of peri-implantitis) (p = 0.0065), while G/A genotype had OR 4.9 (0.9539-24.9394) folds increased risk of peri-implantitis, (p = 0.0572). But it was not statistically significant and G/G genotype had a one-fold increase risk of peri-implantitis. CONCLUSION The increased level of inflammatory cytokine (interleukin-23) might add to the systemic inflammatory burden a predisposing factor, which may lead to impaired osseointegration and subsequent bone loss or implant failure. In addition, IL-17A gene polymorphism may play a role in peri-implant disease susceptibility, especially in persons carrying the rs2275913 A allele at a higher risk of developing peri-implantitits as compared with those carrying the G allele.
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Affiliation(s)
- Ehab Qasim Talib
- Department of Basic Sciences, College of Dentistry, University of Baghdad, Baghdad, Iraq.
| | - Ghada Ibrahim Taha
- Department of Basic Sciences, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Corbella S, Morandi B, Calciolari E, Alberti A, Francetti L, Donos N. The influence of implant position and of prosthetic characteristics on the occurrence of peri-implantitis: a retrospective study on periapical radiographs. Clin Oral Investig 2023; 27:7261-7271. [PMID: 37910236 PMCID: PMC10713669 DOI: 10.1007/s00784-023-05303-9] [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: 06/05/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The present retrospective study aimed to investigate the influence of malposition on the occurrence of peri-implantitis. MATERIALS AND METHODS The study included clinical records of systemically healthy patients with single and partial implant-supported rehabilitations and at least 1-year post-loading follow-up. The parameters collected included implant-related factors, patient-related factors, site-related factors, and prosthesis-related factors. The radiographic measurements were taken by using a dedicated software and the diagnosis of peri-implantitis was made based on all the available clinical and radiographic data. Descriptive statistics were provided for all variables. Following an exploratory approach, an implant-level analysis of factors influencing the occurrence of peri-implantitis was done through a multilevel multivariate logistic regression (mixed). RESULTS A total of 180 implants belonging to 90 subjects were randomly selected. Malposition showed no statistically significant association with the occurrence of peri-implantitis. According to the multi-level analysis, the parameters that were significantly associated with peri-implantitis included presence / history of periodontitis (OR = 5.945, 95% CI: 1.093 - 32.334, P = 0.039) and presence of an emergence profile angle ≥ 45° (OR = 9.094, 95% CI: 2.017 - 40.995, P = 0.005). CONCLUSIONS Implant malposition, as defined following Buser's criteria (2004), did not influence the occurrence of peri-implantitis in the selected cohort. Conversely, history of periodontitis and presence of a prosthetic emergence profile with an angle ≥ 45° were correlated to an increased risk of peri-implantitis.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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Lombardo G, D'Agostino A, Nocini PF, Signoriello A, Zangani A, Pardo A, Lonardi F, Trevisiol L. Clinical outcomes and periodontal conditions of dental implants placed in free fibula flaps (FFF): a retrospective study with a mean follow-up of 6 years. Clin Oral Investig 2023; 27:7737-7751. [PMID: 37917356 PMCID: PMC10713700 DOI: 10.1007/s00784-023-05364-w] [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: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Up-to-date literature regarding long-term success of implant rehabilitations after microvascular reconstructions with free fibula flap (FFF) is still very scarce. This study aimed to evaluate clinical outcomes, especially related to oral hygiene conditions, of patients rehabilitated with this technique. MATERIALS AND METHODS A total of 25 patients who underwent maxillofacial reconstructive surgery with FFF were retrospectively evaluated for soft tissues conditions, oral hygiene habits, and implant survival and success, assessed with a mean follow-up of 6 (range 2-15) years after loading. RESULTS Fourteen patients received full-arch fixed prostheses and 11 removable bar-supported overdentures. At the follow-up evaluation, 52% of prostheses did not allow proper accessibility for oral hygiene. Overall prosthetic survival was 100%, and implant survival and success were respectively 93.6% and 72%. Prevalence of peri-implantitis was 29% at implant level and that at patient level 96%. CONCLUSIONS Six-year clinical outcomes of this study reveal that poor oral hygiene practices and compliance by patients who underwent maxillofacial reconstruction with FFF are significantly associated with peri-implant disease. CLINICAL RELEVANCE Findings of the present study underline the need by clinicians for a careful assessment, in reference to a specific implant therapy, of patient's prosthetic accessibility for oral hygiene procedures.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Antonio D'Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alessia Pardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
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Wang Z, Wang J, Wu R, Wei J. Construction of functional surfaces for dental implants to enhance osseointegration. Front Bioeng Biotechnol 2023; 11:1320307. [PMID: 38033823 PMCID: PMC10682203 DOI: 10.3389/fbioe.2023.1320307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Dental implants have been extensively used in patients with defects or loss of dentition. However, the loss or failure of dental implants is still a critical problem in clinic. Therefore, many methods have been designed to enhance the osseointegration between the implants and native bone. Herein, the challenge and healing process of dental implant operation will be briefly introduced. Then, various surface modification methods and emerging biomaterials used to tune the properties of dental implants will be summarized comprehensively.
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Affiliation(s)
- Zhenshi Wang
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
| | - Jiaolong Wang
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
- College of Chemistry and Chemical Engineering, Nanchang University, Nanchang, China
| | - Runfa Wu
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
| | - Junchao Wei
- School of Stomatology, Nanchang University, Nanchang, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, China
- College of Chemistry and Chemical Engineering, Nanchang University, Nanchang, China
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Ryoo KS, Kim KH, Cho YD, Seol YJ, Ku Y. Effects of adjacent periodontitis on osseointegrated dental implants. J Periodontal Implant Sci 2023; 53:53.e51. [PMID: 38014772 DOI: 10.5051/jpis.2302400120] [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: 06/01/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE This study aimed to investigate whether new-onset periodontitis or apical periodontitis in the adjacent teeth affects osseointegrated dental implants in a beagle dog model. METHODS One control group and 2 experimental groups (periodontitis and apical periodontitis groups) were defined based on the presence of experimental periodontitis or apical periodontitis, with 1 beagle dog randomly assigned to each group. The mandibular second and fourth premolars on both sides of the 3 beagles were extracted. Eight weeks after extraction, 4 bone-level implant fixtures, 2 on both sides of each mandible, were placed in each beagle. Six weeks after implant surgery, healing abutments were connected. After sufficient osseointegration, plaque control was performed in the control group, while periodontitis and apical periodontitis were induced in the experimental groups. The beagles were euthanized for histological analyses 20 weeks after induction of experimental periodontitis. Statistical analyses were performed using the Kruskal-Wallis test with the Bonferroni correction to compare the 3 groups. RESULTS The implants in the control and apical periodontitis groups were well-maintained, while those in the periodontitis group showed clinical signs of inflammation with bone resorption. The bone-to-implant contact (BIC) and bone area values in the periodontitis group were lower than those in the other groups. The distance between the implant shoulder and the first BIC was significantly greater in the periodontitis group than in the control group (P<0.05). CONCLUSIONS The presence of periodontitis in adjacent teeth can pose a risk to dental implants, potentially resulting in peri-implantitis. However, this was not observed for apical periodontitis. Within the limitations of this study, periodontal care is necessary to reduce the impact of periodontitis in adjacent teeth on osseointegrated implants.
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Affiliation(s)
- Keun-Soo Ryoo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Kyoung-Hwa Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Young Ku
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
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Padhye NM, Calciolari E, Zuercher AN, Tagliaferri S, Donos N. Survival and success of zirconia compared with titanium implants: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:6279-6290. [PMID: 37740825 PMCID: PMC10630218 DOI: 10.1007/s00784-023-05242-5] [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: 11/11/2022] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered. MATERIALS AND METHODS A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved. RESULTS Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0). CONCLUSION Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants. CLINICAL RELEVANCE Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up. TRIAL REGISTRATION Systematic review registration number-CRD42021288704 (PROSPERO).
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Affiliation(s)
- Ninad Milind Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Department of Medicine and Surgery, Centre of Dentistry, University of Parma, Parma, Italy
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Clinic of Reconstructive Dentistry, Centre of Dental Medicine, Zurich, Switzerland
| | - Sara Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Center of Excellence for Toxicological Research, CERT, University of Parma, Parma, Italy
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
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11
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Camolesi GCV, Veronese HRM, Celestino MA, Blum DFC, Márquez-Zambrano JA, Carmona-Pérez FA, Jara-Venegas TA, Pellizzon ACA, Bernaola-Paredes WE. Survival of osseointegrated implants in head and neck cancer patients submitted to multimodal treatment: a systematic review and meta-analysis. Support Care Cancer 2023; 31:641. [PMID: 37851170 DOI: 10.1007/s00520-023-08088-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis. METHODS An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle-Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool. RESULTS A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20-99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56-99.48, p < 0.001). CONCLUSIONS Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.
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Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain.
| | | | | | - Davi Francisco Casa Blum
- Department of Oral and Maxillofacial Surgery, Atitus Education, Passo Fundo, Rio Grande Do Sul, Brazil
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12
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Iușan SAL, Costache C, Lucaciu OP, Petrescu BN, Mirică IC, Toc DA, Albu S. Correlations between Dental Implant Infectious Pathologies and Maxillary Sinusitis: A Review Article. J Clin Med 2023; 12:5059. [PMID: 37568461 PMCID: PMC10419797 DOI: 10.3390/jcm12155059] [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: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point that can be complicated by various sinus diseases. The purpose of this review article is to synthesize the existing information in the specialized literature regarding the existing correlations between peri-implant and maxillary sinusitis. (2) Methods: The articles published in five databases were researched using different combinations of search terms. We selected 12 articles from the 250 found, by applying the inclusion and exclusion criteria and removing duplicates. (3) Results: We analyzed the included studies and we found that all of them reported a positive correlation between maxillary sinusitis and peri-implant infectious diseases. There are also reported other pathologies with a peri-implant infectious disease as a starting point such as abscesses, oro-antral communications, or foreign body reactions due to implant or bone graft materials migration. (4) Conclusions: This scoping review highlighted the existence of correlations between peri-implant and sinus pathology and the importance of preventing peri-implant diseases of an infectious nature to avoid the occurrence of these complications.
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Affiliation(s)
| | - Carmen Costache
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ondine Patricia Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Bianca-Nausica Petrescu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Ioana Codruța Mirică
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Dan-Alexandru Toc
- Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Silviu Albu
- II-nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
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13
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Gulati K, Chopra D, Kocak-Oztug NA, Verron E. Fit and forget: The future of dental implant therapy via nanotechnology. Adv Drug Deliv Rev 2023; 199:114900. [PMID: 37263543 DOI: 10.1016/j.addr.2023.114900] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak-Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, 34116 Istanbul, Turkey
| | - Elise Verron
- Nantes Université, CNRS, CEISAM, UMR 6230, 44000 Nantes, France
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14
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Olmedo-Gaya MV, Romero-Olid MN, Ocaña-Peinado FM, Vallecillo-Rivas M, Vallecillo C, Reyes-Botella C. Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04962-y. [PMID: 36977760 DOI: 10.1007/s00784-023-04962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. MATERIAL AND METHODS This randomized controlled clinical trial enrolled 108 patients (n=108 implants) distributed in three study groups: group 1 (n=36) underpreparation technique, group 2 (n=36) expander technique, and group 3 (n=36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. RESULTS ISQ values were associated with the patient's bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences (p<0.0001). Lower stability results were obtained when conventional drilling (69.31) was used compared to the use of underpreparation (74.29) or expanders (73.99) with a level of significance of p=0.008 and p=0.005, respectively. CONCLUSIONS The surgical technique influences the PS when there is low-quality bone. In low-quality bones, conventional drilling obtains lower ISQ values. CLINICAL RELEVANCE Replace the conventional drilling technique for an alternative, underpreparation or expanders, in low-quality bone in order to achieve greater primary stability.
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Affiliation(s)
| | | | | | | | - Cristina Vallecillo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.
- Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071, Granada, Spain.
| | - Candela Reyes-Botella
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
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15
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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16
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Microcirculation and neutrophil-related cytokine concentrations are not altered around narrow diameter implants in T2DM patients during wound healing. Clin Oral Investig 2023; 27:1167-1175. [PMID: 36229741 PMCID: PMC9985571 DOI: 10.1007/s00784-022-04731-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study was to assess the microcirculation and the expression patterns of wound-healing-related cytokines around narrow-diameter implants in type 2 diabetes mellitus (T2DM) and normo-glycemic patients. MATERIALS AND METHODS A total of 31 patients, 16 of which diagnosed with T2DM (HbA1c > 6.5) and 15 normo-glycemic patients, received narrow diameter implants in the posterior mandible or maxilla. During the 3-month healing period, soft-tissue perfusion was monitored via laser Doppler flowmetry. Peri-implant fluid (PICF) was harvested and analyzed for concentrations of interleukin-1ß (IL-1ß), interleukin-23 (IL-23), interleukin-17 (IL-17), and granulocyte colony-stimulating factor (G-CSF) by a multiplex, bead-based immunoassay. RESULTS Microcirculatory perfusion patterns during wound healing exhibited no significant differences throughout the observation period. IL-1ß concentrations were expectedly elevated during the early phases of wound healing. At the first visit after surgery, IL-23 concentrations were significantly higher in implants of diabetic patients. This difference was diminished over the course of the observation period. For the other tested analytes, no differences were observable between both groups. CONCLUSION Wound healing after implant surgery was similar in T2DM and healthy patients. Hydrophilic-surface titanium-zirconium implants with reduced diameter may be considered for implant therapy of diabetes mellitus type II patients. REGISTRATION NUMBER NCT04630691 (clinicaltrials.gov).
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17
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Vilarrasa J, Soldini MC, Pons R, Valles C, Blasi G, Monje A, Nart J. Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis. Clin Oral Investig 2023:10.1007/s00784-023-04918-2. [PMID: 36786958 DOI: 10.1007/s00784-023-04918-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up. METHODS This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models. RESULTS A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed. CONCLUSION Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm). CLINICAL RELEVANCE This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.
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Affiliation(s)
- Javi Vilarrasa
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Maria Costanza Soldini
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Ramón Pons
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Gonzalo Blasi
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain.,Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, Sant Cugat del Vallés, 08195, Barcelona, Spain
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18
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Takashima M, Arai Y, Matsuzaki N, Yamazaki Y, Nishiyama H, Nohno K. Masseter muscle cross-sectional area and late implant failure: A case-control study. Clin Implant Dent Relat Res 2023; 25:313-320. [PMID: 36726209 DOI: 10.1111/cid.13189] [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: 10/18/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. PURPOSE This case-control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. METHODS This case-control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. RESULTS The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82-10.79; p < 0.01). CONCLUSION Higher masseter muscle CSA increases the risk of late implant failure.
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Affiliation(s)
- Makiko Takashima
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoshiaki Arai
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Nanaka Matsuzaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yuta Yamazaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaname Nohno
- Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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19
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Parvini P, Buser D, Pippenger BE, Imber JC, Stavropoulos A, Bellón B, Jarry C, Schwarz F. Influence of loading and grafting on hard- and soft-tissue healing at immediately placed implants: An experimental study in minipigs. J Clin Periodontol 2023; 50:232-241. [PMID: 36217692 PMCID: PMC10092114 DOI: 10.1111/jcpe.13734] [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: 02/23/2022] [Revised: 09/12/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023]
Abstract
AIM To histologically evaluate the influence of (1) loading and (2) grafting on osseointegration and peri-implant soft-tissue healing at immediately placed, self-cutting progressive tissue-level implants (TLX) in a minipig model. MATERIALS AND METHODS TLX implants (n = 56) were immediately placed following the extraction of the mandibular first and second premolars, bilaterally, in a total of n = 14 minipigs. In each animal, the implant sites were allocated to the following four groups: (1) unloaded with simultaneous grafting using a bovine bone mineral; (2) unloaded without grafting; (3) loaded with simultaneous grafting; and (4) loaded without grafting. Histomorphometric assessments at 4 and 12 weeks (n = 7 animals each) included primary (i.e., bone-to-implant contact [BIC]) and secondary outcome measures (e.g., first BIC [fBIC], junctional epithelium length [JE], connective tissue contact length [CTC], biological width [BW = JE + CTC]). RESULTS At 4 weeks, mean BIC values ranged from 74.5 ± 11.6% in Group 2 to 83.8 ± 13.3% in Group 1, and, at 12 weeks, from 75.5% ± 7.9% in Group 2 to 79.9 ± 8.6% in Group 1. Multivariate linear mixed regression did not reveal any associations between BIC and implant loading or grafting at 4 and 12 weeks. At 12 weeks, significantly higher fBIC values were noted in Group 2 when compared with Group 1. All groups showed comparable JE, CTC, and BW values. CONCLUSIONS Implant loading and grafting had no major effects on osseointegration and peri-implant soft tissue healing at TLX implants.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - Daniel Buser
- Buser Consulting Services, Gümligen, Switzerland
| | - Benjamin Evans Pippenger
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Benjamin Bellón
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Christian Jarry
- Department of Global Medical Education, Institut Straumann AG, Basel, Switzerland.,Department of Implantology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
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20
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Correia F, Gouveia SA, Pozza DH, Felino AC, Faria-Almeida R. A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1220. [PMID: 36770223 PMCID: PMC9919245 DOI: 10.3390/ma16031220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 ± 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 ± 0.126, and test group with a mean of 0.092 ± 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.
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Affiliation(s)
- Francisco Correia
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Sónia Alexandre Gouveia
- Intelligent Systems Associate Laboratory (LASI), Department of Electronics, Telecommunications and Informatics (DETI), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Daniel Humberto Pozza
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Histology, Faculty of Nutrition and Food Sciences, University of Porto, 4150-177 Porto, Portugal
- Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal
| | - António Campos Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Ricardo Faria-Almeida
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
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21
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Short Implants versus Standard Implants and Sinus Floor Elevation in Atrophic Posterior Maxilla: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with ≥5 Years' Follow-Up. J Pers Med 2023; 13:jpm13020169. [PMID: 36836403 PMCID: PMC9960634 DOI: 10.3390/jpm13020169] [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] [Received: 12/10/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background and objectives: The aim of this systematic review with meta-analysis was to assess the performance of short implants in comparison with standard implants and sinus floor elevation in atrophic posterior maxilla. Materials and methods: The protocol of the study was registered in the PROSPERO database (CRD42022375320). An electronic search on three databases (PubMed, Scopus, Web of Science) was performed to find randomized clinical trials (RCTs) with ≥5 years' follow-up, published until December 2022. Risk of bias (ROB) was calculated using Cochrane ROB. A meta-analysis was performed for primary (implant survival rate, ISR) and secondary outcomes (marginal bone loss, MBL; biological and prosthetic complications). Results: Of 1619 articles, 5 RCTs met the inclusion criteria. The ISR showed a risk ratio (RR) of 0.97 [0.94, 1.00] (CI 95%), p = 0.07. The MBL indicated a WMD of -0.29 [-0.49, -0.09] (CI 95%), p = 0.005. Biological complications showed a RR of 0.46 [0.23, 0.91] (CI 95%), p = 0.03. Prosthetic complications showed a RR of 1.51 [0.64, 3.55] (CI 95%), p = 0.34. Conclusions: The available evidence suggests that short implants might be used as an alternative to standard implants and sinus floor elevation. After 5 years, in terms of ISR, standard implants and sinus floor elevation showed a higher survival rate comparted to short implants, although statistical significance was not achieved. Future RCTs with long-term follow-up are needed to draw a clear conclusion on the advantages of one method over another.
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Rostami AM, Feldman S, Zeiger DN. Prevention of intrusion of natural teeth surrounded by freestanding implants. J Prosthodont 2023; 32:281-284. [PMID: 36635441 DOI: 10.1111/jopr.13643] [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: 10/13/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
Intrusion is frequently observed as a complication associated with tooth-implant-supported prostheses: the natural tooth that serves as an abutment moves apically and out of occlusion. However, intrusion of teeth proximal to implants has yet to be reported in the literature. In this manuscript, three presentations of tooth intrusion proximal to implants are reported; potential causes of the phenomenon are discussed; and a potential treatment for patients experiencing this condition is presented. Intrusion of teeth surrounded by freestanding implants is a rare phenomenon, a cause of which may be excessively tight proximal contacts that are below the height of contour of adjacent implants. Alleviating these contacts enables the intruded tooth to erupt back and should be considered a viable treatment option.
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Affiliation(s)
- Arash Mike Rostami
- Greater Baltimore Prosthodontics and Periodontics, Towson, Maryland, USA
| | | | - Diana N Zeiger
- Greater Baltimore Prosthodontics and Periodontics, Towson, Maryland, USA
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Galindo‐Moreno P, Catena A, Pérez‐Sayáns M, Fernández‐Barbero JE, O'Valle F, Padial‐Molina M. Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study. Clin Implant Dent Relat Res 2022; 24:630-642. [PMID: 35831919 PMCID: PMC9796358 DOI: 10.1111/cid.13122] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of this study was to establish an objective criterion in terms of marginal bone level (MBL) to know the prognosis of an implant. MATERIALS AND METHODS A group of 176 patients in whom 590 implants were placed were included in this retrospective study. Patients older than 18 years, presenting either Kennedy class I or II edentulous section, or totally edentulous at least in one of the dental arches were included in this study. Those with any type of disturbance able to alter bone metabolism or with nontreated periodontal disease were excluded. Data on radiographic MBL at loading, 6 and 18 months later, age, gender, smoking habits, history of periodontitis, bone substratum, implant, and prosthetic features were recorded. Nonparametric receiver operating curves (ROC) were constructed for the MBL at 18 months in order to establish a distinction among high bone loser (HBL) and low bone loser (LBL) implants. Differences as a function of main variables were also determined, particularly abutment height and periodontal disease. RESULTS HBL implants lost at least 0.48 mm of MBL 6 months after loading; they reached at least 2 mm of MBL 18 months after loading. MBL rate followed a nonlinear trend, except in implants restored over long prosthetic abutments and in patients with history of severe periodontitis; in whom the rate of MBL over the time was nearly zero. CONCLUSION Implants that lose more than 0.5 mm of marginal bone 6 months after loading are at great risk of not being radiographically successful anymore. Therefore, 0.5 mm of MBL is proposed as a distinctive and objective criterion of success in Implant Dentistry within a 6-month follow-up period. A prosthetic abutment height ≥2 mm resulted the most protective factor in the peri-implant bone maintenance.
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Affiliation(s)
- Pablo Galindo‐Moreno
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
| | - Andrés Catena
- Department of Experimental Psychology, School of PsychologyUniversity of GranadaGranadaSpain
| | - Mario Pérez‐Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | | | - Francisco O'Valle
- Department of Pathology, School of Medicine & IBIMERUniversity of GranadaGranadaSpain,Instituto de Investigación Biosanitariaibs.GRANADAGranadaSpain
| | - Miguel Padial‐Molina
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
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Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6681-6698. [PMID: 36070150 DOI: 10.1007/s00784-022-04628-1] [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: 03/25/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Short implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL). METHODS Screening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration's tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed. RESULTS Fourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01-0.20) mm (p = 0.03) and 0.23 (0.07-0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants. DISCUSSION Within the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs. CLINICAL CLINICAL RELEVANCE The low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.
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Surgical safety checklists for dental implant surgeries-a scoping review. Clin Oral Investig 2022; 26:6469-6477. [PMID: 36028779 DOI: 10.1007/s00784-022-04698-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry. METHODS An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed. RESULTS Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion. CONCLUSIONS Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation. CLINICAL RELEVANCE Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it.
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Cheng YC, Ewers R, Morgan K, Hirayama M, Murcko L, Morgan J, Bergamo ETP, Bonfante EA. Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women. Clin Oral Investig 2022; 26:6569-6582. [PMID: 36001145 DOI: 10.1007/s00784-022-04609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effects of antiresorptive treatment on the survival of plateau-root form dental implants. MATERIALS AND METHODS Patients undergoing antiresorptive therapy via oral or intravenous administration as well as patients not undergoing antiresorptive therapy and healthy control patients were included in this retrospective cohort study. In total, 1472 implants placed in 631 postmenopausal patients (M: 66.42 ± 9.10 years old), who were followed for a period of up to 20 years (8.78 ± 5.68 years). Kaplan-Meier survival analysis was performed, and univariate and multivariate Cox regression, clustered by each patient, was used to evaluate and study factors affecting the survival of their implants. RESULTS Implants placed in patients undergoing oral antiresorptive treatment presented significantly higher survival rates, than implants placed in the osteoporosis/osteopenia control cohort (p value < 0.001), and similar survival rates, when compared to healthy controls (p value = 0.03). Additionally, clustered univariate and multivariate Cox regression analysis also revealed higher implant survival when oral antiresorptive drugs (p value = 0.01 and 0.007, respectively) were used, and lower implant survival in the presence of untreated osteoporosis/osteopenia (p value = 0.002 and 0.005, respectively). Overall, the 20-year implant survival in osteoporotic patients undergoing antiresorptive therapy was 94%. For the failed implants, newly replaced implants in patients under antiresorptive treatment presented a 10-year survival of 89%. CONCLUSIONS Long-term plateau-root form implant survival in osteoporotic patients taking oral antiresorptives was similar to a healthy population and significantly higher than the untreated controls. CLINICAL RELEVANCE These results suggest that plateau-root form implants provide a robust solution for treating tooth loss in patients, who are undergoing antiresorptive therapy.
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Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rolf Ewers
- University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
| | | | | | | | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil
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Moraschini V, Kischinhevsky ICC, Sartoretto SC, de Almeida Barros Mourão CF, Sculean A, Calasans-Maia MD, Shibli JA. Does implant location influence the risk of peri-implantitis? Periodontol 2000 2022; 90:224-235. [PMID: 35913455 DOI: 10.1111/prd.12459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Peri-implantitis is characterized by nonreversible and progressive loss of supporting bone and is associated with bleeding and/or suppuration on probing. Peri-implant disease is considered as the main etiologic factor related to implant failure. Peri-implant disease has a pathogenesis similar to that of periodontal disease, both being triggered by an inflammatory response to the biofilm accumulation. Although the prevalence of peri-implantitis has been evaluated by several clinical studies with different follow-ups, there are currently little data on the impact of implant location and the prevalence of peri-implantitis. The aim of this review, therefore, was to summarize the evidence concerning the prevalence of peri-implantitis in relation to implant location and associated risk predictors. Even though most studies evaluating the prevalence of peri-implantitis in relation to implant location are cross-sectional or retrospective, they suggest that the occurrence of peri-implantitis is most prevalent in the anterior regions of the maxilla and mandible. Moreover, it seems that there is a higher prevalence of peri-implantitis in the maxilla than in the mandible.
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Affiliation(s)
- Vittorio Moraschini
- Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro, Brazil.,Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Suelen Cristina Sartoretto
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Monica Diuana Calasans-Maia
- Department of Oral Surgery, Dentistry School, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, São Paulo, Brazil
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Development of a new preclinical model to study early implant loss: a validation study in the beagle dog. Clin Oral Investig 2022; 26:6805-6815. [PMID: 35882681 PMCID: PMC9643266 DOI: 10.1007/s00784-022-04642-3] [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: 01/13/2022] [Accepted: 07/12/2022] [Indexed: 12/03/2022]
Abstract
Objectives To develop a new preclinical model to study early implant loss, where local infection conditions would impair the implant osseointegration. Materials and methods Forty-eight smooth, 2.9-mm diameter experimental implants were placed in the mandible of 8 beagle dogs (3 in each side). In half of the animals (test group, n = 24 implants), the implants received ligatures around the implant-abutment connection. In the other half, no ligatures were placed (control group, n = 24 implants). Four weeks later, implants were extracted in a flapless approach and standard 3.3-mm diameter SLActive implants were placed into the same osteotomy site without any further drilling. Eight weeks after the second implantation, animals were sacrificed and analyzed in terms of implant survival. Results After 8 weeks of healing, 4 implants were lost in the control group and 14 in the test group. This corresponded to a 17.4% of early implant loss in the control group and 58.3% in the test. Most of the early failures occurred within the first 5 weeks of healing. Conclusions Implants placed in a pre-contaminated site present higher early loss than those placed in a non-contaminated site. This study represents a valid and robust preclinical model to study mechanisms and reduction of early implant loss as new technologies become available. Clinical relevance Scientific rationale for the study: There is lack of animal models to study early implant loss. Thus, a proposal of a new model is presented. With the validation of this model, new technologies can be implemented to prevent early implant loss.
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29
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Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial. Clin Oral Investig 2022; 26:5247-5260. [PMID: 35618961 PMCID: PMC9381616 DOI: 10.1007/s00784-022-04493-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Objectives To compare the 3-year clinical and radiographic outcomes of two different reconstructive surgical management of peri-implantitis using a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM). Material and methods Fifty-one patients who had at least one implant presenting peri-implantitis with an intrabony defect were filled with a xenogenic bone grafting material and covered either CGF or CM. Clinical and radiographic assessments were carried out at baseline and postoperative years 1 and 3. Three different composite outcomes were defined to evaluate treatment success at a 3-year follow-up. The effects of possible prognostic indicators on treatment success were identified by using multilevel regression analysis. Results The changes in probing depth (PD) and radiographic vertical defect depth (VDD) between baseline and year 1 and baseline and year 3 presented significantly greater decreases for the CM group in comparison with the CGF group (p < 0.05). No significant differences between the two treatment modalities were demonstrated regarding treatment success outcomes. History of periodontitis, VDD at baseline, and the number of intrabony defect walls revealed significant impacts on treatment success (p = 0.033; OR = 3.50, p = 0.039; OR = 0.975, and p = 0.024; OR = 7.0 and p = 0.019;OR = 6.0, respectively). Conclusions CM in combination with a bone substitute seems to have slightly better outcomes compared to the CGF membranes in reconstructive surgical therapy of peri-implantitis. The history of periodontitis, baseline VDD, and peri-implant bone defect configuration could be possible predictors influencing treatment success. Trial registration ClinicalTrials.gov NCT04769609. Clinical relevance For the reconstruction of peri-implant bone defects, using a bone substitute in combination with a collagen membrane may show more favorable outcomes.
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Molnár B, Jung AK, Papp Z, Martin A, Orbán K, Pröhl A, Jung O, Barbeck M, Windisch P. Comparative analysis of lateral maxillary sinus augmentation with a xenogeneic bone substitute material in combination with piezosurgical preparation and bony wall repositioning or rotary instrumentation and membrane coverage: a prospective randomized clinical and histological study. Clin Oral Investig 2022; 26:5261-5272. [PMID: 35593928 PMCID: PMC9381628 DOI: 10.1007/s00784-022-04494-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The present randomized controlled clinical study aimed to investigate if, in lateral maxillary sinus augmentation, the repositioned bony wall or the application of a collagen membrane results in more preferable new hard tissue formation. MATERIALS AND METHODS Forty patients were divided into two study groups. Both groups received a xenogeneic bone substitute material (BSM) during lateral sinus augmentation. In the bony wall group (BW), following piezosurgery, the retrieved bony wall was repositioned. In the collagen membrane group (CM), following rotary instrument preparation, collagen membrane coverage was applied. After 6 months, biopsies were taken to histologically analyze the percentage of BSM, connective tissue (CT), and newly formed bone (NFB) following both approaches. RESULTS Forty implants were placed and 29 harvested biopsies could be evaluated. Duration of surgery, membrane perforations, and VAS were detected. Histomorphometrical analysis revealed comparable amounts of all analyzed parameters in both groups in descending order: CT (BW: 39.2 ± 9%, CM: 37,9 ± 8.5%) > BSM (BW: 32.9 ± 6.3%, CM: 31.8 ± 8.8%) > NB (BW: 27.8 ± 11.2%, CM: 30.3 ± 4.5%). CONCLUSIONS The results of the present study show that the closure of the access window by means of the retrieved bony wall or a native collagen membrane led to comparable bone augmentation results. CLINICAL TRIAL clinicaltrials.gov NCT04811768. CLINICAL RELEVANCE Lateral maxillary sinus augmentation with the application of a xenogeneic BSM in combination with a native collagen membrane for bony window coverage represents a reliable method for surgical reconstruction of the posterior maxilla. Piezosurgery with bony window repositioning delivers comparable outcomes without membrane coverage.
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Affiliation(s)
- Bálint Molnár
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary.
| | - Anne-Kathrin Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Zsuzsanna Papp
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | - Anna Martin
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | - Kristóf Orbán
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
| | | | - Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | | | - Péter Windisch
- Department of Periodontology, Semmelweis University Budapest, Szentkiralyi u. 47, 1088, Budapest, Hungary
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Harlos MM, da Silva TB, Montagner PG, Teixeira LN, Gomes AV, Martinez EF. Histomorphometric evaluation of different graft associations for maxillary sinus elevation in wide antral cavities: a randomized controlled clinical trial. Clin Oral Investig 2022; 26:1-9. [PMID: 35511290 DOI: 10.1007/s00784-022-04515-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/23/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Pneumatization of the maxillary sinus can make it difficult, if not impossible, to install osseointegrated implants, and undertake their eventual functional rehabilitation, which may ultimately require regenerative techniques to achieve. This randomized controlled study proposed conducting a histological evaluation of the behavior of different graft materials in wide maxillary sinuses, at a height of 8 to 10 mm from the alveolar ridge, combined with bone remnants less than 3mm. MATERIALS AND METHODS Thirty-six patients underwent a sinus elevation procedure through the lateral window. The sinuses were randomly filled with the following materials (n=12/group): group 1, xenogenic bone + autogenous bone (ratio 70:30, respectively); group 2, xenogenic bone + L-PRF; and group 3, xenogenic bone. At 8 months, bone biopsies of engrafted sites were harvested and analyzed histomorphometrically in order to quantify newly formed bone tissue. RESULTS The results showed a greater area of newly formed bone for G1, averaging 2678.37 (1116.40) μm2, compared with G2 at 984.87 (784.27) μm2, and G3 at 480.66 (384.76) μm2 (p < 0.05). Additionally, fewer xenogenic bone particles and a large amount of connective tissue were observed in G2. CONCLUSIONS In maxillary sinuses with large antral cavities, autogenous bone combined with xenogenic bone seems to demonstrate better graft remodeling and improve bone formation, compared with the addition of L-PRF. CLINICAL RELEVANCE L-PRF produces few advantages regarding new bone formation in the wide maxillary sinuses. TRIAL REGISTRATION Brazilian Clinical Trials Registry (REBEC) number RBR-2pbbrvg.
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Affiliation(s)
- Mauricio Marcelo Harlos
- Division of Implantology, Faculdade São Leopoldo Mandic (SLMandic), R. Dr. José Rocha Junqueira, 13, Campinas, São Paulo, Brazil
| | - Thiago Bezerra da Silva
- Division of Implantology, Faculdade São Leopoldo Mandic (SLMandic), R. Dr. José Rocha Junqueira, 13, Campinas, São Paulo, Brazil
| | - Pedro Giorgetti Montagner
- Division of Implantology, Faculdade São Leopoldo Mandic (SLMandic), R. Dr. José Rocha Junqueira, 13, Campinas, São Paulo, Brazil
| | - Lucas Novaes Teixeira
- Division of Cell Biology, Faculdade São Leopoldo Mandic (SLMandic), Campinas, São Paulo, Brazil
| | - Adriana Vanderley Gomes
- Division of Implantology, Faculdade São Leopoldo Mandic (SLMandic), R. Dr. José Rocha Junqueira, 13, Campinas, São Paulo, Brazil
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Rakasevic D, Lazic Z, Soldatovic I, Scepanovic M, Gabric D. Influence of titanium implant macrodesign on peri-implantitis occurrence: a cross-sectional study. Clin Oral Investig 2022; 26:5237-5246. [PMID: 35460428 DOI: 10.1007/s00784-022-04492-z] [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: 01/22/2022] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess whether implant macrodesign parameters interacting with implant time in function (Tf) could influence the peri-implantitis occurrence. MATERIALS AND METHODS One hundred and two patients (55.17 ± 11.2 years old) with diagnosed early/moderate peri-implantitis around endosseous implants with implant-supported prosthetics reconstruction (n = 139) were recruited. Implant macrodesign (implant shape, thread number, implant collar), clinical parameters (peri-implant probing depth (PPD), clinical attachment level (CAL), keratinised tissue width (KTW), plaque index, bleeding on probe), implant placement localisation and region, and Tf were assessed and compared. RESULTS Peri-implantitis occurred approximately 6.1 ± 3.38 years after implant loading. There was a significant positive correlation between the implant macrodesign and Tf. Peri-implantitis rates were statistically significantly higher in implants with a cylindric shape and triple-thread in the posterior part of the mandible (p = 0.037 and 0.012, respectively). The thread number and implant shape interacting with Tf showed statistically significant influences on CAL and PPD increase (p < 0.05). Results indicated a statistically positive interaction between Tf and KTW decrease around the implants with microthreaded collar (p < 0.001). CONCLUSION Peri-implantitis might be presented as a time-dependent disease. Implant-based factors, such as Tf and implant macrodesign, could influence peri-implantitis occurrence, exacerbate clinical parameters, and promote progressive bone loss. CLINICAL RELEVANCE Peri-implantitis can be affected by implant macrodesign and Tf. The implant body shape, thread number, and design of the implant collar may be considered peri-implantitis-related risk indicators that should be taken into account in proper implant planning and therapy.
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Affiliation(s)
- Dragana Rakasevic
- Department of Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade, 4, Dr Subotica, 11000, Beograd, Serbia
| | - Zoran Lazic
- Department of Implantology, Medical Military Academy, 4, Crnotravska, 11000, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute for Biomedical Statistics, Faculty of Medicine, University of Belgrade, 6, Dr Subotica, 11000, Beograd, Serbia
| | - Miodrag Scepanovic
- Department of Prosthodontics, School of Dental Medicine, University of Belgrade, 4, Dr Subotica, 11000, Beograd, Serbia
| | - Dragana Gabric
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, 5, Gunduliceva, 10000, Zagreb, Croatia. .,University Hospital Centre Zagreb, 5, Gunduliceva, 10000, Zagreb, Croatia.
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Abstract
Healthy peri-implant tissues have become synonymous with implant success and a major challenge in contemporary implant dentistry. Numerous local and systemic factors, as well as iatrogenic and other hitherto underappreciated factors of potential clinical relevance may influence the outcome of implant therapy. In this volume of Periodontology 2000, a group of outstanding experts has elaborated on the latest insights on the prevention and management of major surgical, biological and technical complications, to facilitate the establishment and maintenance of peri-implant health. This volume focusses on factors affecting early and late implant loss and the potential role of systemic diseases and local conditions. It comprehensively discusses the implementation of guided implant surgery to facilitate the cleansibility of implant-supported restorations, as well as iatrogenic factors related to bone augmentation/sinus grafting procedures. The challenges associated with soft-tissue grafting and the prevention of esthetic complications are also reviewed as the paradigm of success in implant dentistry shifts from implant survival towards a greater focus on patient-reported outcomes. Prosthetic failures remain a significant challenge and are discussed in light of new evidence, as is the relevance of the structural dimensions of the peri-implant mucosa. The volume closes with detailed and well-illustrated appraisals of the surgical management of peri-implantitis, the management and sequelae of dental implant removal, and the latest evidence for the oral health related quality of life in patients treated with dental implants.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany
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Mordechai F, Tali C, Jonathan M, Ori P, Yaron B, Ram S, Guy T. The effect of type of specialty (periodontology/oral surgery) on early implant failure: a retrospective "Big-Data" study from a nation-wide dental chain in Israel. Clin Oral Investig 2022; 26:6159-6163. [PMID: 35759088 PMCID: PMC9525354 DOI: 10.1007/s00784-022-04565-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate early implant failure rate of implants placed by maxillofacial-oral surgeons and periodontists. MATERIAL AND METHODS A nested case-case study was performed to analyze treatment outcome of 27 oral surgeons and 30 periodontists who performed at least 100 dental implants between 2017 and 2019 in 54 clinics of "Maccabi-Dent," a nation-wide dental chain. A total of 26,865 implants were evaluated. RESULTS The early failure rate of 1.3% achieved by the periodontists was lower than the 1.7% early failure rate achieved by oral surgeons. Differences were not statistically different. Oral surgeons in the study cohort were insignificantly older in age, with more years of experience as dentists and as specialists. However, the only parameter found to be a predictor to early implant failure in a linear regression model was related to postgraduate training. Explicitly, the mean number of implants placed during specialty program. This number was higher for the periodontists and found to be significantly contributing predictor to early implant failure. Clinicians' age and years of experience as dentists or as specialist were not found to be predictors to early implant failure rate. CONCLUSIONS No statistically significant differences were found in early implant failure rate between oral surgeons and periodontists. The number of implants placed during specialty program has a statistical predictive value to early implant failure rate. CLINICAL RELEVANCE Care and attention should be taken to re-evaluate clinical training in the field of implantology during specialty program. To optimize surgeons' control on treatment outcome.
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Affiliation(s)
- Findler Mordechai
- Dental Research Unit - Maccabi-Dent, Maccabi Healthcare Fund, Tel Aviv, Israel
| | - Chackartchi Tali
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Mann Jonathan
- Dental Research Unit - Maccabi-Dent, Maccabi Healthcare Fund, Tel Aviv, Israel
| | - Platner Ori
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Bernstein Yaron
- Dental Research Unit - Maccabi-Dent, Maccabi Healthcare Fund, Tel Aviv, Israel
| | - Shefer Ram
- Dental Research Unit - Maccabi-Dent, Maccabi Healthcare Fund, Tel Aviv, Israel
| | - Tobias Guy
- Department of Community Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Zhou N, Huang H, Liu H, Li Q, Yang G, Zhang Y, Ding M, Dong H, Mou Y. Microbiota analysis of peri-implant mucositis in patients with periodontitis history. Clin Oral Investig 2022; 26:6223-6233. [PMID: 35672515 PMCID: PMC9525361 DOI: 10.1007/s00784-022-04571-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the bacterial diversity in peri-implant plaques and the effect of periodontitis history on the occurrence of peri-implant mucositis. MATERIALS AND METHODS Three groups of subgingival plaques were collected from peri-implant sulci in the first molar area. The three groups included healthy implants in patients without periodontitis (NH implant), healthy implants in patients with periodontitis history (PH implant), and peri-implant mucositis implants in patients with periodontitis history (PM implant). Subgingival plaques in periodontal pockets of contralateral natural first molars were also collected. Bacterial DNA was extracted and the V4 region of the 16S rDNA sequence was amplified and sequenced on an Illumina HiSeq platform. The operational taxonomic units obtained from amplicon sequencing were used to analyze the prevalence and identity of bacteria based on public databases and advanced techniques. RESULTS Analysis of similarities indicated a significant difference in bacterial structures between the NH implant and PM implant groups. Additionally, a significantly higher relative abundance of the genera Actinomyces and Streptococcus was found in the samples of the NH implant group. The genera Fusobacterium and Prevotella could be considered as potential biomarkers for peri-implant mucositis. Moreover, more gram-negative anaerobic bacteria (Porphyromonas and Prevotella) were detected in the samples from patients with periodontitis history. CONCLUSIONS The increased accumulation of Fusobacterium and Prevotella is associated with a higher risk of peri-implant mucositis. In addition, patients with periodontal history may be more likely to develop peri-implant mucositis. CLINICAL RELEVANCE The increase in periodontal pathogens and the decrease in health-associated bacteria in patients with periodontitis history may be more likely to develop peri-implant mucositis. These results provide a bacteriological basis for the prevention and treatment of peri-implant mucositis in patients with periodontitis history.
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Affiliation(s)
- Na Zhou
- Department of Jiangbei, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Haohao Huang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui Liu
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qiang Li
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guangwen Yang
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yu Zhang
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Meng Ding
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Heng Dong
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Yongbin Mou
- Department of Oral Implantology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
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