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Yum H, Han HS, Kim K, Kim S, Cho YD. The cumulative survival rate of sandblasted, large-grit, acid-etched dental implants: a retrospective analysis. J Periodontal Implant Sci 2024; 54:122-135. [PMID: 37524380 PMCID: PMC11065536 DOI: 10.5051/jpis.2301440072] [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: 03/01/2023] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE This retrospective study aimed to assess the long-term cumulative survival rate of titanium, sandblasted, large-grit, acid-etched implants over a 10-year follow-up period and investigate the factors affecting the survival rate and change in marginal bone loss (MBL). METHODS The study included 400 patients who underwent dental implant placement at the Department of Periodontology of Seoul National University Dental Hospital (SNUDH) between 2005 and 2015. Panoramic radiographic images and dental records of patients were collected and examined using Kaplan-Meier analysis, Cox proportional hazards regression analysis, and multiple regression analysis to determine the survival rates and identify any factors related to implant failure and MBL. RESULTS A total of 782 implants were placed with a follow-up period ranging from 0 to 16 years (mean: 8.21±3.75 years). Overall, 25 implants were lost, resulting in a cumulative survival rate of 96.8%. Comparisons of the research variables regarding cumulative survival rate mostly yielded insignificant results. The mean mesial and distal MBLs were 1.85±2.31 mm and 1.59±2.03 mm, respectively. Factors influencing these values included age, diabetes mellitus (DM), jaw location, implant diameter, bone augmentation surgery, and prosthetic unit. CONCLUSIONS This study found that the implant survival rates at SNUDH fell within the acceptable published criteria. The patients' sex, age, DM status, implant location, implant design, implant size, surgical type, bone augmentation, and prosthetic unit had no discernible influence on long-term implant survival. Sandblasted, large-grit, acid-etched implants might offer advantages in terms of implant longevity and consistent clinical outcomes.
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Affiliation(s)
- Haeji Yum
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Kitae Kim
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
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Jolic M, Ruscsák K, Emanuelsson L, Norlindh B, Thomsen P, Shah FA, Palmquist A. Leptin receptor gene deficiency minimally affects osseointegration in rats. Sci Rep 2023; 13:15631. [PMID: 37730735 PMCID: PMC10511412 DOI: 10.1038/s41598-023-42379-5] [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: 05/24/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023] Open
Abstract
Metabolic syndrome represents a cluster of conditions such as obesity, hyperglycaemia, dyslipidaemia, and hypertension that can lead to type 2 diabetes mellitus and/or cardiovascular disease. Here, we investigated the influence of obesity and hyperglycaemia on osseointegration using a novel, leptin receptor-deficient animal model, the Lund MetS rat. Machined titanium implants were installed in the tibias of animals with normal leptin receptor (LepR+/+) and those harbouring congenic leptin receptor deficiency (LepR-/-) and were left to heal for 28 days. Extensive evaluation of osseointegration was performed using removal torque measurements, X-ray micro-computed tomography, quantitative backscattered electron imaging, Raman spectroscopy, gene expression analysis, qualitative histology, and histomorphometry. Here, we found comparable osseointegration potential at 28 days following implant placement in LepR-/- and LepR+/+ rats. However, the low bone volume within the implant threads, higher bone-to-implant contact, and comparable biomechanical stability of the implants point towards changed bone formation and/or remodelling in LepR-/- rats. These findings are corroborated by differences in the carbonate-to-phosphate ratio of native bone measured using Raman spectroscopy. Observations of hypermineralised cartilage islands and increased mineralisation heterogeneity in native bone confirm the delayed skeletal development of LepR-/- rats. Gene expression analyses reveal comparable patterns between LepR-/- and LepR+/+ animals, suggesting that peri-implant bone has reached equilibrium in healing and/or remodelling between the animal groups.
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Affiliation(s)
- Martina Jolic
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Krisztina Ruscsák
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Lena Emanuelsson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Birgitta Norlindh
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Furqan A Shah
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Anders Palmquist
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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Cherian JM, Samuel S, Sabu AM, Thomas AM, Injety RJ. Dental implants in growing patients: A quality assessment of systematic reviews. J Oral Biol Craniofac Res 2023; 13:610-615. [PMID: 37565026 PMCID: PMC10410509 DOI: 10.1016/j.jobcr.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/10/2023] [Accepted: 07/20/2023] [Indexed: 08/12/2023] Open
Abstract
Background Dental implants in the recent past have become indispensable in restoring loss of space and support as well as aiding the aesthetics. Although in practice for a few years there is no consensus on the protocols for placement and usage of dental implants in growing jaws. Objective The present study aims to evaluate evidence-based literature on single or multiple dental implant placements in children(up to 17 years) and to identify areas lacking and gaps in knowledge. The quality assessment tool,namely AMSTAR-2, will also aim to evaluate the quality of said research around paediatric dental implants. Design The study was prospectively registered on the Open Science Framework https://osf.io/e59bt/?view_only=ec8fb69455c240ecbfc7379734784bf7.For source selection, electronic searches were performed on MEDLINE, EMBASE, Scopus databases as well as Google Scholar for all English language systematic reviews and meta analysis on dental implants placed on children up to 17yrs of age by 2 reviewers, wherein the publications until December 2020 were included. A final dataset of 4 systematic reviews were incorporated and analysed using the AMSTAR-2 grading tool. Results It was seen that only one study showed moderate overall confidence while one low overall confidence as per the AMSTAR-2. The other 2 systematic reviews were of critically low confidence levels. Hence, the existing systematic reviews on the subject are not of high quality. Most of the reviews have no consensus regarding use and placement of implants in growing patients. Conclusion More research and stricter adherence to the quality assessment guidelines is recommended for all future systematic reviews regarding dental implant in children.
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Affiliation(s)
- Joe Mathew Cherian
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, 141008, India
| | - Shannon Samuel
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, 141008, India
| | - Aneeta Mary Sabu
- Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, 141008, India
| | - Abi M. Thomas
- Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, 141008, India
| | - Ranjit J. Injety
- Department of Community Medicine, Christian Medical College Ludhiana, 141008, India
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Ayele S, Sharo N, Chrcanovic BR. Marginal bone loss around dental implants: comparison between diabetic and non-diabetic patients-a retrospective clinical study. Clin Oral Investig 2023; 27:2833-2841. [PMID: 36715774 PMCID: PMC10264467 DOI: 10.1007/s00784-023-04872-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The aim of the present retrospective study was to compare the marginal bone loss (MBL) around dental implants in a group of diabetic patients in relation to a matched group of non-diabetic patients. MATERIALS AND METHODS The present dental record-based retrospective study included patients selected from individuals treated with dental implants at one specialist clinic in Malmö, Sweden. Patients were excluded if they had history of periodontitis and/or were treated for periodontal disease. The study group included 710 implants installed in 180 patients (mean age 60.3±13.0 years), 349 implants in 90 diabetic (21 T1DM and 69 T2DM patients), and 361 implants in 90 non-diabetic patients. RESULTS The results suggested that jaw (greater MBL in the maxilla), diabetes (greater MBL for diabetic patients, and worse for T1DM patients), bruxism (greater MBL for bruxers), and smoking (greater MBL for smokers and former smokers) had a statistically significant influence on MBL over time. CONCLUSIONS Patients with diabetes have an estimated greater MBL over time compared to non-diabetic patients. The difference was greater in patients with diabetes type 1 compared to patients with diabetes type 2. Bruxism, smoking, and implant location (maxilla) were also associated with a higher loss of marginal bone around implants over time. CLINICAL RELEVANCE Awareness of the possible influence of diabetes on the long-term outcomes of dental implant treatment is important, in order to be able to minimize the possibility of a high MBL with time, which can eventually lead to the loss of the implant.
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Affiliation(s)
- Sarah Ayele
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nora Sharo
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, SE-214 21 Malmö, Sweden
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D’Orto B, Polizzi E, Nagni M, Tetè G, Capparè P. Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811735. [PMID: 36142007 PMCID: PMC9517153 DOI: 10.3390/ijerph191811735] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 05/08/2023]
Abstract
The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.
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Affiliation(s)
- Bianca D’Orto
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Elisabetta Polizzi
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Center for Oral Hygiene and Prevention, Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Nagni
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Paolo Capparè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Correspondence:
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Pauletto P, Polmann H, Réus JC, de Oliveira JMD, Chaves D, Lehmkuhl K, Massignan C, Stefani CM, Martins CC, Flores-Mir C, De Luca Canto G. Critical appraisal of systematic reviews of intervention in dentistry published between 2019-2020 using the AMSTAR 2 tool. Evid Based Dent 2022:10.1038/s41432-022-0802-5. [PMID: 36104402 DOI: 10.1038/s41432-022-0802-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/11/2021] [Indexed: 06/15/2023]
Abstract
Introduction The number of systematic reviews (SRs) in dentistry published each year has grown considerably, and they have been essential in clinical decision-making and health policy.Objective The objective is to critically appraise SRs of intervention in dentistry using the 'A Measurement Tool to Assess Systematic Reviews 2' (AMSTAR 2) tool published within one year.Methods A search in the Medline/PubMed database was performed. The SRs were identified in two phases. The first phase identified SRs of interventions in dentistry by title and abstract. In the second phase, the full text was read, applying the eligibility criteria. Three calibrated reviewers methodologically assessed all SRs identified using the AMSTAR 2 tool. Data were analysed descriptively, and SRs were grouped according to methodological quality as moderate/high and low/critically low. A logistic regression model was applied to explore the associations between methodological quality and the study's characteristics.Results Two hundred and twenty-two SRs were included. The methodological quality of the SRs included in this study were: critically low (56.8%), low (27.9%), moderate (14.4%) and high (0.9%), according to AMSTAR 2. There were no statistical differences between moderate/high and low/critically low methodological quality and publication year, continent, journal Impact Factor and dental speciality.Conclusion Less than 1% of recently published SRs in dentistry were classified with high methodological quality. We hope that this study will alert researchers about the need to improve the methodological quality of SRs.
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Affiliation(s)
- Patrícia Pauletto
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil; Dentistry Faculty, Universidad de Las Américas (UDLA), Quito, Ecuador.
| | - Helena Polmann
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Jéssica Conti Réus
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Júlia Meller Dias de Oliveira
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Débora Chaves
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Karyn Lehmkuhl
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Carla Massignan
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Cristine Miron Stefani
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Carolina Castro Martins
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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7
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Kim YM, Lee JB, Um HS, Chang BS, Lee JK. Long-term effect of implant-abutment connection type on marginal bone loss and survival of dental implants. J Periodontal Implant Sci 2022; 52:496-508. [PMID: 36468468 PMCID: PMC9807847 DOI: 10.5051/jpis.2200960048] [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: 02/07/2022] [Revised: 05/02/2022] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE This study aimed to compare the long-term survival rate and peri-implant marginal bone loss between different types of dental implant-abutment connections. METHODS Implants with external or internal abutment connections, which were fitted at Gangneung-Wonju National University Dental Hospital from November 2011 to December 2015 and followed up for >5 years, were retrospectively investigated. Cumulative survival rates were evaluated for >5 years, and peri-implant marginal bone loss was evaluated at 1- and 5-year follow-up examinations after functional loading. RESULTS The 8-year cumulative survival rates were 93.3% and 90.7% in the external and internal connection types, respectively (P=0.353). The mean values of marginal bone loss were 1.23 mm (external) and 0.72 mm (internal) (P<0.001) after 1 year of loading, and 1.20 mm and 1.00 mm for external and internal abutment connections, respectively (P=0.137) after 5 years. Implant length (longer, P=0.018), smoking status (heavy, P=0.001), and prosthetic type (bridge, P=0.004) were associated with significantly greater marginal bone loss, and the use of screw-cement-retained prosthesis was significantly associated (P=0.027) with less marginal bone loss. CONCLUSIONS There was no significant difference in the cumulative survival rate between implants with external and internal abutment connections. After 1 year of loading, marginal bone loss was greater around the implants with an external abutment connection. However, no significant difference between the external and internal connection groups was found after 5 years. Both types of abutment connections are viable treatment options for the reconstruction of partially edentulous ridges.
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Affiliation(s)
- Young-Min Kim
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Jong-Bin Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Heung-Sik Um
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Beom-Seok Chang
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
| | - Jae-Kwan Lee
- Department of Periodontology and Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
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Diehl D, Winkler M, Bilhan H, Friedmann A. Implant stability of narrow diameter implants in hyperglycemic patients-A 3-month case-control study. Clin Exp Dent Res 2022; 8:969-975. [PMID: 35578391 PMCID: PMC9382047 DOI: 10.1002/cre2.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this prospective case-control study was to compare the development of implant stability quotients of narrow diameter implants in patients with type 2 diabetes mellitus (T2DM) and healthy individuals within the first 3 months after implant insertion. METHODS Sixteen patients with T2DM (HbA1C > 6.5%) as test group and 16 nondiabetic patients (HbA1C < 5.9%) as the control group were evaluated. All patients received narrow-diameter tissue level implants in an edentulous area posterior to the canine. The implant stability was measured by means of resonance frequency analysis after 3 days, 7 days, 4 weeks, and 3 months postplacement. Statistical analysis of intergroup differences and correlation to HbA1c values and treated jaw was performed in PRISM 8. RESULTS The means for implant stability quotients showed a significant increase between Day 3 and 3-month assessment in both groups. No significant differences between study groups and no correlation of implant stability to HbA1c were found. CONCLUSION The present study shows encouraging clinical outcomes for narrow-diameter implants inserted in the posterior zone in patients with uncontrolled T2DM.
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Affiliation(s)
- Daniel Diehl
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany.,Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Marianna Winkler
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Saito N, Mikami R, Mizutani K, Takeda K, Kominato H, Kido D, Ikeda Y, Buranasin P, Nakagawa K, Takemura S, Ueno T, Hosaka K, Hanawa T, Shinomura T, Iwata T. Impaired dental implant osseointegration in rat with streptozotocin-induced diabetes. J Periodontal Res 2022; 57:412-424. [PMID: 35037248 DOI: 10.1111/jre.12972] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/03/2021] [Accepted: 01/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Few studies have reported on the impact of oxidative stress on the dental implant failure. The aim of this study was to investigate the impact of hyperglycemia-induced oxidative stress on dental implant osseointegration in diabetes mellitus (DM). METHODS Acid-treated titanium implants were bilaterally placed in the maxillary alveolar ridge of streptozotocin-induced diabetic (DM group) and control rats after extraction of first molars. Histological analysis and micro-push-out test were performed 4 weeks after surgery. Oxidative stress and osteogenic markers in the surrounding bone were quantified by real-time polymerase chain reaction. In the in vitro study, rat bone marrow-derived mesenchymal stem cells (BMMSCs) were cultured on acid-treated titanium discs in a high-glucose (HG) or normal environment. Intracellular reactive oxygen species (ROS), cell proliferation, alkaline phosphatase (ALP) activity, and extracellular calcification were evaluated following antioxidant treatment with N-acetyl-L-cysteine (NAC). RESULTS The implant survival rate was 92.9% and 75.0% in control and DM group, respectively. Bone-implant contact and push-out loads were significantly lower in the DM group. Expression of superoxide dismutase 1 at the mRNA level and on immunohistochemistry was significantly lower in the DM group. In vitro experiments revealed that the HG condition significantly increased ROS expression and suppressed the proliferation and extracellular calcification of BMMSCs, while NAC treatment significantly restored ROS expression, cell proliferation, and calcification. The ALP activity of both groups was not significantly different. CONCLUSION In diabetes, high-glucose-induced oxidative stress downregulates proliferation and calcification of BMMSCs, impairing osseointegration and leading to implant failure.
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Affiliation(s)
- Natsumi Saito
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kohei Takeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiromi Kominato
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Daisuke Kido
- Oral Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Ikeda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Prima Buranasin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Keita Nakagawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shu Takemura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takeshi Ueno
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keiichi Hosaka
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Regenerative Dental Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takao Hanawa
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tamayuki Shinomura
- Department of Tissue Regeneration, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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10
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Systematic review on diabetes mellitus and dental implants: an update. Int J Implant Dent 2022; 8:1. [PMID: 34978649 PMCID: PMC8724342 DOI: 10.1186/s40729-021-00399-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.
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Nourah D, Aldahlawi S, Andreana S. Should the Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on Implant Survival. Curr Diabetes Rev 2022; 18:e060821195367. [PMID: 34365929 DOI: 10.2174/1573399817666210806120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used is as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. AIM This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less than optimal glycemic control. DISCUSSION Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. CONCLUSION In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.
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Affiliation(s)
- Dalia Nourah
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
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Friedmann A, Winkler M, Diehl D, Yildiz MS, Bilhan H. One-year performance of posterior narrow diameter implants in hyperglycemic and normo-glycemic patients-a pilot study. Clin Oral Investig 2021; 25:6707-6715. [PMID: 33939006 PMCID: PMC8602141 DOI: 10.1007/s00784-021-03957-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of the study was to compare the performance of narrow diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals during the first 12 months after implant loading. MATERIAL AND METHODS In 16 T2DM patients with HbA1C > 6.5% (test group) and 16 normo-glycemic patients (HbA1C < 6.0%; control group), one to two narrow diameter tissue level implants were placed in the posterior maxilla or mandible. After 3-month lasting integration period, implants were loaded by fixed dentures. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession and papilla bleeding index (PBI) were assessed manually at loading and after 12 months of function. The paired digital periapical radiographs were analyzed with regard to the change in marginal bone level (MBL) from baseline to 12 months' control. The mean values calculated for both patient groups were statistically analyzed. The technical complications were recorded. RESULTS The T2DM group accounted 13 patients due to 3 dropouts. The overall implant survival rate after 12 months was 100%. The differences in means for the clinical parameters and the MBL were statistically non-significant between the T2DM and normo-glycemic patients for the short period of loaded function reported here. No technical complications were recorded. CONCLUSIONS The study demonstrated an encouraging clinical outcome with narrow diameter implants in patients with uncontrolled T2DM compared to non-diabetics after 12 months post loading. For the short observation period, no biological and technical complications were reported regardless the glycemic status. CLINICAL RELEVANCE Patients with HbA1C > 6.5% may benefit from the treatment with narrow diameter implants by avoiding complex surgical interventions with augmentation procedures. TRIAL REGISTRATION Clinicaltrials.gov : NCT04630691.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Marianna Winkler
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Daniel Diehl
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Stockumer Straße 10, 58453 Witten, Germany
| | - Mehmet Selim Yildiz
- Department of Periodontology, Faculty of Dentistry, Altınbaş University, Zuhuratbaba, İncirli Cd. No:11-A, 34147 Bakırköy, Istanbul, Turkey
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
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Factors Affecting Implant Failure and Marginal Bone Loss of Implants Placed by Post-Graduate Students: A 1-Year Prospective Cohort Study. MATERIALS 2020; 13:ma13204511. [PMID: 33053722 PMCID: PMC7601912 DOI: 10.3390/ma13204511] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 01/25/2023]
Abstract
Statement of the problem: Most of the clinical documentation of implant success and survival published in the literature have been issued by either experienced teams from university settings involving strict patient selection criteria or from seasoned private practitioners. By contrast, studies focusing on implants placed and rehabilitated by inexperienced post-graduate students are scarce. Purpose: To record failure rates and identify the contributing factors to implant failure and marginal bone loss (MBL) of implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up. Material and Methods: A prospective cohort study was conducted on study participants scheduled for implant therapy at the International University of Catalonia. An experienced mentor determined the treatment plan in accordance with the need of each participant who signed an informed consent. All surgeries and prosthetic rehabilitation were performed by the post-graduate students. Implant failure rate, contributors to implant failure, and MBL were investigated among 24 variables related to patient health, local site, and implant and prosthetic characteristics. The risk of implant failure was analyzed with a simple binary logistic regression model with generalized equation equations (GEE) models, obtaining unadjusted odds ratios (OR). The relationship between MBL and the other independent variables was studied by simple linear regression estimated with GEE models and the Wald chi2 test. Results: One hundred and thirty dental implants have been placed and rehabilitated by post-graduate students. Five implants failed before loading and none after restoration delivery; survival and success rates were 96.15% and 94.62%, respectively. None of the investigated variables significantly affected the implant survival rate. At the one-year follow-up, the mean (SD) MBL was 0.53 (0.39) mm. The following independent variables significantly affected the MBL: Diabetes, implant depth placement. The width of keratinized tissue (KT) and probing depth (PD) above 3 mm were found to be good indicators of MBL, with each additional mm of probing depth resulting in 0.11 mm more MBL. Conclusion: The survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up were high. No contributing factor was identified regarding implant failure. However, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and width of KT. Clinical Implications: Survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students were high at the one-year follow-up, similar to experienced practitioners. No contributing factors were identified regarding implant failure; however, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and KM.
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Storman M, Storman D, Jasinska KW, Swierz MJ, Bala MM. The quality of systematic reviews/meta-analyses published in the field of bariatrics: A cross-sectional systematic survey using AMSTAR 2 and ROBIS. Obes Rev 2020; 21:e12994. [PMID: 31997545 DOI: 10.1111/obr.12994] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/24/2019] [Accepted: 12/09/2019] [Indexed: 12/17/2022]
Abstract
High-quality systematic reviews (SR) and meta-analyses (MA) are considered to be reliable sources of information. This study aims to assess the quality of studies published as SR or MA in the field of bariatrics in 2016 and 2017. We identified SR and MA in the field of bariatrics by searching electronic databases (MEDLINE, Embase, and Cochrane Database of Systematic Reviews). Eligible studies were those identified as SR/MA in the title/abstract, which aimed to assess any outcome in patients with morbid obesity undergoing or scheduled to undergo bariatric surgery. Two authors independently reviewed all titles and abstracts, assessed full texts of potentially eligible studies, and assessed the quality of included studies. Any discrepancies were resolved by the third reviewer. We evaluated the quality and risk of bias of each SR/MA using AMSTAR 2 checklist and ROBIS tool, respectively. Seventy-eight of 4236 references met inclusion criteria and were assessed for their quality/risk of bias. The methodological quality of 99% of all papers was classified as "critically low." A total of 6% of the studies were at low risk of bias, and 78% were assessed as being at high risk of bias. The methodological quality of studies published in 2016 and 2017 as SR/MA is highly unsatisfactory.
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Affiliation(s)
- Monika Storman
- Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland
| | - Dawid Storman
- Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Katarzyna W Jasinska
- Students' Research Group, Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz J Swierz
- Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Malgorzata M Bala
- Systematic Reviews Unit, Jagiellonian University Medical College, Krakow, Poland.,Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland.,Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
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