1
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Masaki C, Kondo Y, Tomoeda K, Nodai T, Munemasa T, Mukaibo T, Hosokawa R. Treatment strategies for dental implant removal: A literature review. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:120-127. [PMID: 39444488 PMCID: PMC11497076 DOI: 10.1016/j.jdsr.2024.01.002] [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: 08/18/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 10/25/2024] Open
Abstract
Dental implants have been widely used with success, but long-term usage sometimes leads to implant loss. The purpose of this review was to summarize the etiology of early and late failure requiring dental implant removal and the treatment strategies for the removal of failed implants and reimplantation. Early failures are often caused by patient-related factors, such as smoking, diabetes, radiotherapy, bone quality, and periodontitis of the remaining natural teeth. The most common cause of late failure is peri-implantitis, followed by implant fracture and implant malpositioning. Implants should be removed if they are mobile or if their superstructure cannot be maintained (e.g., implant fracture). For peri-implantitis, implant removal should be determined based on the patient's age and esthetic needs, the implant site, and the severity of bone loss. Many reports have been published on implant removal techniques. The reverse torque technique should always be the first choice because of its low invasiveness. The weighted survival rate for the replacement of failed implants is 86.3%, with a much lower survival rate after the second or subsequent implantations. Therefore, patient-specific problems, such as smoking habits and bruxism, should be checked before reimplantation and controlled to the greatest extent possible.
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Affiliation(s)
- Chihiro Masaki
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Yusuke Kondo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Kei Tomoeda
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Tomotaka Nodai
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Takashi Munemasa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Taro Mukaibo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Ryuji Hosokawa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
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Carlos A, Ziada H, Abubakr NH. Correlation between marginal bone loss around dental implants and various systemic diseases: a cross-sectional study. Int J Implant Dent 2024; 10:46. [PMID: 39446189 PMCID: PMC11502616 DOI: 10.1186/s40729-024-00566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 10/17/2024] [Indexed: 10/25/2024] Open
Abstract
PURPOSE Diminished bone levels or the lack of osseointegration can lead to higher rates of failure of dental implants. The present study is aimed to evaluate the correlation between hypertension, diabetes mellitus and hyperlipidemia, on the marginal bone loss (MBL) surrounding dental implants among patients attending the University of Nevada, Las Vegas dental clinics. METHODS Clinical notes from patients at the University of Nevada, Las Vegas (UNLV) dental clinics were analyzed using AxiUm™ software. The study included patients with dental implants diagnosed with hypertension, diabetes mellitus, and hyperlipidemia who attended the UNLV School of Dental Medicine clinics from 2012 to 2022. Exclusions were made for patients with acquired immune deficiency syndrome and those with a limited number of radiographs. A search was conducted using keywords such as 'systemic disease,' 'marginal bone loss,' 'dental implant,' 'high cholesterol,' 'hypertension,' and 'diabetes' within the system. RESULTS Out of 1,310 potentially eligible patients, 57 fulfilled the inclusion criteria. The total number of evaluated implants was 165. 18% of the sample patients were 55 to 64 years of age, and 79% were 65 or above. 45.6% of patients reported having more than four systemic diseases and 67% of patients had four or more prescription medications. Patients diagnosed with hypertension (78.95%) or hyperlipidemia (73.68%) had the highest presence of marginal bone loss surrounding the dental implant(s) while those with diabetes (40.35%) had the least amount of MBL. Patients diagnosed with both hypertension and hyperlipidemia (29.82%) experienced the highest incidence of MBL around implants. The medications prescribed to combat these health issues, such as statins and antihypertensive, also showed the same trends and corresponded with a higher prevalence of MBL. CONCLUSIONS Within the limitations of the present investigation, patients diagnosed with hyperlipidemia and hypertension were more likely to exhibit MBL surrounding dental implants.
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Affiliation(s)
- Alicia Carlos
- DMD Student, School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Hassan Ziada
- Clinical Science Department, School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Neamat Hassan Abubakr
- Biomedical Science Department, School of Dental Medicine, University of Nevada, MS 7415, Las Vegas, NV, 89106, USA.
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3
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Alterman M, Casap N. The Approach to Periimplantitis. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00058-X. [PMID: 39389838 DOI: 10.1016/j.coms.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Peri-implant diseases require an extensive approach that includes pre-operative risk assessment, patient education on oral hygiene, and ensuring sufficient tissue support and accurate implant placement. Treatment typically starts with comprehensive decontamination using mechanical debridement, chemical agents, and advanced therapies such as laser or photodynamic therapy. Depending on the severity of the disease and the extent of bone loss, surgical strategies are adapted, ranging from less invasive access surgery in initial stages to more intensive resective or regenerative procedures in advanced cases. The following article will present a holistic and systematic approach to managing periimplantitis.
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Affiliation(s)
- Michael Alterman
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel.
| | - Nardy Casap
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel
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4
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Callahan NF, Weyh AM, Ghunaim D, Miloro M. The Effect of Patient-associated Factors on Long-term Survival of Dental Implants. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00076-1. [PMID: 39368890 DOI: 10.1016/j.coms.2024.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2024]
Abstract
Dental implant therapy has developed over the past half century to have documented successful outcomes in most patients who receive treatment. The long-term survival of dental implants depends upon a variety of factors including patient, surgeon, restorative dentist, and materials-related factors. The impact of patient-associated factors may impact significantly on the success of dental implants including diabetes mellitus, medications, smoking, parafunctional habits, oral hygiene, head and neck radiation, and the use of bisphosphonates, antiangiogenic, and antiresorptive medications.
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Affiliation(s)
- Nicholas F Callahan
- Department of Oral and Maxillofacial Surgery, UIHealth Head and Neck Oncology Integrated Practice Unit, University of Illinois Chicago College of Dentistry, 801 S Paulina Street, Room 110, (MC 835), Chicago, IL 60612, USA
| | - Ashleigh M Weyh
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, 801 S Paulina Street, Room 110, (MC 835), Chicago, IL 60612, USA
| | - Dima Ghunaim
- Advanced Prosthodontics Program, Department of Restorative Dentistry, University of Illinois Chicago College of Dentistry, 801 S Paulina Street Room 367A, (MC 555), Chicago, IL 60612, USA
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois College of Dentistry, 801 South Paulina Street, Room 110 (MC 835), Chicago, IL 60612, USA.
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5
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Rezallah NNF, Luke AM. Evaluating Micro-computed Tomography in Dental Implant Osseointegration: A Systematic Review and Meta-analysis. Acad Radiol 2024:S1076-6332(24)00660-3. [PMID: 39368915 DOI: 10.1016/j.acra.2024.09.011] [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: 07/15/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 10/07/2024]
Abstract
RATIONALE AND OBJECTIVES The success of dental implants is heavily dependent on the implant's efficient integration with the surrounding bone, a process known as osseointegration. This integration is influenced by a range of individual characteristics of each patient, as well as the accuracy of diagnostic imaging techniques. Micro-computed tomography (micro-CT) is capable of capturing detailed three-dimensional images with high resolution. It may offer superior capabilities for assessing the connections between bones and implants compared to older techniques such as cone-beam computed tomography (CBCT) and intraoral radiography. This systematic review will discuss the uses of micro-CT in dental implant osseointegration, compare it to other radiography methods, and discuss it's effect on patients, especially those with previous history of periodontal disease. MATERIALS AND METHODS This research performed an extensive search across multiple databases, choosing papers based on specific criteria for inclusion and exclusion. The study focus was on using micro-CT to evaluate bone osseointegration. Meta-analyses were conducted to measure the impact of micro-CT on bone loss and the success rates of implants, while comparing various surgical procedures and depths of implantation. This systematic review is registered in PROSPERO with the registration number CRD42023482747. RESULTS The result of this study comprised 28 papers, incorporating a meta-analysis of 8. It emphasized the exceptional spatial resolution of micro-CT, which enables accurate assessments of bone volume and density, crucial factors for implant success. Micro-CT, when compared to CBCT and intraoral radiography, provides more comprehensive information, but it faces limitations due to its elevated expenses and radiation exposure. The analysis also indicated that micro-CT could be particularly advantageous in tailored therapy planning, particularly for patients with impaired conditions. Systemic factors like diabetes or periodontal disease can cause bone conditions. CONCLUSION Micro-CT is a highly advanced imaging technique that offers extensive information about dental implants, which is essential for evaluating osseointegration. Although micro-CT has several limitations, it has the capacity to improve clinical outcomes by providing more accurate diagnoses and tailored implant techniques. Subsequent investigations should focus on assessing its cost-effectiveness and establishing protocols to mitigate radiation exposure.
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Affiliation(s)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE; Center for Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman, UAE.
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6
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Thomas DC, Bellani D, Piermatti J, Kodaganallur Pitchumani P. Systemic Factors Affecting Prognosis of Dental Implants. Dent Clin North Am 2024; 68:555-570. [PMID: 39244244 DOI: 10.1016/j.cden.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Clinicians who place and restore implants are always concerned about the success and longevity of the same. There are several local and systemic factors that affect osseointegration and the health of the peri-implant tissues. In this study, we review the systemic factors that can affect implant survival, osseointegration, and long-term success. The study highlights the importance of delineating, and taking into consideration these systemic factors from the planning phase to the restorative phase of dental implants. A thorough medical history, including prescription and over-the-counter medications, is vital, as there may be numerous factors that could directly or indirectly influence the prognosis of dental implants.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | | | - Jack Piermatti
- Nova Southeastern University College of Dental Medicine, FL, USA
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7
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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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8
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Giok KC, Veettil SK, Menon RK. Risk factors for Peri-implantitis: An umbrella review of meta-analyses of observational studies and assessment of biases. J Dent 2024; 146:105065. [PMID: 38762079 DOI: 10.1016/j.jdent.2024.105065] [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: 04/19/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES To perform a comprehensive quantitative and qualitative analysis of the findings from previously published meta-analyses and to assess existing biases. DATA/SOURCES A search was conducted for meta-analyses of observational studies investigating the association between any risk factor and peri‑implantitis in PubMed, Scopus, Cochrane Database of Systematic Reviews, and Epistemonikos, from inception until October 2023 (PROSPERO: CRD42024512408). STUDY SELECTION From a total of 5002 publications, 51 full-text articles were evaluated for eligibility, and 12 articles that described 41 unique meta-analyses evaluating the association between risk factors and periimplantitis were selected. Among 41 associations, 24 associations were significant. None of the associations were graded as convincing evidence. Two associations, presence of periodontitis (OR = 3.84 [95 % CI 2.58,5.72]) and cigarette smoking (RR=2.07 [95 % CI 1.41,3.04]) were graded as highly suggestive. Eight associations, diabetes mellitus, hyperglycaemia, lack of prophylaxis, history of chronic periodontal disease, ongoing or history of periodontal disease, implants located in the anterior region of the jaw (maxillary and mandibular), osteoprotegerin (OPG) gene polymorphisms, and lack of keratinized mucosal width were graded as suggestive evidence. CONCLUSIONS Periodontitis and cigarette smoking are highly suggestive risk factors for peri‑implantitis. The remaining risk factors which are suggestive require more high-quality studies to be performed to upgrade the level of evidence. CLINICAL SIGNIFICANCE The highly suggestive and suggestive risk factors for peri‑implantitis summarized in this umbrella review should be rigorously assessed, monitored and managed by clinicians to reduce the risk peri‑implantitis, as well as to form part of the preoperative consent process.
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Affiliation(s)
- Koay Chun Giok
- School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajesh K Veettil
- School of Pharmacy, Department of Pharmacy Practice, College of pharmacy, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia; School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Rohit Kunnath Menon
- Prosthodontics, College of Dentistry, Ajman University, Ajman, United Arab Emirates.
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9
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Lumbikananda S, Srithanyarat SS, Mattheos N, Osathanon T. Oral Fluid Biomarkers for Peri-Implantitis: A Scoping Review. Int Dent J 2024; 74:387-402. [PMID: 38065782 PMCID: PMC11123564 DOI: 10.1016/j.identj.2023.11.005] [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: 08/06/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 05/18/2024] Open
Abstract
Peri-implantitis, a prevalent complication in dental implant therapy, poses a significant threat to long-term implant success. The identification of reliable biomarkers for the early detection and monitoring of peri-implantitis is crucial for timely intervention and improved treatment outcomes. Salivary and peri-implant sulcular fluid (PISF) biomarkers have become promising diagnostic tools in the field of implant dentistry. This scoping review aims to explore current studies in the literature on salivary and PISF biomarkers for peri-implantitis. A systematic search was conducted on 2 databases (PubMed and Scopus) to identify relevant studies published up to January 2023. A total of 86 articles were included, which underwent data extraction and analysis. Several biomarkers have been investigated in salivary and PISF samples for association with peri-implantitis. Investigations included a wide range of biomarkers, including inflammatory markers, matrix metalloproteinases and bone loss markers. The findings suggested that certain salivary and PISF biomarkers demonstrated potential in distinguishing healthy peri-implant conditions from peri-implantitis. Elevated levels of proinflammatory cytokines, such as interleukin-1β (IL-1β) and interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), and matrix metalloproteinases, have been consistently associated with peri-implantitis. Additionally, alterations in bone loss markers have shown potential as indicators of disease progression and treatment response. In conclusion, this scoping review provides an overview of current knowledge on salivary and PISF biomarkers for peri-implantitis. The identified biomarkers are promising as noninvasive diagnostic tools for early detection, monitoring, and personalised management of peri-implantitis. Future studies should focus on establishing standardised protocols and conducting well-designed clinical trials to validate the diagnostic accuracy and clinical relevance of these biomarkers.
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Affiliation(s)
- Supanat Lumbikananda
- Center of Excellence for Dental Stem Cell Biology and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Supreda Suphanantachat Srithanyarat
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Center of Excellence for Periodontology and Dental Implants, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Thanaphum Osathanon
- Center of Excellence for Dental Stem Cell Biology and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Enteghad S, Shirban F, Nikbakht MH, Bagherniya M, Sahebkar A. Relationship Between Diabetes Mellitus and Periodontal/Peri-Implant Disease: A Contemporaneous Review. Int Dent J 2024; 74:426-445. [PMID: 38614881 PMCID: PMC11123523 DOI: 10.1016/j.identj.2024.03.010] [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: 08/27/2023] [Revised: 02/11/2024] [Accepted: 03/17/2024] [Indexed: 04/15/2024] Open
Abstract
The prevalence of diabetes mellitus (DM), a major chronic disease and a leading cause of death and disability around the world, is rising. According to the latest data, the global prevalence of DM has increased to 463 million (9.3% of adults) in 2019 and is estimated to reach 700 million by 2045. Periodontal disease, result of periodontium inflammation, is a common, chronic disease and has long been considered one of the complications of DM. Moreover, literature reflects a spectrum of conflicting viewpoints on the effect of diabetic conditions on the implant treatment strategies. The current review aims to update the recent epidemiologic evidence regarding the relationship between DM and periodontal/peri-implant disease, emphasising the effects of glycaemic control on the severity of these diseases and describing the pathobiological mechanisms underlying this association. This review's findings indicate a bidirectional relationship between DM and periodontal/peri-implant disease and that this relationship seems causal, implying that controlling these two diseases might help prevent each other's incidence. Additionally, the severity of periodontal/peri-implant disease is directly related to metabolic control. Although patients with diabetes can obtain implant success similar to those in systemically healthy individuals, an increased risk of peri-implantitis has been reported in DM patients. Therefore, the importance of glycaemic control and maintaining proper oral hygiene cannot be overstated.
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Affiliation(s)
- Shabnam Enteghad
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farinaz Shirban
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | | | - Mohammad Bagherniya
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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11
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Bergamo EP, Witek L, Ramalho IS, Lopes ACD, Nayak VV, Torroni A, Slavin BV, Bonfante EA, Uhrich KE, Graves DT, Coelho PG. Sustained Release of Salicylic Acid for Halting Peri-Implantitis Progression in Healthy and Hyperglycemic Systemic Conditions: A Gottingen Minipig Model. ACS Biomater Sci Eng 2024; 10:3097-3107. [PMID: 38591966 PMCID: PMC11094686 DOI: 10.1021/acsbiomaterials.4c00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
To develop a peri-implantitis model in a Gottingen minipig and evaluate the effect of local application of salicylic acid poly(anhydride-ester) (SAPAE) on peri-implantitis progression in healthy, metabolic syndrome (MS), and type-2 diabetes mellitus (T2DM) subjects. Eighteen animals were allocated to three groups: (i) control, (ii) MS (diet for obesity induction), and (iii) T2DM (diet plus streptozotocin for T2DM induction). Maxillary and mandible premolars and first molar were extracted. After 3 months of healing, four implants per side were placed in both jaws of each animal. After 2 months, peri-implantitis was induced by plaque formation using silk ligatures. SAPAE polymer was mixed with mineral oil (3.75 mg/μL) and topically applied biweekly for up to 60 days to halt peri-implantitis progression. Periodontal probing was used to assess pocket depth over time, followed by histomorphologic analysis of harvested samples. The adopted protocol resulted in the onset of peri-implantitis, with healthy minipigs taking twice as long to reach the same level of probing depth relative to MS and T2DM subjects (∼3.0 mm), irrespective of jaw. In a qualitative analysis, SAPAE therapy revealed decreased levels of inflammation in the normoglycemic, MS, and T2DM groups. SAPAE application around implants significantly reduced the progression of peri-implantitis after ∼15 days of therapy, with ∼30% lower probing depth for all systemic conditions and similar rates of probing depth increase per week between the control and SAPAE groups. MS and T2DM conditions presented a faster progression of the peri-implant pocket depth. SAPAE treatment reduced peri-implantitis progression in healthy, MS, and T2DM groups.
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Affiliation(s)
- Edmara
T. P. Bergamo
- Department
of Prosthodontics, NYU Dentistry, New York, New York 10010, United States
| | - Lukasz Witek
- Biomaterials
Division, NYU Dentistry, New York, New York 10010, United States
- Department
of Biomedical Engineering, NYU Tandon School
of Engineering, Brooklyn, New York 11201, United States
- Hansjörg
Wyss Department of Plastic Surgery, NYU
Grossman School of Medicine, New
York, New York 10016, United States
| | - Ilana Santos Ramalho
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Adolfo Coelho de
Oliveira Lopes
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Vasudev Vivekanand Nayak
- Department
of Biochemistry and Molecular Biology, University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Andrea Torroni
- Hansjörg
Wyss Department of Plastic Surgery, NYU
Grossman School of Medicine, New
York, New York 10016, United States
| | - Blaire V. Slavin
- University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Estevam A. Bonfante
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Kathryn E. Uhrich
- Department
of Chemistry, University of California Riverside, Riverside, California 92521, United States
| | - Dana T. Graves
- Department
of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Paulo G. Coelho
- Department
of Biochemistry and Molecular Biology, University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
- Division
of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, United States
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Wang Y, Cao X, Shen Y, Zhong Q, Huang Y, Zhang Y, Huang Q, Xu C. Osteogenic effect of low-intensity pulsed ultrasound on peri-implant bone: A systematic review and meta-analysis. J Prosthodont Res 2024; 68:215-226. [PMID: 37518333 DOI: 10.2186/jpr.jpr_d_23_00068] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Purpose This study aimed to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on promoting osseointegration around dental implants.Study selection A comprehensive search was performed on two databases, including MEDLINE (PubMed) and Web of Science to identify relevant studies published before June 1, 2022. Randomized controlled trials that met the inclusion criteria were selected for the study. The year of publication, study design, animal species, number of animals, number of implants, implant position, implant size, intervention, follow-up time, bone volume ratio (BV/TV), bone-implant contact ratio (BIC), and implant removal torque value (RTV) measurements, including mean and SD, were extracted.Results Ten randomized trials were included in this meta-analysis. The results showed that LIPUS significantly promoted osteogenesis around dental implants. Furthermore, in animal models of pre-existing diseases such as osteoporosis and diabetes, LIPUS had the same effect. The included data were divided into subgroups to explore the effects of different follow-up time, acoustic intensities, and frequencies. Results showed that higher acoustic intensities and frequencies significantly improve the osteogenic effects of LIPUS. There was some degree of heterogeneity owing to bias in the included studies. More high-quality randomized controlled trials are necessary in the future.Conclusions LIPUS can promote bone healing around dental implants and is an attractive option for edentulous patients, especially those with pre-existing diseases. Further clinical trials on the use of LIPUS in implant dentistry are warranted. Furthermore, future studies must pay more attention to acoustic intensity and frequency.
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Affiliation(s)
- Yingying Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ximeng Cao
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yingyi Shen
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qi Zhong
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yujie Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yifan Zhang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qingfeng Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Wang Y, Sun Y, Yang B, Li J, Liang C. The effect and mechanism of liraglutide on the biological functions of BMSCs in diabetic patients. Oral Dis 2024. [PMID: 38501359 DOI: 10.1111/odi.14931] [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: 08/04/2023] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To investigate the effect of liraglutide on osteogenesis in human alveolar bone marrow mesenchymal stem cells (BMSCs) and the influence of liraglutide on implant-bone integration in rats with T2DM. SUBJECTS AND METHODS Extracting BMSCs from the alveoli of diabetic patients treated with insulin. BMSCs were treated with different concentrations of liraglutide. Osteogenesis and the underlying mechanism were investigated via ALP detection, ALP staining, Alizarin Red S staining, Western blotting, and RT-PCR. Liraglutide was given to Wistar and GK rats after implantation, and new bone formation around the implants was analyzed via micro-CT. Implant-bone integration in rats was investigated via toluidine blue staining. RESULTS Liraglutide enhanced osteogenesis in BMSCs via the BMP2/Smad/Runx2 signaling pathway. The optimal concentration of liraglutide that promoted osteogenesis was 10-8 mol/L. At concentrations higher than 10-7 mol/L, liraglutide had a negative effect on BMSCs. At a concentration of 10-8 mol/L liraglutide, BMSCs and diabetes mellitus-bone marrow stromal cells (DM-BMSCs) showed optimal osteogenesis. Liraglutide promoted implant-bone integration and new bone formation in Wistar and GK rats. CONCLUSIONS Liraglutide not only promotes osteogenesis of BMSCs in normoglycemic individuals but also enhances osteogenesis of BMSCs in diabetic patients treated with insulin and enhances osseointegration in rats.
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Affiliation(s)
- Yao Wang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Yujie Sun
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Bo Yang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Jun Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
| | - Chao Liang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Beijing, China
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Samara W, Moztarzadeh O, Hauer L, Babuska V. Dental Implant Placement in Medically Compromised Patients: A Literature Review. Cureus 2024; 16:e54199. [PMID: 38496195 PMCID: PMC10942790 DOI: 10.7759/cureus.54199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
As a discipline of dentistry, oral implantology deals with the diagnosis, design, insertion, restoration, and/or management of alloplastic or autogenous oral structures for the purpose of regaining contour, function, aesthetics, and speech in a partially or completely edentulous patient. The present review aims to provide the currently available knowledge about the impact of certain systemic disorders and the usage of some medications on the survival rate of dental implant therapy and to highlight the importance of patient management under these conditions. Diabetes, osteoporosis, cardiovascular diseases, and the intake of some medications can increase the risk of the failure of a dental implant. Even though there are relatively few medical contraindications to dental implant treatment, certain conditions may increase the risk of failure or complications.
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Affiliation(s)
- Walla Samara
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Omid Moztarzadeh
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Lukas Hauer
- Department of Stomatology, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
| | - Vaclav Babuska
- Department of Medical Chemistry and Biochemistry, Faculty of Medicine in Pilsen, Charles University, Czech Republic, Pilsen, CZE
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Ruggiero T, Carossa M, Camisassa D, Bezzi M, Rivetti G, Nobile V, Pol R. Hyaluronic Acid Treatment of Post-Extraction Tooth Socket Healing in Subjects with Diabetes Mellitus Type 2: A Randomized Split-Mouth Controlled Study. J Clin Med 2024; 13:452. [PMID: 38256586 PMCID: PMC10816872 DOI: 10.3390/jcm13020452] [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: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The present study aimed to investigate the effect of HA in improving post-extraction socket healing in subjects with diabetes mellitus (DM) type 2. DM patients requiring bilateral extraction of the homologous teeth were visited at the C.I.R. Dental School, University of Turin. After the extractions, one site was randomly assigned to the test (T) group (postoperative application of HA), while the other site was assigned to the control group (C, no treatment). Patients were then followed after 3, 7, 14, and 21 days. Primary outcomes were the healing index and socket closure. The Mann-Whitney test or the Student's t-test was used for nonparametric or parametric distributed variables. The chi-square test was used if the estimated data in any given cell were >5, otherwise the Fisher test was adopted. A p < 0.05 was considered statistically significant. In total, 36 patients (n = 36) were enrolled in this study for a total of 72 extractions (n = 72). Sockets treated with HA showed significantly (p < 0.05) better healing index values at day 7 (p = 0.01) and at day 14 (p = 0.02) and significantly (p < 0.05) better socket closure values at day 3 (p = 0.04), day 7 (p = 0.001) and day 14 (p = 0.001) compared to the C group. Based on the clinical results, HA seems to be promising in improving the timing and the quality of post-extractive wound healing in DM patients. Further clinical research, as well as histological investigations, are required to confirm the results.
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Affiliation(s)
- Tiziana Ruggiero
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
- Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Massimo Carossa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Davide Camisassa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Marta Bezzi
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Rivetti
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Vincenzo Nobile
- Complife Italia S.r.l., Via Mons. Angelini 21, 27028 San Martino Siccomario, Italy
| | - Renato Pol
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
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16
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Biguetti CC, Arteaga A, Chandrashekar BL, Rios E, Margolis R, Rodrigues DC. A Model of Immediate Implant Placement to Evaluate Early Osseointegration in 129/Sv Diabetic Mice. Int J Oral Maxillofac Implants 2023; 38:1200-1210. [PMID: 38085752 PMCID: PMC11181517 DOI: 10.11607/jomi.10335] [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] [Indexed: 12/18/2023] Open
Abstract
PURPOSE To analyze the process of early oral osseointegration of titanium (Ti) implants in diabetic 129/Sv mice through microCT and histologic and immunohistochemical analysis. MATERIALS AND METHODS A group of 30 male 129/Sv mice was equally subdivided into two groups: (1) nondiabetic (ND), in which mice did not undergo systemic alterations and received a standard diet, and (2) diabetic (D), in which mice were provided a high-fat diet from the age of 6 weeks until the conclusion of the study and received two intraperitoneal (IP) injections of streptozotocin (STZ) at a concentration of 100 mg/Kg each. Each mouse underwent extraction of a maxillary first molar, and customized Ti screws (0.50 mm diameter, 1.5 mm length) were placed in the residual alveolar sockets of the palatal roots. At 7 and 21 days after implant placement, the animals were euthanized for maxilla and pancreas collection. Maxillae containing Ti implants were analyzed with microCT, histology, and immunohistochemistry for cells that were positive for F4/80, CD146, runt-related transcription factor 2 (Runx2), and proliferating cell nuclear antigen (PCNA). Pancreata were histologically analyzed. Quantitative data were statistically analyzed with a significance level at 5% (P < .05). RESULTS ND mice presented successful healing and osseointegration, with a significantly higher fraction of bone volume compared to D mice, both at the alveolar sockets (53.39 ± 5.93 and 46.08 ± 3.18, respectively) and at the implant sites (68.88 ± 7.07 and 44.40 ± 6.98, respectively) 21 days after implant placement. Histologic evaluation revealed that the ND mice showed a significant decrease in inflammatory infiltrate and a significant increase in newly formed bone matrix at 21 days, whereas peri-implant sites in the D mice were predominantly encapsulated by fibrous tissue and chronic inflammatory infiltrate. Immunohistochemical characterization revealed higher Runx2 osteoblast differentiation and higher cell proliferation activity in the ND mice at 7 days, while higher amounts of macrophages were present in D mice at 7 and 21 days. Interestingly, no differences were found in CD146-positive cells when comparing ND and D mice. CONCLUSIONS This study evaluated the effects of immediate dental implant placement in 129/Sv diabetic mice by using specific healing markers to identify changes in cellular events involved in early oral osseointegration. This approach may serve as tool to evaluate new materials and surface coatings to improve osseointegration in diabetic patients.
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Khachatryan H, Hakobyan G. Diagnostic and prognostic value of indicators of markers of bone metabolism in type 2 diabetes mellitus patients with UV functionalised dental implants. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101608. [PMID: 37648210 DOI: 10.1016/j.jormas.2023.101608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Diabetes mellitus affects many organ systems, including bone tissue.In diabetic patients, the activity of osteoblasts is suppressed and the activity of osteoclasts in the bone matrix increases, bone formation decreases, which can disrupt the process of osseointegration and ultimately lead to disintegration and failed implants. Based on the foregoing, with diabetes, it is very important to study bone metabolism to predict and dynamically control dental implants. OBJECTIVES To assess the indicators of bone metabolism markers Osteocalcin and β-Cross-Laps in blood serum in patients with type 2 diabetes mellitus with intraosseous dental implants. METHODS The study included 86 patients, diagnosed type 2 diabetes mellitus in period 2018 - 2023 with partially or complete edentulous. Implant surgery was performed after periodontal therapy using 367 UV functionalized dental implants in patients 1 group. Patients 2 group was performed implant surgery using 54 dental implants that were not UV functionalization. Final dental prosthetics was performed 4-5 months. UV functionalization of the implant surface was carried out using a UV Activator YWJ-QSY001 (Foshan, Wenjian Medikal Enstriman) for 20 s. The content biochemical markers of bone Osteocalcin and β-Cross-Laps serum was determined by enzyme-linked immunosorbent assay ELISA (ELISA, IFA Roche Diagnostics, Basel, Switzerland) before and after dental implantation according to the manufacturers' protocols. Outcomes assessed included; implant survival, men MBL, PPD, BOP, RFA, prosthetic success. RESULTS There were no clinical examinations of serious biological or prosthetic complications. There is a correlation between different concentrations of Osteocalcin or β-Cross- Laps and the success rate of implants. Implants were shown to be unsuccessful low concentrations of Osteocalcin and high concentrations β-Cross- Laps in serum compared with average mean biochemical markers of bone in 2 group patients. In patients of the 2nd group, the indicators of biochemical bone markers were within the normal range; no correlation was found between osseointegration failers and the complication of peri-implatitis. Short implants success rate was 96,7 %, standart implants success rate was after 97,5 after 5 years. CONCLUSION Implant therapy can be successfully used in diabetic patients with UV photofunctionalized implants, blood glucose levels should be constantly maintained at a normal level. Monitoring of bone metabolism markers in patients with type 2 diabetes mellitus may have prognostic value for implants and will encourage the practitioner to apply corrective drug therapy in case of violation of markers.
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Affiliation(s)
- Hakob Khachatryan
- Maxillofacial surgeon, Central clinical Military hospital (Ministry of Defence of The Republic of Armenia), Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Armenia
| | - Gagik Hakobyan
- Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after M. Heratsi, Armenia.
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18
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Anderson KD, Beckmann C, Heermant S, Ko FC, Dulion B, Tarhoni I, Borgia JA, Virdi AS, Wimmer MA, Sumner DR, Ross RD. Zucker Diabetic-Sprague Dawley Rats Have Impaired Peri-Implant Bone Formation, Matrix Composition, and Implant Fixation Strength. JBMR Plus 2023; 7:e10819. [PMID: 38025036 PMCID: PMC10652173 DOI: 10.1002/jbm4.10819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
An increasing number of patients with type 2 diabetes (T2DM) will require total joint replacement (TJR) in the next decade. T2DM patients are at increased risk for TJR failure, but the mechanisms are not well understood. The current study used the Zucker Diabetic-Sprague Dawley (ZDSD) rat model of T2DM with Sprague Dawley (SPD) controls to investigate the effects of intramedullary implant placement on osseointegration, peri-implant bone structure and matrix composition, and fixation strength at 2 and 10 weeks post-implant placement. Postoperative inflammation was assessed with circulating MCP-1 and IL-10 2 days post-implant placement. In addition to comparing the two groups, stepwise linear regression modeling was performed to determine the relative contribution of glucose, cytokines, bone formation, bone structure, and bone matrix composition on osseointegration and implant fixation strength. ZDSD rats had decreased peri-implant bone formation and reduced trabecular bone volume per total volume compared with SPD controls. The osseointegrated bone matrix of ZDSD rats had decreased mineral-to-matrix and increased crystallinity compared with SPD controls. Osseointegrated bone volume per total volume was not different between the groups, whereas implant fixation was significantly decreased in ZDSD at 2 weeks but not at 10 weeks. A combination of trabecular mineral apposition rate and postoperative MCP-1 levels explained 55.6% of the variance in osseointegration, whereas cortical thickness, osseointegration mineral apposition rate, and matrix compositional parameters explained 69.2% of the variance in implant fixation strength. The results support the growing recognition that both peri-implant structure and matrix composition affect implant fixation and suggest that postoperative inflammation may contribute to poor outcomes after TJR surgeries in T2DM patients. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Kyle D Anderson
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
| | - Christian Beckmann
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - Saskia Heermant
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - Frank C Ko
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - Bryan Dulion
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
| | - Imad Tarhoni
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
| | - Jeffrey A Borgia
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
| | - Amarjit S Virdi
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - Markus A Wimmer
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - D Rick Sumner
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
| | - Ryan D Ross
- Department of Anatomy and Cell BiologyRush University Medical CenterChicagoILUSA
- Department of Orthopedic SurgeryRush University Medical CenterChicagoILUSA
- Department of Microbial Pathogens and ImmunityRush University Medical CenterChicagoILUSA
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Afrasiabi S, Heidari M, Younespour S, Chiniforush N. Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:751. [PMID: 37828479 PMCID: PMC10571232 DOI: 10.1186/s12903-023-03337-9] [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: 05/10/2023] [Accepted: 08/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes. METHODS Publications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected. RESULTS Two randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I2 = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I2 = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I2 = 0.00%, p = 0.47). CONCLUSION Given that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Heidari
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Younespour
- Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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Alevizakos V, Achilles N, Rahlf B, Jehn P, von See C, Schiller M. Comparing Original and Universal Screwdrivers and How They Affect Friction in the Screw. J ORAL IMPLANTOL 2023; 49:532-536. [PMID: 36893110 DOI: 10.1563/aaid-joi-d-20-00249] [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: 08/03/2020] [Revised: 08/05/2021] [Accepted: 09/21/2022] [Indexed: 03/10/2023]
Abstract
The present study focused on investigating whether universal screwdriver kits cause less friction between the screwdriver and the abutment screw than original screwdrivers. For this purpose, 2 original screwdrivers (Straumann and BEGO) and a universal screwdriver kit (bredent) were investigated. On 1 implant per screwdriver, 26 abutments were properly attached one after the other with the corresponding abutment screws. After tightening the abutment screw, the force required to pull the screwdriver off the screw head was determined with a spring balance. For both manufacturers, greater pull-off forces were measured when using the original screwdrivers than when using the universal screwdriver. The pull-off force (mean ± SD) required for the Straumann original screwdriver was 3.7 ± 1.4 N, while that required for the universal screwdriver was 0.1 ± 0.1 N (P < .001). The pull-off force was 1.5 ± 1.5 N for the BEGO original screwdriver and 0.7 ± 0.9 N for the universal screwdriver (P = .19). Using original manufacturer-supplied screwdrivers could thus minimize the risk of the screwdriver slipping out of the screw head during dental treatment and being swallowed or aspirated by the patient.
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Affiliation(s)
- Vasilios Alevizakos
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Nadine Achilles
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Björn Rahlf
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Philipp Jehn
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
| | - Constantin von See
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Marcus Schiller
- Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover, Germany
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Baniulyte G, Ali K. How does diabetes mellitus impact on the prognosis of dental implants? Evid Based Dent 2023; 24:114-115. [PMID: 37563223 PMCID: PMC10516744 DOI: 10.1038/s41432-023-00909-0] [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: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/12/2023]
Abstract
DATA SOURCES Web of Science, Embase, PubMed and Cochrane Library databases were searched for publications up to August 2021. STUDY SELECTION The study noted clear inclusion and exclusion criteria. Search terms were provided; only observational studies were considered. DATA EXTRACTION AND SYNTHESIS A total of 122 studies were identified through the search strategy. Following deduplication, two reviewers conducted the screening. RESULTS A total of 21 observational studies were included, involving cohort, case-control, and cross-sectional study designs. A meta-analysis identified increased risk of peri-implantitis in patients with diabetes mellitus and in smokers when compared to non-diabetic subjects and non-smokers. No significant association was found between poor plaque control or periodontal history and peri-implantitis. CONCLUSIONS Patients with diabetes mellitus appear to have a higher risk of peri-implantitis.
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Affiliation(s)
- Gabriele Baniulyte
- Oral and Maxillofacial Department, Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
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22
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Dong S, Zhao T, Wu W, Zhang Z, Wu J, Cai K, Li G, Lv J, Zhou H, Tang C. Sandblasted/Acid-Etched Titanium Surface Modified with Calcium Phytate Enhances Bone Regeneration in a High-Glucose Microenvironment by Regulating Reactive Oxygen Species and Cell Senescence. ACS Biomater Sci Eng 2023; 9:4720-4734. [PMID: 37491189 DOI: 10.1021/acsbiomaterials.3c00385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Hyperglycemia in patients with diabetes affect osteoblast function, leading to abnormal bone metabolism and implant failure. Adequate bone volume surrounding an implant is essential for osseointegration, which can be improved by implant surface modifications. In this study, titanium surfaces were hydrothermally treated with a mixture of phytic acid (PA) and calcium hydroxide to produce a calcium-decorated surface. The control group comprised pure titanium with a sandblasted/acid-etched (SLA) surface. The elemental composition, hydrophilicity, surface roughness, and morphology of the titanium surfaces were examined. Evaluation of in vitro osteogenic differentiation ability in a high-glucose environment using alkaline phosphatase (ALP) staining, ALP activity assays, Alizarin Red S staining, quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and immunofluorescence staining revealed that Ca-PA-modified SLA titanium surfaces can promote osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs). Evaluation of oxidative stress and aging using reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and β-galactosidase staining revealed that Ca-PA-modified SLA titanium surfaces can reduce ROS production and ameliorate oxidative stress damage in hBMSCs. In vivo assessment of osteogenesis in a diabetic rat model revealed that Ca-PA coating promotes peri-implant osseointegration. Ca-PA-modified SLA titanium surface is a candidate for improving implant osseointegration in patients with diabetes.
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Affiliation(s)
- Shuo Dong
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Tong Zhao
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Wei Wu
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Zhewei Zhang
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Jin Wu
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Kunzhan Cai
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Guoqing Li
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Jiaxin Lv
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Heyang Zhou
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
| | - Chunbo Tang
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
- Jiangsu Province Key Laboratory of Oral Diseases, Nanjing 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210000, China
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23
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De Angelis P, Rella E, Manicone PF, De Rosa G, Gallottini S, Liguori MG, Papi P, Desantis V, Passarelli PC, D'Addona A. The Effect of Diabetes and Hyperglycemia on Horizontal Guided Bone Regeneration: A Clinical Prospective Analysis. Healthcare (Basel) 2023; 11:1801. [PMID: 37372917 DOI: 10.3390/healthcare11121801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Guided bone regeneration (GBR) is a reconstructive procedure for treating atrophic alveolar ridges. This study aims to assess the correlation between different glycemic control levels and clinical findings in patients undergoing horizontal GBR before implant placement. The study population consisted of all patients requiring horizontal GBR. Patients were divided into three groups based on HbA1c levels: non-diabetic normoglycemic patients (HbA1c < 5.7%), non-diabetic hyperglycaemic patients (HbA1c < 6.5%), and patients with controlled diabetes (HbA1c < 7%). The primary outcomes were the horizontal (mm) and vertical (mm) dimensional changes of the alveolar ridge 6 months after the procedure. The study sample consisted of 54 patients. Sixty-eight implants (95.8%) were classified as "successful," meaning the possibility of inserting a standard-sized implant following the GBR (diameter ≥ 4 mm). There was a statistically significant difference between the three groups in terms of horizontal gain at 6 months: in particular, there was a statistically significant difference between group 1 and group 2 (p = 0.026) and between group 1 and group 3 (p = 0.030). The present investigation showed that patients with HbA1c levels below 7% could undergo GBR and obtain a statistically significant horizontal bone gain.
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Affiliation(s)
- Paolo De Angelis
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Edoardo Rella
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Francesco Manicone
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe De Rosa
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sofia Gallottini
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Margherita Giorgia Liguori
- Department of Life, Health and Environmental Sciences, Università degli Studi dell'Aquila, 67100 L'Aquila, Italy
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00168 Rome, Italy
| | - Viviana Desantis
- Department of Oral Surgery, University of Milan, 20122 Milan, Italy
| | - Pier Carmine Passarelli
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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24
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D’Ambrosio F, Amato A, Chiacchio A, Sisalli L, Giordano F. Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review. Dent J (Basel) 2023; 11:146. [PMID: 37366669 PMCID: PMC10296829 DOI: 10.3390/dj11060146] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this umbrella review is to evaluate what are the most common medications and systemic diseases that can affect bone-implant integration, the success rate and survival rate of dental implants, peri-implant tissue health, and implant loss. Systematic reviews, with meta-analysis or not, about how systemic diseases and medications influence dental implant osseointegration, survival rate, success rate, and peri-implant diseases, published only in the English language, are electronically searched across the most important scientific databases. The present umbrella review includes eight systematic reviews, and osteoporosis and diabetes are the most investigated pathologies. Systemic diseases, such as neurologic disorders, HIV, hypothyroidism, cardiovascular diseases, and drugs, such as beta blockers, anti-hypertensives, or diuretics do not show a decreased rate of implant osseointegration. It seems that drugs, such as proton-pump inhibitors (PPIs) or serotonin reuptake inhibitors (SSRIs), negatively affect implant osseointegration. Few studies compare the effects of drugs and systemic diseases on the parameters considered in this overview. It is important to underline how the results of this review need to be validated with subsequent and more reviews.
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Affiliation(s)
- Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Chiacchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Laura Sisalli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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25
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Chen S, Darby I. Inter-implant distance and buccal bone thickness for a novel implant design: a preclinical study. Clin Oral Investig 2023; 27:3261-3274. [PMID: 36944803 PMCID: PMC10264275 DOI: 10.1007/s00784-023-04942-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study assessed bone height between novel tapered implants at different inter-implant thread peak (TP) distances, and the impact of TP distance from outer buccal bone (BB) on marginal bone levels (MBL). MATERIALS AND METHODS Fully tapered implants with 0.5-mm thread depth and TP diameter 1 mm wider than the shoulder diameter were placed in healed ridges of minipigs. On one side, four implants were placed with inter-implant TP distances of 1, 2, or 3 mm corresponding to inter-implant implant shoulder distances of 2, 3, and 4 mm respectively. Three implants were placed on the other side with TP distances to outer BB of > 1 mm, 0.5-1 mm, or < 0.5 mm. After 12 weeks, (a) first bone-to-implant contact (fBIC), total BIC, bone area-to-total area (BATA), and coronal bone height between implants (Bi ½ max) for inter-implant distance, and (b) fBIC, BIC, and perpendicular crest to implant shoulder (pCIS) for BB were evaluated. RESULTS No significant differences in bone healing and inter-implant bone height were noted for any of the TP distances. BB resorption was significant when TP distance to outer BB was < 0.5 mm. However, fBIC was lowest with TP to outer BB of 1.75 mm. CONCLUSIONS Inter-implant bone height between adjacent implants can be maintained even at an inter-implant TP distance as low as 1 mm. A minimum TP to outer BB distance of 0.75 mm is required for predictable maintenance of MBL. CLINICAL RELEVANCE Inter-implant distance and BB thickness are clinically relevant and require preclinical research to clarify concepts.
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Affiliation(s)
- Stephen Chen
- Periodontics, Melbourne Dental School, The University of Melbourne, Victoria, Australia.
| | - Ivan Darby
- Periodontics, Melbourne Dental School, The University of Melbourne, Victoria, Australia
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26
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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27
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Kuntjoro M, Hendrijantini N, Prasetyo EP, Legowo D, Sitalaksmi RM, Agustono B, Ari MDA, Hong G. Human umbilical cord mesenchymal stem cells accelerate and increase implant osseointegration in diabetic rats. J Appl Oral Sci 2023; 31:e20220375. [PMID: 36995883 PMCID: PMC10065760 DOI: 10.1590/1678-7757-2022-0375] [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: 10/06/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE This study was conducted to assess the effect of hUCMSCs injection on the osseointegration of dental implant in diabetic rats via Runt-related Transcription Factor 2 (Runx2), Osterix (Osx), osteoblasts, and Bone Implant Contact (BIC). METHODOLOGY The research design was a true experimental design using Rattus norvegicus Wistar strain. Rattus norvegicus were injected with streptozotocin to induce experimental diabetes mellitus. The right femur was drilled and loaded with titanium implant. Approximately 1 mm from proximal and distal implant site were injected with hUCMSCs. The control group was given only gelatin solvent injection. After 2 and 4 weeks of observation, the rats were sacrificed for further examination around implant site using immunohistochemistry staining (RUNX2 and Osterix expression), hematoxylin eosin staining, and bone implant contact area. Data analysis was done using ANOVA test. RESULTS Data indicated a significant difference in Runx2 expression (p<0.001), osteoblasts (p<0.009), BIC value (p<0.000), and Osterix expression (p<0.002). In vivo injection of hUCMSCs successfully increased Runx2, osteoblasts, and BIC value significantly, while decreased Osterix expression, indicating an acceleration of the bone maturation process. CONCLUSION The results proved hUCMSCs to accelerate and enhance implant osseointegration in diabetic rat models.
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Affiliation(s)
- Mefina Kuntjoro
- Universitas Airlangga, Faculty of Dental Medicine, Department of Prosthodontic, Surabaya, Indonesia
| | - Nike Hendrijantini
- Universitas Airlangga, Faculty of Dental Medicine, Department of Prosthodontic, Surabaya, Indonesia
| | - Eric Priyo Prasetyo
- Universitas Airlangga, Faculty of Dental Medicine, Department of Conservative Dentistry, Surabaya, Indonesia
| | - Djoko Legowo
- Universitas Airlangga, Faculty of Veterinary Medicine, Surabaya, Indonesia
| | - Ratri Maya Sitalaksmi
- Universitas Airlangga, Faculty of Dental Medicine, Department of Prosthodontic, Surabaya, Indonesia
| | - Bambang Agustono
- Universitas Airlangga, Faculty of Dental Medicine, Department of Prosthodontic, Surabaya, Indonesia
| | | | - Guang Hong
- Tohoku University, Graduate Scholl of Dentistry, Liaison Center for Innovative Dentistry, Aoba-Ku, Sendai, Japan
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28
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PURPOSE Given the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. MATERIAL AND METHODS An extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. RESULTS A total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. CONCLUSIONS The evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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29
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Berger MB, Cohen DJ, Bosh KB, Kapitanov M, Slosar PJ, Levit MM, Gallagher M, Rawlinson JJ, Schwartz Z, Boyan BD. Bone marrow stromal cells generate an osteoinductive microenvironment when cultured on titanium-aluminum-vanadium substrates with biomimetic multiscale surface roughness. Biomed Mater 2023; 18. [PMID: 36827708 PMCID: PMC9993812 DOI: 10.1088/1748-605x/acbf15] [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: 06/29/2022] [Accepted: 02/24/2023] [Indexed: 02/26/2023]
Abstract
Osseointegration of titanium-based implants possessing complex macroscale/microscale/mesoscale/nanoscale (multiscale) topographies support a direct and functional connection with native bone tissue by promoting recruitment, attachment and osteoblastic differentiation of bone marrow stromal cells (MSCs). Recent studies show that the MSCs on these surfaces produce factors, including bone morphogenetic protein 2 (BMP2) that can cause MSCs not on the surface to undergo osteoblast differentiation, suggesting they may produce an osteogenic environmentin vivo. This study examined if soluble factors produced by MSCs in contact with titanium-aluminum-vanadium (Ti6Al4V) implants possessing a complex multiscale biomimetic topography are able to induce osteogenesis ectopically. Ti6Al4V disks were grit-blasted and acid-etched to create surfaces possessing macroscale and microscale roughness (MM), micro/meso/nanoscale topography (MN), and macro/micro/meso/nanoscale topography (MMNTM). Polyether-ether-ketone (PEEK) disks were also fabricated by machining to medical-grade specifications. Surface properties were assessed by scanning electron microscopy, contact angle, optical profilometry, and x-ray photoelectron spectroscopy. MSCs were cultured in growth media (GM). Proteins and local factors in their conditioned media (CM) were measured on days 4, 8, 10 and 14: osteocalcin, osteopontin, osteoprotegerin, BMP2, BMP4, and cytokines interleukins 6, 4 and 10 (IL6, IL4, and IL10). CM was collected from D14 MSCs on MMNTMand tissue culture polystyrene (TCPS) and lyophilized. Gel capsules containing active demineralized bone matrix (DBM), heat-inactivated DBM (iDBM), and iDBM + MMN-GM were implanted bilaterally in the gastrocnemius of athymic nude mice (N= 8 capsules/group). Controls included iDBM + GM; iDBM + TCPS-CM from D5 to D10 MSCs; iDBM + MMN-CM from D5 to D10; and iDBM + rhBMP2 (R&D Systems) at a concentration similar to D5-D10 production of MSCs on MMNTMsurfaces. Legs were harvested at 35D. Bone formation was assessed by micro computed tomography and histomorphometry (hematoxylin and eosin staining) with the histology scored according to ASTM 2529-13. DNA was greatest on PEEK at all time points; DNA was lowest on MN at early time points, but increased with time. Cells on PEEK exhibited small changes in differentiation with reduced production of BMP2. Osteoblast differentiation was greatest on the MN and MMNTM, reflecting increased production of BMP2 and BMP4. Pro-regenerative cytokines IL4 and IL10 were increased on Ti-based surfaces; IL6 was reduced compared to PEEK. None of the media from TCPS cultures was osteoinductive. However, MMN-CM exhibited increased bone formation compared to iDBM and iDBM + rhBMP2. Furthermore, exogenous rhBMP2 alone, at the concentration found in MMN-CM collected from D5 to D10 cultures, failed to induce new bone, indicating that other factors in the CM play a critical role in that osteoinductive microenvironment. MSCs cultured on MMNTMTi6Al4V surfaces differentiate and produce an increase in local factors, including BMP2, and the CM from these cultures can induce ectopic bone formation compared to control groups, indicating that the increased bone formation arises from the local response by MSCs to a biomimetic, multiscale surface topography.
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Affiliation(s)
- Michael B Berger
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America
| | - D Joshua Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America
| | - Kyla B Bosh
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America
| | - Marina Kapitanov
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America
| | - Paul J Slosar
- SpineCare Medical Group, 455 Hickey Blvd., Suite 310, Daly City, CA 94015, United States of America
| | - Michael M Levit
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America
| | - Michelle Gallagher
- Medtronic, Applied Research-Spine, Minneapolis, MN, United States of America
| | - Jeremy J Rawlinson
- Medtronic, Applied Research-Spine, Minneapolis, MN, United States of America
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America.,Department of Periodontology, University of Texas Health Science Center at San Antonio, 7703, Floyd Curl Drive, San Antonio, TX 78229, United States of America
| | - Barbara D Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, United States of America.,Wallace H. Coulter Department of Biomedical Engineering at the Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, United States of America
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30
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Attia MS, Elewa GM, Abdelgawad N, Ismail RM, Hassan Eid M, Ghoneim MM. The Influence of Low-Level Laser Therapy on CBCT Radiographic and Biochemical Profiles of Type II Controlled Diabetic Patients After Dental Implant Insertion: A Randomized Case-Control Study. Cureus 2023; 15:e36559. [PMID: 37102010 PMCID: PMC10123229 DOI: 10.7759/cureus.36559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
Background Low-level laser treatment (LLLT) was thought to increase bone quality during osseointegration when combined with dental implants. However, there is no sufficient information on its impact on dental implants in diabetics. Osteoprotegerin (OPG) has been described as a marker for bone turnover to determine implant prognosis. The current research aims to evaluate the effect of low-level laser therapy (LLLT) on bone density (BD) and osteoprotegerin levels in peri-implant crevicular fluid (PICF) in type II diabetic patients. Methods This study comprised 40 individuals with type II diabetes mellitus (T2DM). Implants were randomly placed in 20 non-lasered T2DM patients (control) and 20 lasered T2DM patients (LLLT group). At the follow-up stages, BD and OPG levels in the PICF were evaluated in both groups. Results Significant variations were shown among control and LLLT groups concerning OPG level and BD (p≤0.001). OPG was significantly decreasing with follow-up points (p≤0.001). There was a significant decrease in OPG with time in both groups with a higher decrease in the control group. Conclusion LLLT is promising in controlled T2DM patients due to its outstanding influence on BD and estimated crevicular levels of OPG. Regarding its clinical significance, LLLT significantly improved bone quality during osseointegration on dental implants in T2DM. LLLT is considered potentially important for T2DM patients during implant placement. Trial registration The study was registered on ClinicalTrial.gov under registration number NCT05279911 (registration date: March 15, 2022) (https://clinicaltrials.gov/ct2/show/NCT05279911).
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Affiliation(s)
- Mai S Attia
- Department of Oral Medicine, Periodontology, Diagnosis, and Radiology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, EGY
- Department of Periodontology, Oral Diagnosis, and Oral Radiology, Faculty of Oral and Dental Medicine, Misr International University, Cairo, EGY
| | - Gasser M Elewa
- Department of Oral Medicine, Diagnosis, and Periodontology, Faculty of Oral and Dental Medicine, Delta University of Science and Technology, Gamasa, EGY
| | - Nora Abdelgawad
- Department of Oral Medicine, Periodontology, Diagnosis, and Radiology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, EGY
| | - Radwa M Ismail
- Department of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, Misr University for Science and Technology (MUST), Cairo, EGY
| | - Mohamed Hassan Eid
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University, Ismailia, EGY
| | - Mohamed M Ghoneim
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sinai University, El-Arish, EGY
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Alsayed H, Bukhari IA, Alsaif R, Vohra F. Efficacy of indocyanine green and methylene blue mediated-photodynamic therapy on peri-implant outcomes among diabetics with peri-implant mucositis. Photodiagnosis Photodyn Ther 2023; 42:103344. [PMID: 36841279 DOI: 10.1016/j.pdpdt.2023.103344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND This study aimed to assess the efficacy of indocyanine green (ICG)-mediated versus methylene blue (MB)-mediated photodynamic therapy (PDT) as an adjunct to conventional mechanical debridement (MD) on the peri‑implant clinical, radiographic, microbiological, and immunological outcomes among diabetics with peri‑implant mucositis (pi-M). METHODS For this 3-month follow-up study, diabetics having pi-M were randomly divided into 3 groups: group-I (n = 20) subjects received only MD; group-II (n = 20) participants received ICG-mediated adjunct PDT; and group-III (n = 20) subjects received MB-mediated adjunct PDT. Peri-implant clinical (i.e., plaque index [PI], bleeding on probing [BOP], probing depth [PD]), radiographic (crestal bone loss [CBL]), microbiological (Fusobacterium nucleatum [F. nucleatum], Tannerella forsythia [T. forsythia], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans]), and immunological (interleukin [IL]-6, IL-1β, tumor necrosis factor-alpha [TNF-α]) outcomes were assessed at baseline and 3-month follow-up. RESULTS Mean changes between baseline and 3-month follow-up in peri‑implant clinico-radiographic parameters were significantly different between control (PI: 12.42±21.80%; BOP: 12.10±19.30%; PD: 0.45±0.41 mm; CBL: 1.10±1.02 mm) and test groups (ICG-mediated PDT [PI: 26.55±25.80%; BOP: 28.77±29.24%; PD: 0.84±0.62 mm; CBL: 1.98±1.85 mm] and MB-mediated PDT [PI: 27.24±26.15%; BOP: 27.71±28.16%; PD: 0.85±0.63 mm; CBL: 1.95±1.80 mm]), however comparable differences were observed in peri‑implant PI, BOP, PD, and CBL between group-II and group-III participants (p>0.05). The proportions of T. forsythia were significantly reduced in group-II (4.78 × 104 colony-forming unit per milliliter [CFU/mL]) and group-III (4.76 × 104 CFU/mL) as compared to group-I (-4.40 × 103 CFU/mL) at 3-month follow-up (p = 0.02). No statistically significant differences were observed between the study groups regarding the proportions of the other assessed target bacterial species. For IL-6 (group-I: 210±108; group-II: 298±165; group-III: 277±121 pg/mL; p = 0.03), IL-1β (group-I: 101±95; group-II: 84±98; group-III: 86±74 pg/mL; p = 0.02), and TNF-α (group-I: 336±121; group-II: 385±210; group-III: 366±198 pg/mL; p = 0.03) peri‑implant sulcular fluid [PISF] levels, all three study groups demonstrated statistically significant reduction at 3-month follow-up. CONCLUSIONS ICG-mediated and MB-mediated adjunctive PDT showed statistically significant improvements in peri‑implant clinical, radiographic, microbiological, and immunological parameters as compared to conventional MD alone at 3-month follow-up among diabetics with pi-M. However, comparable outcomes were demonstrated by ICG-mediated and MB-mediated adjunctive PDT regarding the assessed peri‑implant parameters.
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Affiliation(s)
- Hussain Alsayed
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Ishfaq A Bukhari
- Department of Pharmacology, Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY 41501, USA
| | - Rawan Alsaif
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia.
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Sbricoli L, Bazzi E, Stellini E, Bacci C. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent J (Basel) 2022; 11:dj11010010. [PMID: 36661547 PMCID: PMC9857470 DOI: 10.3390/dj11010010] [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: 12/01/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.
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Gasmi Benahmed A, Gasmi A, Tippairote T, Mujawdiya PK, Avdeev O, Shanaida Y, Bjørklund G. Metabolic Conditions and Peri-Implantitis. Antibiotics (Basel) 2022; 12:65. [PMID: 36671266 PMCID: PMC9854649 DOI: 10.3390/antibiotics12010065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
Dental implants to replace lost teeth are a common dentistry practice nowadays. Titanium dental implants display a high success rate and improved safety profile. Nevertheless, there is an increasing peri-implantitis (PI), an inflammatory disease associated with polymicrobial infection that adversely affects the hard and soft tissues around the implant. The present review highlights the contribution of different metabolic conditions to PI. The considerations of both local and systemic metabolic conditions are crucial for planning successful dental implant procedures and during the treatment course of PI. Un- or undertreated PI can lead to permanent jaw bone suffering and dental implant losses. The common mediators of PI are inflammation and oxidative stress, which are also the key mediators of most systemic metabolic disorders. Chronic periodontitis, low-grade tissue inflammation, and increased oxidative stress raise the incidence of PI and the underlying systemic metabolic conditions, such as obesity, diabetes mellitus, or harmful lifestyle factors (cigarette smoking, etc.). Using dental biomaterials with antimicrobial effects could partly solve the problem of pathogenic microbial contamination and local inflammation. With local dentistry considering factors, including oral microbiota and implant quality control, the inclusion of the underlying systemic metabolic conditions into the pre-procedure planning and during the treatment course should improve the chances of successful outcomes.
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Affiliation(s)
- Asma Gasmi Benahmed
- Académie Internationale de Médecine Dentaire Intégrative, 75000 Paris, France
| | - Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, 69100 Villeurbanne, France
| | - Torsak Tippairote
- Faculty of Medicine Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok 10400, Thailand
- Nutritional and Environmental Medicine Department, BBH Hospital, Bangkok 10540, Thailand
| | | | - Oleksandr Avdeev
- Pediatric Dentistry Department, I. Horbachevsky Ternopil National Medical University, 46003 Ternopil, Ukraine
| | - Yurii Shanaida
- Pediatric Dentistry Department, I. Horbachevsky Ternopil National Medical University, 46003 Ternopil, Ukraine
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine, 8610 Mo i Rana, Norway
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Wang Z, Zhang J, Hu J, Yang G. Gene-activated titanium implants for gene delivery to enhance osseointegration. BIOMATERIALS ADVANCES 2022; 143:213176. [PMID: 36327825 DOI: 10.1016/j.bioadv.2022.213176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Osseointegration is the direct and intimate contact between mineralized tissue and titanium implant at the bone-implant interface. Early establishment and stable maintenance of osseointegration is the key to long-term implant success. However, in patients with compromised conditions such as osteoporosis and patients beginning early load-bearing activities such as walking, lower osseointegration around titanium implants is often observed, which might result in implant early failure. Gene-activated implants show an exciting prospect of combining gene delivery and biomedical implants to solve the problems of poor osseointegration formation, overcoming the shortcomings of protein therapy, including rapid degradation and overdose adverse effects. The conception of gene-activated titanium implants is based on "gene-activated matrix" (GAM), which means scaffolds using non-viral vectors for in situ gene delivery to achieve a long-term and efficient transfection of target cells. Current preclinical studies in animal models have shown that plasmid DNA (pDNA), microRNA (miRNA), and small interference RNA (siRNA) functionalized titanium implants can enhance osseointegration with safety and efficiency, leading to the expectation of applying this technique in dental and orthopedic clinical scenarios. This review aims to comprehensively summarize fabrication strategies, current applications, and futural outlooks of gene-activated implants, emphasizing nucleic acid targets, non-viral vectors, implant surface modification techniques, nucleic acid/vector complexes loading strategies.
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Affiliation(s)
- Zhikang Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jing Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Jinxing Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310000, China.
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Herrero F, de Souza RF, Feine JS, Alexander PP, Green AV, Oates TW. The impact of implant-retained overdentures on type-2 diabetic and non-diabetic edentulous patients: Satisfaction and quality of life in a prospective cohort study. J Dent 2022; 127:104357. [PMID: 36351489 PMCID: PMC9691604 DOI: 10.1016/j.jdent.2022.104357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To evaluate the benefits of implant therapy for patients with diabetes, we compared (i) healthy, (ii) well controlled T2DM and (iii) poorly controlled T2DM patients, in terms of oral health-related quality of life (OHRQoL) and satisfaction with mandibular 2-implant overdentures over 12 months following restoration. MATERIALS AND METHODS This single-center, prospective, cohort study recruited 165 edentulous adults (HbA1c<12%) to receive two endosseous implants in the anterior mandible to support mandibular overdentures. Participants were enrolled as having T2DM or not, with T2DM participants divided according to HbA1c into well-controlled (<8.1%) and poorly controlled (≥ 8.1%) groups. Participants provided responses to the OHIP-20 (OHRQoL) and the McGill Denture Satisfaction Questionnaire, before implant therapy and 6 and 12 months after overdenture insertion using Locator attachments. HbA1c was measured at the same time points. The effect of groups and time was verified using generalized estimating equations (α=0.025). RESULTS At 12 months, 137 participants provided responses. The two diabetes groups showed improvements in OHRQoL to the same extent as the non-diabetic control group at both 6 and 12 months. Patient satisfaction showed similar improvements with no between-group differences and similar increases identified at 6 and 12 months. HbA1c was not affected by time or groups. CONCLUSIONS Dental implant therapy provided significant improvements in patient-perceived benefits of mandibular two-implant overdentures for T2DM individuals, which are similar to those found for healthy edentulous individuals. Importantly, those benefits extend to those individuals with poorly controlled glycaemia. The addition of 2-implant supported mandibular overdentures did not affect glycaemic status over 12 months following insertion. CLINICAL SIGNIFICANCE As risks for implant therapy relative to glycaemic status are better understood, this study documents that implant therapy may offer important benefits in QoL for T2DM patients independent of glycaemic status.
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Affiliation(s)
- Frances Herrero
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States
| | - Raphael F de Souza
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Jocelyne S Feine
- Oral Health and Society, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Peggy P Alexander
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Adriana Vargas Green
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, United States
| | - Thomas W Oates
- Department of Advanced Oral Sciences & Therapeutics, School of Dentistry, University of Maryland, Baltimore, United States.
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36
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Pinotti FE, Aron MAT, de Oliveira GJPL, Marcantonio E, Marcantonio RAC. Implants with hydrophilic surfaces equalize the osseointegration of implants in normo- and hyperglycaemic rats. Braz Dent J 2022; 33:71-77. [PMID: 36477967 PMCID: PMC9733365 DOI: 10.1590/0103-6440202204793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to evaluate the effect of a surface modified by blasting and acid attack and maintained in an isotonic solution compared to a machined surface on osseointegration in normo- and hyperglycaemic animals. Sixty-four animals were allocated into 4 groups with 16 animals each, and they were subdivided into two experimental periods (15 and 45 days), with 8 animals in each group. The groups were divided according to the type of implant that was installed in the animals' tibia and the animals' systemic condition: CM - Machined implants placed in Healthy animals; CH - Hydrophilic implants placed in Healthy animals, HM - Machined implants placed in animals with hyperglycaemia; HH- Hydrophilic implants installed in animals with hyperglycaemia. The following analyses were performed: biomechanical (removal torque), microtomographic (evaluation of the bone volume around the implants- BV/TV), and histomorphometric (evaluation of bone-implant contact BIC% and of the bone formation area between the threads BBT%). It was found that the implants with hydrophilic surfaces presented higher removal torques and quantities of BV/TV% and higher BIC% and BBT% values in normo- and hyperglycaemic animals. The results of this study indicated that the hydrophilic surface accelerates the osseointegration process (~ 15% BIC/BBT at 15-day period), especially in animals with hyperglycaemia. The hydrophilic surface equaled the osseointegration between normo- and hyperglycaemic animals, reversing the negative potential of hyperglycaemia on the osseointegration process.
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Affiliation(s)
- Felipe Eduardo Pinotti
- Department of Diagnosis and Surgery, São Paulo State University(Unesp), School of Dentistry, Araraquara, Brazil
| | | | | | - Elcio Marcantonio
- Department of Diagnosis and Surgery, São Paulo State University(Unesp), School of Dentistry, Araraquara, Brazil
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Dharmarajan L, Prakash PSG, Appukuttan D, Crena J, Subramanian S, Alzahrani KJ, Alsharif KF, Halawani IF, Alnfiai MM, Alamoudi A, Kamil MA, Balaji TM, Patil S. The Effect of Laser Micro Grooved Platform Switched Implants and Abutments on Early Crestal Bone Levels and Peri-Implant Soft Tissues Post 1 Year Loading among Diabetic Patients-A Controlled Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101456. [PMID: 36295619 PMCID: PMC9609409 DOI: 10.3390/medicina58101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/24/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: The study aimed to compare the mean crestal bone level (CBL) and peri-implant soft tissue parameters in laser micro-grooved (LMG) platform switched implants and abutments (I&A) post 1 year of functional loading among non-diabetic and type II diabetic individuals. Materials and methods: Patients with an edentulous site having minimum bone height and width of ≥13 mm and ≥6 mm, respectively, were divided into two groups: (i) Non-diabetic-8 (control) and (ii) diabetic-8 (test). LMG Implants were placed and loaded immediately with a provisional prosthesis. Mean crestal bone level (MCBL) was evaluated radiographically at baseline and at 1 year. Peri-implant attachment level (PIAL) and relative position of the gingival margin (R-PGM) were recorded. Implant stability quotient (ISQ) level and implant survival rate (ISR) were evaluated at 1 year. Results: Early MCBL within the groups 1 year postloading was similar both mesially and distally (control-0.00 to 0.16 mm and 0.00 to 0.17 mm, respectively; test-0.00 to 0.21 mm and 0.00 to 0.22 mm, respectively) with statistical significance (p ≤ 0.003, p ≤ 0.001 and p ≤ 0.001, p ≤ 0.001, respectively). However, intergroup comparison showed no significant difference statistically in the MCBL in 1 year post functional loading. The peri-implant soft tissue parameters showed no significant difference between the groups. ISQ level between both groups did not reveal any significant changes (p ≤ 0.92), and ISR was 100%. Conclusions: LMG Implants resulted in minimal and comparable early crestal bone loss and soft tissue changes post 1 year of functional loading in moderately controlled diabetic and non-diabetic individuals, suggesting that this could be a reliable system for use in systemically compromised individuals.
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Affiliation(s)
- Lalli Dharmarajan
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai 600089, India
| | - P. S. G. Prakash
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai 600089, India
- Correspondence: (P.S.G.P.); (S.P.)
| | - Devapriya Appukuttan
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai 600089, India
| | - Jasmine Crena
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai 600089, India
| | - Sangeetha Subramanian
- Department of Periodontics, SRM Dental College and Hospital, Ramapuram, Chennai 600089, India
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Khalaf F. Alsharif
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ibrahim F. Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mrim M. Alnfiai
- Department of Information Technology, College of Computers and Information Technology, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ahmed Alamoudi
- Oral Biology Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mona Awad Kamil
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia
| | | | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UT 84095, USA
- Correspondence: (P.S.G.P.); (S.P.)
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38
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Nibali L, Gkranias N, Mainas G, Di Pino A. Periodontitis and implant complications in diabetes. Periodontol 2000 2022; 90:88-105. [PMID: 35913467 DOI: 10.1111/prd.12451] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the "sixth complication" of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long-term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri-implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri-implant disease in diabetic patients and the potential role of the dental professional in the diabetes-periodontal interface.
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Affiliation(s)
- Luigi Nibali
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Nikolaos Gkranias
- Centre for Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University London (QMUL), London, UK
| | - Giuseppe Mainas
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Antonino Di Pino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Sykara M, Maniatakos P, Tentolouris A, Karoussis IK, Tentolouris N. The necessity of administrating antibiotic prophylaxis to patients with diabetes mellitus prior to oral surgical procedures-a systematic review. Diabetes Metab Syndr 2022; 16:102621. [PMID: 36183455 DOI: 10.1016/j.dsx.2022.102621] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Μany studies suggest the use of antibiotic prophylaxis (AP) as an appropriate preventive measure for patients with diabetes mellitus (DM) due to the increased possibility of an impaired wound healing and infections after surgical procedures in the oral cavity. Existing recommendations regarding antibiotic prophylaxis before surgical procedures are not definitive and are based on expert opinions. The purpose of this study was to review the available scientific data about the necessity of administrating AP as a preventive measure prior to oral surgical procedures. METHOD PubMed®, Scopus® και Cochrane Central Register of Controlled Trials (CENTRAL) were used as databases to search for published research. All articles were initially identified and classified based on the title and subsequently on their abstract. For the next level the full scientific paper was read and evaluated. RESULTS Overall, 22 articles were included in the study, of which 2 were systematic reviews, 2 cohort studies, 2 case-control studies, 1 case series, 8 case reports and 7 professional association publications. CONCLUSIONS In the scientific literature, there is a wide range of recommendations and inconsistency regarding the need to administer AP prior to surgical dental operations in patients with DM, while there is no scientific evidence demonstrating its' effectiveness as a precautionary measure. Both blood glucose level measurements and recent HbA1c measurement should be evaluated before any dental procedure. Poor regulation may result to life-threatening infections after tooth extraction. AP is recommended prior to the placement of dental implant. Randomized, controlled, clinical trials with large number of participants and greater variety of surgical dental procedures are needed.
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Affiliation(s)
- Maria Sykara
- Department of Periodontology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Maniatakos
- Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Tentolouris
- First Department of Propaedeutic Internal Medicine and Diabetes Center, Laiko General Hospital, Athens, Greece.
| | - Ioannis K Karoussis
- Department of Periodontology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine and Diabetes Center, Laiko General Hospital, Athens, Greece
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40
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Liang C, Liu X, Yan Y, Sun R, Li J, Geng W. Effectiveness and Mechanisms of Low-Intensity Pulsed Ultrasound on Osseointegration of Dental Implants and Biological Functions of Bone Marrow Mesenchymal Stem Cells. Stem Cells Int 2022; 2022:7397335. [PMID: 36199628 PMCID: PMC9529500 DOI: 10.1155/2022/7397335] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Dental implant restoration is the preferred choice for patients with dentition defects or edentulous patients, and obtaining stable osseointegration is the determining factor for successful implant healing. The risk of implant failure during the healing stage is still an urgent problem in clinical practice due to differences in bone quality at different implant sites and the impact of some systemic diseases on bone tissue metabolism. Low-intensity pulsed ultrasound (LIPUS) is a noninvasive physical intervention method widely recognized in the treatment of bone fracture and joint damage repair. Moreover, many studies indicated that LIPUS could effectively promote the osseointegration of dental implants and improve the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). This review is aimed at investigating the research progress on the use of LIPUS in dental implant medicine from three aspects: (1) discuss the promoting effects of LIPUS on osseointegration and peri-implant bone regeneration, (2) summarize the effects and associated mechanisms of LIPUS on the biological functions of BMSCs, and (3) introduce the application and prospects of LIPUS in the clinical work of dental implantation. Although many challenges need to be overcome in the future, LIPUS is bound to be an efficient and convenient therapeutic method to improve the dental implantation success rate and expand clinical implant indications.
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Affiliation(s)
- Chao Liang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Xiu Liu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Yuwei Yan
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Rongxin Sun
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Jun Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Wei Geng
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
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Cheng YC, Ewers R, Morgan K, Hirayama M, Murcko L, Morgan J, Bergamo ETP, Bonfante EA. Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women. Clin Oral Investig 2022; 26:6569-6582. [PMID: 36001145 DOI: 10.1007/s00784-022-04609-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effects of antiresorptive treatment on the survival of plateau-root form dental implants. MATERIALS AND METHODS Patients undergoing antiresorptive therapy via oral or intravenous administration as well as patients not undergoing antiresorptive therapy and healthy control patients were included in this retrospective cohort study. In total, 1472 implants placed in 631 postmenopausal patients (M: 66.42 ± 9.10 years old), who were followed for a period of up to 20 years (8.78 ± 5.68 years). Kaplan-Meier survival analysis was performed, and univariate and multivariate Cox regression, clustered by each patient, was used to evaluate and study factors affecting the survival of their implants. RESULTS Implants placed in patients undergoing oral antiresorptive treatment presented significantly higher survival rates, than implants placed in the osteoporosis/osteopenia control cohort (p value < 0.001), and similar survival rates, when compared to healthy controls (p value = 0.03). Additionally, clustered univariate and multivariate Cox regression analysis also revealed higher implant survival when oral antiresorptive drugs (p value = 0.01 and 0.007, respectively) were used, and lower implant survival in the presence of untreated osteoporosis/osteopenia (p value = 0.002 and 0.005, respectively). Overall, the 20-year implant survival in osteoporotic patients undergoing antiresorptive therapy was 94%. For the failed implants, newly replaced implants in patients under antiresorptive treatment presented a 10-year survival of 89%. CONCLUSIONS Long-term plateau-root form implant survival in osteoporotic patients taking oral antiresorptives was similar to a healthy population and significantly higher than the untreated controls. CLINICAL RELEVANCE These results suggest that plateau-root form implants provide a robust solution for treating tooth loss in patients, who are undergoing antiresorptive therapy.
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Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rolf Ewers
- University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
| | | | | | | | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil
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Considerations for restorative dentistry secondary care referrals - part 3: assessment of case complexity. Br Dent J 2022; 233:202-210. [PMID: 35962091 DOI: 10.1038/s41415-022-4549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/17/2022] [Indexed: 11/08/2022]
Abstract
Assessing the complexity of a case is a challenging exercise, with many tooth-specific as well as patient-specific considerations required. This decision is not made in isolation but goes hand in hand with the assessment of restorability, as well as strategic importance, both of which have been covered by the previous papers in this series. A number of guidelines regarding this matter have been devised in order to aid clinicians in determining the complexity of their patients and thus the most appropriate setting for their treatment. This paper aims to discuss the various complexity criteria available and their application, thus aiding clinicians in managing some of the more challenging cases.
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Rahman B, Acharya AB, Siddiqui R, Verron E, Badran Z. Photodynamic Therapy for Peri-Implant Diseases. Antibiotics (Basel) 2022; 11:antibiotics11070918. [PMID: 35884171 PMCID: PMC9311944 DOI: 10.3390/antibiotics11070918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed.
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Affiliation(s)
- Betul Rahman
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Anirudh Balakrishna Acharya
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, University City, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates;
| | - Elise Verron
- CNRS, UMR 6230, CEISAM, UFR Sciences et Techniques, Université de Nantes, 2, rue de la Houssinière, BP 92208, CEDEX 3, 44322 Nantes, France;
| | - Zahi Badran
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
- Correspondence:
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Madern AL, Anderson NK, Colosi D, Mahdian M. The relationship between diabetes and carotid artery calcifications detected via dental cone-beam computed tomography in patients undergoing implant treatment planning. J Am Dent Assoc 2022; 153:878-883. [PMID: 35760601 DOI: 10.1016/j.adaj.2022.05.005] [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: 02/21/2022] [Revised: 05/05/2022] [Accepted: 05/17/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The authors investigated the association between carotid artery calcifications (CACs) detected incidentally on dental cone-beam computed tomographic scans and positive diabetes status. METHODS Two patient groups were identified retrospectively from a patient database: positive for CACs based on cone-beam computed tomographic scans and positive diabetes status. In addition to demographic characteristics, data including diabetes status and presence, type, and absence of CACs were obtained. A χ2 statistical analysis was completed by means of dividing the data into sets of known CAC and known history of diabetes; significance level was P < .05. RESULTS To satisfy the a priori power analysis, records from 2010 through 2021 were used. For the positive CAC group, data were obtained from 288 patients (171 men, 117 women) and 68 patients (24%) had a positive diabetes status at the time of cone-beam computed tomography (P < .001). There were significantly more male patients (n = 47) than female patients (n = 21) with diabetes (χ2 = 9.9; P = .002). For the positive diabetes group, data were obtained from 225 patients (149 men, 76 women), and 100 patients (44%) had an identifiable CAC. There were significantly more male patients (n = 73) than female patients (n = 27) with CAC (χ2 = 21.2; P < .001). CONCLUSIONS There was a significant relationship to diabetes for patients with CACs, indicating potential undiagnosed diabetes. Male patients with diabetes are significantly more at risk of developing CACs. PRACTICAL IMPLICATIONS People with CAC may be at risk of having undiagnosed diabetes and require heightened awareness during implant treatment planning.
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Masri D, Masri-Iraqi H, Nissan J, Nemcovsky C, Gillman L, Naishlos S, Chaushu L. On the Association between Implant-Supported Prosthesis and Glycemic Control (HbA1c Values). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116923. [PMID: 35682506 PMCID: PMC9180096 DOI: 10.3390/ijerph19116923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/04/2022] [Accepted: 06/05/2022] [Indexed: 12/10/2022]
Abstract
Background: Dietary habits, food intake and oral health are important factors for general health. The aim of these present study was to assess the association between implant-supported fixed oral rehabilitation and glycemia, by monitoring HbA1c values before and after implant-supported prostheses (ISP) delivery to diabetic individuals. Methods: Retrospective, cohort study based on dental records. All treatments were performed by experienced oral and maxillofacial surgeons and experienced prosthodontists. Inclusion criteria: ISP delivery, diagnosis of diabetes in the medical files, consecutive individuals. Variables included—primary outcome—differences (delta) in HbA1c values prior to implant placement and one year after ISP delivery, early implant failure (EIF). Confounding factors included age, gender, physical status, smoking, implant jaw location, implant length, implant width, total implant count per individual. Results: Statistically significant (p < 0.01) decrease in HbA1c from 7.10 ± 1.09% to 6.66 ± 1.02% following ISP delivery was recorded. The mean HbA1c delta was 0.44 ± 0.73%, where 39.0% of the patients had a significant improvement (delta decrease > 0.5%). Univariate and multivariate model using logistic regression at individual level showed that initial high HbA1c levels was the only factor positively predicting improvement (OR = 1.96, CI [1.22, 3.14], p < 0.01). Univariate model at implant level demonstrated that implants placed in the anterior maxilla also contributed to significant improvement in HbA1c values. Multivariate analysis at implant level was similar to individual level. Number of missing teeth did not affect the results significantly. Conclusion: ISP delivery to partially or completely edentulous diabetic individuals may improve HbA1c balance. The mechanism awaits future elucidation.
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Affiliation(s)
- Daya Masri
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petach-Tikva 4941492, Israel; (D.M.); (L.G.)
| | - Hiba Masri-Iraqi
- Department of Endocrinology, Rabin Medical Center, Petach-Tikva 4941492, Israel;
| | - Joseph Nissan
- Department of Oral-Rehabilitation, Rabin Medical Center, Petach-Tikva 4941492, Israel;
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Carlos Nemcovsky
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Leon Gillman
- Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Petach-Tikva 4941492, Israel; (D.M.); (L.G.)
| | - Sarit Naishlos
- Department of Pedodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Liat Chaushu
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
- Correspondence:
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Liang C, Liu X, Liu C, Xu Y, Geng W, Li J. Integrin α10 regulates adhesion, migration, and osteogenic differentiation of alveolar bone marrow mesenchymal stem cells in type 2 diabetic patients who underwent dental implant surgery. Bioengineered 2022; 13:13252-13268. [PMID: 35635091 PMCID: PMC9275886 DOI: 10.1080/21655979.2022.2079254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Chao Liang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Xiu Liu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Changying Liu
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Yifan Xu
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Wei Geng
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Jun Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
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Huang T, Yu Z, Yu Q, Chen Y, Jiang Z, Wang Y, Yang G. Electrochemical deposition of lithium coating on titanium implant with enhanced early stage osseointegration. J Biomed Mater Res B Appl Biomater 2022; 110:2399-2410. [PMID: 35604032 DOI: 10.1002/jbm.b.35085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 11/10/2022]
Abstract
Recently, a large number of studies have reported that lithium (Li) displayed a positive effect on osteogenesis. However, only a few studies have investigated the Li-incorporated surfaces through electrochemical deposition. In this study, electrochemical deposition was conducted on a CHI600E electrochemical workstation. The characterization of electrochemical deposition (ECD) and ECD-Li surfaces were detected by field-emission scanning electron microscopy with energy-dispersive spectrometer. rBMSCs were cultured on two surfaces for subsequent adhesion, proliferation and live/dead assay. To evaluate the effects of Li-incorporated implants by electrochemical deposition on osseointegration in vivo, teeth extraction of two premolars and one first molar in bilateral mandible were performed on six male beagle dogs. After 3 months, ZDI and ZDI-Li implants were inserted into the bilateral mandible of each beagle dog. Micro Computed Tomography (Micro-CT) and hard tissue sectioning analysis were carried out to evaluate the osseointegration at 4- and 8-weeks post-implantation. Results showed that ECD-Li surface promoted adhesion and proliferation of BMSCs in the early stage. More importantly, through micro-CT analysis, the values of bone volume/total volume (BV/TV) (0.374 ± 0.015), bone-implant contact (BIC) (0.831 ± 0.025), and Tb.Th (0.412 ± 0.007) in ZDI-Li group was significantly higher than those of ZDI group (0.302 ± 0.009, 0.700 ± 0.023, 0.353 ± 0.001, p < .01) at 4 weeks. Similarly, ZDI-Li group manifested more bone contact with the implant surfaces at 4 weeks based on hard tissue sectioning analysis, whereas no significant difference was detected between two groups at 8 weeks. Therefore, incorporating Li into implant surface through ECD could enhance early osseointegration in vivo.
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Affiliation(s)
- Tingben Huang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhou Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Qiong Yu
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Yitong Chen
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhiwei Jiang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying Wang
- Department of Oral Medicine, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Guoli Yang
- Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
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Effects of Magnetic Stimulation on Dental Implant Osseointegration: A Scoping Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This PRISMA-ScR driven scoping review aims to evaluate the influence of magnetic field stimulation on dental implant osseointegration. Seven databases were screened adopting ad-hoc strings. All clinical and preclinical studies analyzing the effects of magnetic fields on dental implant osseointegration were included. From 3124 initial items, on the basis of the eligibility criteria, 33 articles, regarding both Pulsed ElectroMagnetic Fields (PEMF) and Static magnetic Fields from permanent Magnets (SFM) were finally included and critically analyzed. In vitro studies showed a positive effect of PEMF, but contrasting effects of SFM on bone cell proliferation, whereas cell adhesion and osteogenic differentiation were induced by both types of stimulation. In vivo studies showed an increased bone-to-implant contact rate in different animal models and clinical studies revealed positive effects on implant stability, under magnetic stimulation. In conclusion, although positive effects of magnetic exposure on osteogenesis activity and osseointegration emerged, this scoping review highlighted the need for further preclinical and clinical studies. More standardized designs, accurate choice of stimulation parameters, adequate methods of evaluation of the outcomes, greater sample size and longer follow-ups are needed to clearly assess the effect of magnetic fields on dental implant osseointegration.
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Sant’Anna HR, Casati MZ, Mussi MC, Cirano FR, Pimentel SP, Ribeiro FV, Corrêa MG. Peri-Implant Repair Using a Modified Implant Macrogeometry in Diabetic Rats: Biomechanical and Molecular Analyses of Bone-Related Markers. MATERIALS 2022; 15:ma15062317. [PMID: 35329768 PMCID: PMC8953263 DOI: 10.3390/ma15062317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023]
Abstract
DM has a high prevalence worldwide and exerts a negative influence on bone repair around dental implants. Modifications of the microgeometry of implants have been related to positive results in bone repair. This study assessed, for the first time, the influence of an implant with modified macrodesign based on the presence of a healing chamber in the pattern of peri-implant repair under diabetic conditions. Thirty Wistar rats were assigned to receive one titanium implant in each tibia (Control Implant (conventional macrogeometry) or Test Implant (modified macrogeometry)) according to the following groups: Non-DM + Control Implant; Non-DM + Test Implant; DM + Control Implant; DM + Test Implant. One month from the surgeries, the implants were removed for counter-torque, and the bone tissue surrounding the implants was stored for the mRNA quantification of bone-related markers. Implants located on DM animals presented lower counter-torque values in comparison with Non-DM ones, independently of macrodesign (p < 0.05). Besides, higher biomechanical retention levels were observed in implants with modified macrogeometry than in the controls in both Non-DM and DM groups (p < 0.05). Moreover, the modified macrogeometry upregulated OPN mRNA in comparison with the control group in Non-DM and DM rats (p < 0.05). Peri-implant bone repair may profit from the use of implants with modified macrogeometry in the presence of diabetes mellitus, as they offer higher biomechanical retention and positive modulation of important bone markers in peri-implant bone tissue.
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50
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Thim T, Scholz KJ, Hiller KA, Buchalla W, Kirschneck C, Fleiner J, Woelber JP, Cieplik F. Radiographic Bone Loss and Its Relation to Patient-Specific Risk Factors, LDL Cholesterol, and Vitamin D: A Cross-Sectional Study. Nutrients 2022; 14:864. [PMID: 35215516 PMCID: PMC8877125 DOI: 10.3390/nu14040864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
The influence of patient-specific factors such as medical conditions, low-density lipoprotein cholesterol (LDL-C) or levels of 25-hydroxyvitamin D (25OHD) on periodontal diseases is frequently discussed in the literature. Therefore, the aim of this retrospective cross-sectional study was to evaluate potential associations between radiographic bone loss (RBL) and patient-specific risk factors, particularly LDL-C and 25OHD levels. Patients from a dental practice, who received full-mouth cone beam CTs (CBCTs) and blood-sampling in the course of implant treatment planning, were included in this study. RBL was determined at six sites per tooth from CBCT data. LDL-C and 25OHD levels were measured from venous blood samples. Other patient-specific risk factors were assessed based on anamnesis and dental charts. Statistical analysis was performed applying non-parametric procedures (Mann-Whitney U tests, error rates method). Data from 163 patients could be included in the analysis. RBL was significantly higher in male patients, older age groups, smokers, patients with high DMFT (decayed/missing/filled teeth) score, lower number of teeth, and high LDL-C levels (≥160 mg/dL). Furthermore, patients with high 25OHD levels (≥40 ng/mL) exhibited significantly less RBL. In summary, RBL was found to be associated with known patient-specific markers, particularly with age and high LDL-C levels.
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Affiliation(s)
- Teresa Thim
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
- Private Practice, 63110 Rodgau, Germany
| | - Konstantin Johannes Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Jonathan Fleiner
- Center of Dental Implantology, Periodontology and 3D-Imaging, 78462 Konstanz, Germany;
| | - Johan Peter Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, 79085 Freiburg, Germany;
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (T.T.); (K.J.S.); (K.-A.H.); (W.B.)
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