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Pathak A, Dhamande MM, Gujjelwar S, Sonar PR, Tawade SU, Gupta A. Basal Implant Placement in the Anterior Aesthetic Zone: A Case Report. Cureus 2024; 16:e61782. [PMID: 38975416 PMCID: PMC11227428 DOI: 10.7759/cureus.61782] [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: 05/08/2024] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Aesthetics are one of the primary goals of restorative care. Teeth that are traumatized in the anterior maxilla usually avulse or require extraction due to fractures. Rehabilitation is challenging in such a therapeutic state since it presents several anatomical and aesthetic issues. There are circumstances in which traditional implant placement is problematic. There must be enough bone for implant placement to be uneventful and successful. Other surgical therapies may be necessary in addition to implant placement for certain operations, such as extensive grafting, direct or indirect sinus lifts, and nerve lateralization. Certain procedures are required for these operations but are not always achievable. Because single-piece basal implants provide immediate temporization and loading while receiving adequate anchoring from the basal cortical bone, they have been extensively used to rehabilitate resorbed ridges. This case report demonstrates the placement of the basal implant in the anterior zone.
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Affiliation(s)
- Ankita Pathak
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mithilesh M Dhamande
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Smruti Gujjelwar
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasanna R Sonar
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shubham U Tawade
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aashish Gupta
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ivanovski S, Lee RSB, Fernandez-Medina T, Pinto N, Andrade C, Quirynen M. Impact of autologous platelet concentrates on the osseointegration of dental implants. Periodontol 2000 2024. [PMID: 38647020 DOI: 10.1111/prd.12563] [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: 11/10/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
Osseointegration is defined as the direct deposition of bone onto biomaterial devices, most commonly composed from titanium, for the purpose of anchoring dental prostheses. The use of autologous platelet concentrates (APC) has the potential to enhance this process by modifying the interface between the host and the surface of the titanium implant. The rationale is to modify the implant surface and implant-bone interface via "biomimicry," a process whereby the deposition of the host's own proteins and extracellular matrix enhances the biocompatibility of the implant and hence accelerates the osteogenic healing process. This review of the available evidence reporting on the effect of APC on osseointegration explores in vitro laboratory studies of the interaction of APC with different implant surfaces, as well as the in vivo and clinical effects of APC on osseointegration in animal and human studies. The inherent variability associated with using autologous products, namely the unique composition of each individual's blood plasma, as well as the great variety in APC protocols, combination of biomaterials, and clinical/therapeutic application, makes it is difficult to make any firm conclusions about the in vivo and clinical effects of APC on osseointegration. The available evidence suggests that the clinical benefits of adding PRP and the liquid form of L-PRF (liquid fibrinogen) to any implant surface appear to be limited. The application of L-PRF membranes in the osteotomy site, however, may produce positive clinical effects at the early stage of healing (up to 6 weeks), by promoting early implant stability and reducing marginal bone loss, although no positive longer term effects were observed. Careful interpretation and cautious conclusions should be drawn from these findings as there were various limitations in methodology. Future studies should focus on better understanding of the influence of APCs on the biomaterial surface and designing controlled preclinical and clinical studies using standardized APC preparation and application protocols.
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Affiliation(s)
- Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Ryan S B Lee
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Tulio Fernandez-Medina
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Nelson Pinto
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Catherine Andrade
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven (Periodontology), University Hospitals Leuven, Leuven, Belgium
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R SA, Inbarajan A, Ks A, Raju K, Ks M. Esthetic Rehabilitation of a Young Patient With Immediately Loaded Single-Piece Basal Implants Following a Trauma Involving the Anterior Maxilla: Case Report With Five-Year Follow-Up. Cureus 2023; 15:e42782. [PMID: 37664316 PMCID: PMC10469946 DOI: 10.7759/cureus.42782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Traumatic injuries to the anterior maxilla usually lead to loss of teeth by means of avulsion or extraction due to fracture. Rehabilitation of such a clinical scenario is complex as it involves various anatomic and esthetic challenges. Single-piece basal implants have been widely used in the rehabilitation of resorbed ridges because they gain adequate anchorage from the basal cortical bone, allowing immediate temporization or loading. However, the use of basal implants in the anterior esthetic zone is not much documented. This case report with a five-year follow-up period describes the rehabilitation of lost teeth in the anterior esthetic zone of the anterior maxilla caused due to trauma following a train accident using single-piece axial basal implants with immediate temporization.
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Affiliation(s)
- Shakir Ahmed R
- Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Athiban Inbarajan
- Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Anusha Ks
- Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Kapil Raju
- Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Maheshwaran Ks
- Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Sivakumar I, Arunachalam S, Mahmoud Buzayan M, Sharan J. Does the use of platelet-rich plasma in sinus augmentation improve the survival of dental implants? A systematic review and meta-analysis. J Oral Biol Craniofac Res 2023; 13:57-66. [PMID: 36465890 PMCID: PMC9712696 DOI: 10.1016/j.jobcr.2022.11.002] [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: 08/04/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Platelet-rich plasma is considered an effective modality to promote bone regeneration, improve hard and soft tissue healing in surgical procedures including sinus augmentation. However, the survival of dental implants in sinus augmented sites with platelet-rich plasma has shown equivocal results in recent studies. Purpose In this systematic review, data on dental implants' survival in sinus augmentation sites with platelet-rich plasma were examined. Materials and methods Randomized controlled trials on the topic with a minimum mean follow-up of 6 months with no language restriction were considered. Other study designs on the topic were excluded. Accordingly, relevant articles were searched in Clinicaltrials.gov, Cochrane databases, PubMed/Medline, and Scopus up to April 2021. Using the Cochrane risk of bias assessment tool, the listed studies' risk of bias was evaluated. From the included studies, the pertinent information was taken and pooled for qualitative and quantitative analysis using R software 4.1.1. Results Six randomized controlled trials involving 188 patients who underwent sinus augmentation with and without platelet-rich plasma, and 781 implants were included for qualitative and quantitative analysis. Four hundred and eleven implants were placed in the intervention group (with platelet-rich plasma) and 370 implants were placed in the control group (without platelet-rich plasma). The pooled estimate (OR 0.84, 95% CI 0.37 to 1.91; I2 = 0%) indicated that there was no statistically significant difference observed between the groups. The test for subgroup differences showed no statistically significant differences between the subgroups (p = 0.45) with no heterogeneity (I2 = 0%). Conclusion The bias associated with selective reporting of outcome data was considered as some concern for bias. This systematic review revealed that the effect of platelet-rich plasma is uncertain on the survival of dental implants.
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Sun J, Hu Y, Fu Y, Zou D, Lu J, Lyu C. Emerging roles of platelet concentrates and platelet-derived extracellular vesicles in regenerative periodontology and implant dentistry. APL Bioeng 2022; 6:031503. [PMID: 36061076 PMCID: PMC9439711 DOI: 10.1063/5.0099872] [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: 05/19/2022] [Accepted: 08/08/2022] [Indexed: 11/14/2022] Open
Abstract
Platelet concentrates (PCs) are easily obtained from autogenous whole blood after centrifugation and have evolved through three generations of development to include platelet-rich plasma, platelet-rich fibrin, and concentrated growth factor. Currently, PCs are widely used for sinus floor elevation, alveolar ridge preservation, periodontal bone defects, guided bone regeneration, and treatment of gingival recession. More recently, PCs have been leveraged for tissue regeneration to promote oral soft and hard tissue regeneration in implant dentistry and regenerative periodontology. PCs are ideal for this purpose because they have a high concentration of platelets, growth factors, and cytokines. Platelets have been shown to release extracellular vesicles (P-EVs), which are thought to be essential for PC-induced tissue regeneration. This study reviewed the clinical application of PCs and P-EVs for implant surgery and periodontal tissue regeneration.
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Affiliation(s)
- Jiayue Sun
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yinghan Hu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yinxin Fu
- Wuhan Fourth Hospital, Wuhan, Hubei 430032, China
| | - Derong Zou
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Jiayu Lu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Chengqi Lyu
- Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Mijiritsky E, Assaf HD, Kolerman R, Mangani L, Ivanova V, Zlatev S. Autologous Platelet Concentrates (APCs) for Hard Tissue Regeneration in Oral Implantology, Sinus Floor Elevation, Peri-Implantitis, Socket Preservation, and Medication-Related Osteonecrosis of the Jaw (MRONJ): A Literature Review. BIOLOGY 2022; 11:biology11091254. [PMID: 36138733 PMCID: PMC9495871 DOI: 10.3390/biology11091254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022]
Abstract
Simple Summary Autologous platelet concentrates with high growth factor levels are used in many fields of dentistry. In recent years, the critical role of blood-derived materials in bone and soft tissue engineering has become apparent. After tooth extraction, the alveolar bone is exposed to progressive bone resorption, which can lead to difficulties in implant placement. Hence, many studies have demonstrated that APCs have the potential for soft tissue and bone regeneration. Furthermore, no inflammatory reactions occur, and they may be used alone or in combination with bone grafts, promoting bone growth and maturation. Moreover, the released growth factors and the presence of fibrin structures can induce osteogenesis. This review aims to provide information regarding the applications, indications, advantages, and disadvantages of three APC techniques in hard tissue regeneration. Abstract Over recent years, the usage of autologous platelet concentrates (APCs) has risen in hard tissue regeneration and oral implantology. The purpose of the present review is to offer an overview of the use of three APC techniques in dentistry: platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and concentrated growth factor (CGF). A narrative summary of articles published between January 2011 and April 2022 is provided. The PubMed, Cochrane Library, Scopus, and Embase databases were used to conduct the search. The following keywords were used in the preliminary: “VEGF”, “TGF-b1”, “PRP”, “PRF”, “CGF”, AND “sinus augmentation” OR “implants” OR “peri-implantitis” OR “socket preservation” OR “MRONJ”. A total of 82 articles was finally included. The review then takes into account the application of the three techniques in different areas of treatment—including oral implantology, sinus floor elevation, peri-implantitis, socket preservation, and medication-related osteonecrosis of the jaw (MRONJ)—as well as their advantages and disadvantages.
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Affiliation(s)
- Eitan Mijiritsky
- Head and Neck Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Department of Otolaryngology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 699350, Israel
| | - Haya Drora Assaf
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Roni Kolerman
- Department of Periodontology and Oral Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Luca Mangani
- Department of Translational Medicine and Clinical Science, University of Tor Vegata, 00133 Rome, Italy
| | - Vasilena Ivanova
- Oral Surgery Department, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
- Correspondence:
| | - Stefan Zlatev
- CAD/CAM Center of Dental Medicine at the Research Institute, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
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