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Li JTW, Leung YY. Effect of Antiresorptive Drugs on Osseointegrated Dental Implants: A Systematic Review. J Clin Med 2024; 13:2091. [PMID: 38610856 PMCID: PMC11012270 DOI: 10.3390/jcm13072091] [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: 02/19/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: This systematic review aimed to evaluate the impact of antiresorptive drug therapy on osseointegrated dental implants and the association with medication-related osteonecrosis of the jaw (MRONJ). Methods: A systematic search, including a computer search of several databases with specific keywords, a reference search, and a manual search of four key maxillofacial journals were performed. Relevant articles were then evaluated and those that fulfilled the five predetermined criteria were chosen to enter the final review. A total of 445 implants in 135 subjects were included in the eight studies analyzed in the final review. Results: The failure rate of dental implants after antiresorptive medication in the included studies was 23%, with 83% of failures attributed to MRONJ. The average time from antiresorptive drug initiation to MRONJ development was approximately 34 months, ranging from 3 months to 16 years. The majority of MRONJ cases were classified as stage 2, and all sites showed either complete healing or substantial mucosal coverage after treatment. Conclusions: This review highlights the significant impact of antiresorptive drugs on osseo- integrated implants, with MRONJ identified as a leading cause of implant failure. The potential role of peri-implantitis as a trigger for MRONJ is emphasized. Regular monitoring and maintaining good periodontal health, especially within the first three years of antiresorptive drug therapy initiation, are crucial for implant success. Physicians and dentists should provide comprehensive information to patients prescribed with antiresorptive drugs, emphasizing the need for an awareness of the risks of MRONJ in the context of osseointegrated implants. A longer term of follow-up is recommended to identify and manage MRONJ around dental implants in an early manner.
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Affiliation(s)
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong;
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2
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Quintão Manhanini Souza E, Felipe Toro L, Franzão Ganzaroli V, de Oliveira Alvarenga Freire J, Matsumoto MA, Casatti CA, Tavares Ângelo Cintra L, Leone Buchaim R, Mardegan Issa JP, Gouveia Garcia V, Theodoro LH, Ervolino E. Peri-implantitis increases the risk of medication-related osteonecrosis of the jaws associated with osseointegrated implants in rats treated with zoledronate. Sci Rep 2024; 14:627. [PMID: 38182598 PMCID: PMC10770413 DOI: 10.1038/s41598-023-49647-4] [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: 07/30/2023] [Accepted: 12/11/2023] [Indexed: 01/07/2024] Open
Abstract
This study evaluated the peri-implant tissues under normal conditions and under the influence of experimental peri-implantitis (EPI) in osseointegrated implants installed in the maxillae of rats treated with oncologic dosage of zoledronate. Twenty-eight senescent female rats underwent the extraction of the upper incisor and placement of a titanium dental implant (DI). After eight weeks was installated a transmucosal healing screw on DI. After nine weeks, the following groups were formed: VEH, ZOL, VEH-EPI and ZOL-EPI. From the 9th until the 19th, VEH and VEH-EPI groups received vehicle and ZOL and ZOL-EPI groups received zoledronate. At the 14th week, a cotton ligature was installed around the DI in VEH-EPI and ZOL-EPI groups to induce the EPI. At the 19th week, euthanasia was performed, and the maxillae were processed so that at the implanted sites were analyzed: histological aspects and the percentage of total bone tissue (PTBT) and non-vital bone tissue (PNVBT), along with TNFα, IL-1β, VEGF, OCN and TRAP immunolabeling. ZOL group presented mild persistent peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling, but lower for VEGF, OCN and TRAP in comparison with VEH group. ZOL-EPI group exhibited exuberant peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling when compared with ZOL and VEH-EPI groups. Zoledronate disrupted peri-implant environment, causing mild persistent inflammation and increasing the quantity of non-vital bone tissue. Besides, associated with the EPI there were an exacerbated inflammation and even greater increase in the quantity of non-vital bone around the DI, which makes this condition a risk factor for medication-related osteonecrosis of the jaws.
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Affiliation(s)
| | - Luan Felipe Toro
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Vinícius Franzão Ganzaroli
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Jéssica de Oliveira Alvarenga Freire
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Mariza Akemi Matsumoto
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Cláudio Aparecido Casatti
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | | | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil
| | - João Paulo Mardegan Issa
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, PR, Brazil
| | - Leticia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
- Institute of Biosciences, São Paulo State University (UNESP), Botucatu, SP, Brazil.
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3
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Yong CW, Sng TJH, Choo SHJ, Chew JRJ, Islam I. Implant presence-triggered osteonecrosis: A scoping review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101759. [PMID: 38184196 DOI: 10.1016/j.jormas.2024.101759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024]
Abstract
Unlike medication-related osteonecrosis of the jaw (MRONJ), implant presence-triggered osteonecrosis of the jaw (IPTO) is not well appreciated. Recent reports have suggested a mechanical aetiology unique to osseointegrated dental implants that may be responsible for this phenomenon. A scoping review was performed to consolidate the available evidence. Two reviewers independently searched the PubMed, EMBASE, CINAHL, and Cochrane Library databases. The study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for scoping reviews. Studies that described or evaluated the development of IPTO in osseointegrated implants, which were placed prior to the commencement of anti-resorptive or anti-angiogenic agents, were included. Twenty-three (23) articles were included in this study. Patient characteristics, aetiopathogenesis, presentation, and treatment of the disease were evaluated. Most studies suggested a 6-month period between dental implant insertion and the commencement of anti-resorptive therapy as a criterion for IPTO. Both infective and mechanical processes were reported to be involved in the pathogenesis of IPTO. Most patients required surgical intervention to achieve resolution. While there are several knowledge gaps regarding IPTO, the evidence points towards a continuum in the pathogenesis of the disease, whereby there is a mechanical cause followed by secondary infection. Similar to typical MRONJ, the severity and treatment required also vary. Persistent peri‑implantitis features around a dental implant should alert the clinician to the possibility of IPTO in patients taking anti-resorptive or anti-angiogenic agents. Prompt identification of the disease may play a role in timely management or appropriate referrals.
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Affiliation(s)
- Chee Weng Yong
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Timothy Jie Han Sng
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Sophia Hui Jia Choo
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Jacob Ren Jie Chew
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Intekhab Islam
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
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4
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Shelegova IG, Nurieva NS. [Medication-related osteonecrosis of the jaws associated with the use of bone-modifying agents]. STOMATOLOGIIA 2024; 103:59-62. [PMID: 38372609 DOI: 10.17116/stomat202410301159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
The relevance of the study is associated with the widespread use of osteomodifying agents in patients with bone metastases and osteoporosis. Bisphosphonates and other osteo-modifying agents are widely used in oncology and prevention of age-related changes in the human bone system. The use, therapeutic effects and complications of therapy with osteo modifying agents are being investigated all over the world. However, the etiology and pathogenesis of drug-induced osteonecrosis of the jaws (MONCH) have not been fully studied, in this regard, the study of risk factors and mechanisms of its development remains relevant. New data on the etiology and pathogenesis of drug-induced osteonecrosis are presented. The literature review is carried out on the electronic resource PubMed.
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Affiliation(s)
- I G Shelegova
- South-Urals State Medical University, Chelyabinsk, Russia
| | - N S Nurieva
- South-Urals State Medical University, Chelyabinsk, Russia
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5
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Ramanauskaite A, Krüger N, Obreja K, Borchert F, Dahmer I, Schwarz F. Influence of antiresorptive/antiangiogenic therapy on the surgical treatment outcomes of experimentally induced peri-implantitis lesions. Clin Oral Investig 2023; 27:6657-6666. [PMID: 37783801 PMCID: PMC10630228 DOI: 10.1007/s00784-023-05275-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE To investigate the influence of various antiresorptive and antiangiogenic medications on the resolution of experimentally induced peri-implantitis lesions after different surgical treatment approaches. MATERIALS AND METHODS Forty-eight albino rats randomly received a dual application of the following medications: (1) amino-bisphosphonate (zoledronate (Zo)) (n = 8), (2) RANKL inhibitor (denosumab (De)) (n = 8), (3) antiangiogenic (bevacizumab (Be)) (n = 8), (4) Zo + Be (n = 8), (5) De + Be (n = 8), or (6) no medication (control (Co)) (n = 8). Ligature-induced peri-implantitis lesions were established at 2 maxillary implants over 16 weeks. Afterward, animals were randomly treated either with open flap debridement (OFD) or reconstructive therapy (RT). Treatment procedures were followed by a 12-week healing period. The histological outcomes included residual defect length (DL); defect width (DW) at the bone crest (BC-DW); 25%, 50%, and 75% of the DL; and areas of inflammatory cell infiltrate (ICT). When present, areas of bone sequester (BS) were assessed considering the animal as a statistical unit. RESULTS A total of 21 animals were analyzed (Zo: RT = 3, OFD = 1; De: RT = 3, OFD = 2; Be: OFD = 1; Zo + Be: RT = 2, OFD = 2; Co: RT = 3, OFD = 2). Implant loss rates were comparable among the experimental groups. Except for the 25% and 75% DW values that were significantly higher in the Zo + Be group compared to the Co group (p = 0.04 and p = 0.03, respectively), no significant differences were found among the experimental groups for the DL (lowest-Be: 0.56 mm; highest-Co: 1.05 mm), BC-DW (lowest-De: 0.86 mm, highest-Co: 1.07 mm), 50% DW (lowest-De: 0.86 mm; highest-Be + Zo: 1.29 mm), and ICT (lowest-Be: 0.56 mm2; highest-Be + Zo: 1.65 mm2). All groups, except for the Zo and Be following RT, showed presence of BS. CONCLUSIONS The present findings did not reveal a marked effect of various antiresorptive/antiangiogenic medications on the resolution of experimentally induced peri-implantitis lesions, regardless of the surgical approach employed (OFD and RT). CLINICAL RELEVANCE Resolution of peri-implantitis lesions may not be affected by the investigated antiresorptive/antiangiogenic medications.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Nadine Krüger
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Fanya Borchert
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Iulia Dahmer
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Theodor-Stern-Kai 7, Building 29, 60596, Frankfurt am Main, Germany.
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6
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Al-Omari FA, Kuroshima S, Sawase T. Medication-related Osteonecrosis of the Jaw Induced by Regenerative Therapy in Implant Dentistry: A Scoping Review. J Dent 2023; 138:104682. [PMID: 37708930 DOI: 10.1016/j.jdent.2023.104682] [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: 06/24/2023] [Revised: 08/11/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES There is limited scientific evidence regarding the medication-related osteonecrosis of the jaw (MRONJ) induced by regenerative therapy (RT) associated with dental implant treatment. Thus, the current scoping review systematically maps the MRONJ research induced by RTs in implant dentistry and recognizes the existing gaps in knowledge. DATA Original studies and reviews investigating the impact of RT on the development of MRONJ were included. SOURCES Two reviewers independently searched the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to March 31, 2023. STUDY SELECTION Eighteen articles that fulfilled the inclusion and exclusion criteria were included in this study. Ten mapping parameters for investigating the association of RTs with MRONJ development were examined and evaluated within the selected articles. RESULTS There was severely limited information regarding the procedures of RTs including; the grafting materials, surgical protocols, and success and failure rates. The RT associated with MRONJ cases was sinus floor augmentation in patients taking bisphosphonate and denosumab. Moreover, there were limited data on the implant treatment associated with RTs such as time of insertion, implant length and diameter, and loading protocol. CONCLUSION The current scoping review revealed that some specific RTs associated with other factors hold a potential risk of MRONJ occurrence. However, the scientific evidence is limited with many gaps. Further investigations are needed to establish an evidence-based clinical guideline for treating high-risk patients. CLINICAL SIGNIFICANCE Clinicians should cautiously assess the risk of MRONJ development during implant treatment planning for patients undertaking antiresorptive medications. The adverse outcome of RT procedures should not be underestimated and a complete explanation of the possible risks should be given to the patients.
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Affiliation(s)
- Farah A Al-Omari
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
| | - Shinichiro Kuroshima
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan.
| | - Takashi Sawase
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8588, Japan
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7
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Yoshino T, Seki K, Nagasaki M, Kamimoto A. Peri-implant osteonecrosis of the jaw in a patient prescribed selective estrogen receptor modulators. J Dent Sci 2023; 18:1939-1940. [PMID: 37799902 PMCID: PMC10548008 DOI: 10.1016/j.jds.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/15/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Tona Yoshino
- Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery I, Nihon University School of Dentistry, Tokyo, Japan
| | - Keisuke Seki
- Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
- Division of Dental Education, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Maki Nagasaki
- Department of Oral and Maxillofacial Surgery I, Nihon University School of Dentistry, Tokyo, Japan
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
| | - Atsushi Kamimoto
- Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
- Division of Dental Education, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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8
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Landi L, Leali PT, Barbato L, Carrassi AM, Discepoli N, Muti PCM, Oteri G, Rigoni M, Romanini E, Ruggiero C, Tarantino U, Varoni E, Sforza NM, Brandi ML. Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP). J Orthop Traumatol 2023; 24:36. [PMID: 37453950 DOI: 10.1186/s10195-023-00713-7] [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: 03/08/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023] Open
Abstract
This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon inflammation. Available evidence shows the relationship among osteoporosis, AR agents, periodontitis and implant therapy in relation to the incidence of MRONJ. Uncontrolled periodontitis may lead to tooth loss and to the need to replace teeth with dental implants. Tooth extraction and surgical dental procedures are recognized as the main risk factors for developing MRONJ in individuals taking AR therapy for osteometabolic conditions. Although the incidence of MRONJ in osteometabolic patients taking AR therapy may be as low as 0.9%, the increasing prevalence of osteoporosis and the high prevalence of periodontitis suggest that this potential complication should not be overlooked. Good clinical practice (GCP) guidelines are proposed that aim at a more integrated approach (prescriber, dentist, periodontist and dental hygienist) in the management of periodontitis patients undergoing AR therapy for osteometabolic disorders to reduce the risk of MRONJ. Dental professional and prescribers should educate patients regarding the potential risk associated with the long-term use of AR therapy and oral health behavior.
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Affiliation(s)
- L Landi
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy.
- Private Practice Verona and Roma, Verona, Italy.
| | - P Tranquilli Leali
- SIOT Panel, Rome, Italy
- Department of Orthopedic Diseases, University of Sassari, Sassari, Italy
| | - L Barbato
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Experimental and Clinical Medicine, Research Unit in Periodontology and Periodontal Medicine, University of Florence, Florence, Italy
| | - A M Carrassi
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - N Discepoli
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Medical Biotechnologies, Unit of Periodontology, University of Siena, Siena, Italy
| | - P C M Muti
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Oteri
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - M Rigoni
- SIOT Panel, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - E Romanini
- SIOT Panel, Rome, Italy
- RomaPro, Polo Sanitario San Feliciano, Rome, Italy
| | - C Ruggiero
- SIOT Panel, Rome, Italy
- Department of Medicine and Surgery, Gerontology and Geriatric Section, University of Perugia, Perugia, Italy
| | - U Tarantino
- SIOT Panel, Rome, Italy
- Department of Clinical Sciences and Translational Medicine, "Tor Vergata" University of Rome, Rome, Italy
| | - E Varoni
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - N M Sforza
- SIdP Panel, Via della Balduina 114, 00136, Rome, Italy
- Private Practice Bologna, Bologna, Italy
| | - M L Brandi
- SIOT Panel, Rome, Italy.
- Osservatorio Fratture da Fragilità, Via San Gallo 123, 50100, Florence, Italy.
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Schwarz F, Becker K, Lukman F, Müller KM, Sarabhai V, Rauch N, Kerberger R, Ramanauskaite A, Sader R, Obreja K. Influence of antiresorptive/antiangiogenic therapy on the extension of experimentally induced peri-implantitis lesions. Clin Oral Investig 2023; 27:3009-3019. [PMID: 36800025 PMCID: PMC10264532 DOI: 10.1007/s00784-023-04904-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVES To investigate the extension of experimentally induced peri-implantitis lesions under various antiresorptive and antiangiogenic medications. MATERIAL AND METHODS Fourty-eight albino rats had randomly received the following medications (dual application, n = 8 each): (1) amino-bisphosphonate (zoledronate) (Zo), (2) RANKL inhibitor (denosumab) (De), (3) antiangiogenic (bevacizumab) (Be), (4) Zo+Be, (5) De+Be, or (6) no medication (Co). Ligature- and lipopolysaccharide-induced peri-implantitis lesions were established at 2 maxillary implants over a period of 16 weeks. Histological (e.g., apical extension and surface area of the inflammatory cell infiltrate-aICT, ICT; defect length; defect width; CD68 positive cells) and bone micromorphometric (μCT) outcomes were assessed. The animal was defined as a statistical unit. RESULTS A total of n = 38 animals (Zo = 6, De = 6, Be = 8, Zo + Be = 6, De + Be = 5, Co = 7) were analyzed. ICT's were commonly marked by a positive CD68 antigen reactivity. Comparable median aICT (lowest-Zo: 0.53 mm; highest-Be: 1.22 mm), ICT (lowest-De + Be: 0.00 mm2; highest-Co: 0.49 mm2), defect length (lowest-Zo: 0.90 mm; highest-Co: 1.93 mm) and defect width (lowest-De+Be: 1.27 mm; highest-Be: 1.80 mm) values were noted in all test and control groups. Within an inner (diameter: 0.8 mm) cylindric volume of interest, the bone microstructure did not significantly differ between groups. CONCLUSIONS The present analysis did not reveal any marked effects of various antiresorptive/ antiangiogenic medications on the extension of experimentally induced peri-implantitis lesions. CLINICAL RELEVANCE The extension of peri-implantitis lesions may not be facilitated by the antiresorptive and antiangiogenic medications investigated.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany.
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Fanya Lukman
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
| | | | - Victoria Sarabhai
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Kerberger
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University, Frankfurt am Main, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Frankfurt am Main, Germany
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10
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Ageing-Associated Transcriptomic Alterations in Peri-Implantitis Pathology: A Bioinformatic Study. DISEASE MARKERS 2022; 2022:8456968. [PMID: 36267464 PMCID: PMC9578877 DOI: 10.1155/2022/8456968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
Abstract
Background Ageing is associated with increased incidence of peri-implantitis but the roles of ageing-associated biological mechanisms in the occurrence of peri-implantitis are not known. This study is aimed at performing integrative bioinformatic analysis of publically available datasets to uncover molecular mechanisms related to ageing and peri-implantitis. Methods Gene expression datasets related to ageing and peri-implantitis (PI) were sought, and differentially expressed genes (DEGs) were analysed. Ageing-related genes were also identified from the “Aging Atlas” database. Using intersection analysis, an age-related-PI gene set was identified. Functional enrichment analysis for enriched GO biological process and KEGG pathways, protein-protein interaction (PPI) network analysis, correlation analysis, and immune cell infiltration analysis to determine high-abundance immune cells were performed. Least absolute shrinkage and selection operator (LASSO) logistic regression identified key age-related-PI genes. Transcription factor-gene and drug-gene interactions and enriched KEGG pathways for the key age-related-PI genes were determined. Results A total of 52 genes were identified as age-related-PI genes and found enriched in several inflammation-associated processes including myeloid leukocyte activation, acute inflammatory response, mononuclear cell differentiation, B cell activation, NF-kappa B signalling, IL-17 signalling, and TNF signalling. LYN, CDKN2A, MAPT, BTK, and PRKCB were hub genes in the PPI network. Immune cell infiltration analysis showed activated dendritic cells, central memory CD4 T cells, immature dendritic cells, and plasmacytoid dendritic cells were highly abundant in PI and ageing. 7 key age-related PI genes including ALOX5AP, EAF2, FAM46C, GZMK, MAPT, RGS1, and SOSTDC1 were identified using LASSO with high predictive values and found to be enriched in multiple neurodegeneration-associated pathways, MAPK signalling, and Fc epsilon RI signalling. MAPT and ALOX5AP were associated with multiple drugs and transcription factors and interacted with other age-related genes to regulate multiple biological pathways. Conclusion A suite of bioinformatics analysis identified a 7-signature gene set highly relevant to cooccurrence of ageing and peri-implantitis and highlighted the role of neurodegeneration, autoimmune, and inflammation related pathways. MAPT and ALOX5AP were identified as key candidate target genes for clinical translation.
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Seki K, Hagiwara Y. Peri-implantitis-induced medication-related osteonecrosis of the jaw: A case report. J Dent Sci 2022; 17:576-577. [PMID: 35028087 PMCID: PMC8739731 DOI: 10.1016/j.jds.2021.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 07/19/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Keisuke Seki
- Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan.,Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, Tokyo, Japan
| | - Yoshiyuki Hagiwara
- Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, Japan
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Ueda N, Imada M, Kato Y, Okuda N, Nakaue K, Horita S, Kinoshita S, Kasahara K, Kirita T. Bevacizumab-associated implant presence-triggered osteonecrosis: A case report and literature review. J ORAL IMPLANTOL 2021; 48:325-331. [PMID: 34313770 DOI: 10.1563/aaid-joi-d-21-00155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of bevacizumab-related osteonecrosis of the jaw on previously osseointegrated dental implants has not been adequately studied. Here, we report a case of osteonecrosis of the jaw detected around dental implants placed prior to bevacizumab therapy. A 66-year-old woman undergoing bevacizumab therapy for metastatic triple-negative breast cancer, developed malocclusion following buccal gingival swelling and pain in the #18, #19, and #20 tooth region. The patient visited a local dental clinic, where existing implants in relation to #19 and #20 were removed. Subsequently, the patient visited our department, and intraoral examination revealed necrotic bone in the region corresponding to #19 and #20. Radiographic examination showed a pathological fracture in this region that was considered to result from osteonecrosis of the jaw. Bevacizumab therapy was suspended temporarily till the acute inflammation had subsided. In addition, treatment with antibacterial agents and conservative surgery was considered. Complete soft tissue coverage was observed 14 days following surgery. In recent years, the number of patients receiving bevacizumab treatment has increased. Since bevacizumab-related osteonecrosis of the jaw could occur around previously osseointegrated dental implants as well, this case report suggests an effective treatment regimen based on a combination of antibacterial agents and conservative surgery.
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Affiliation(s)
- Nobuhiro Ueda
- Nara Medical University School of Medicine Graduate School of Medicine: Nara Kenritsu Ika Daigaku Igakubu Igakuka Daigakuin Igaku Kenkyuka Oral and Maxillofacial Surery Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan JAPAN Nara Kashihara 634-8522 Nara Medical University School of Medicine Graduate School of Medicine: Nara Kenritsu Ika Daigaku Igakubu Igakuka Daigakuin Igaku Kenkyuka
| | - Mitsuhiko Imada
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Yui Kato
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Nao Okuda
- Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Kazuhiko Nakaue
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Satoshi Horita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Sayuri Kinoshita
- Department of Medical Technology Center, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan
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