1
|
Yang KR, Hong MH. Improved Biocompatibility and Osseointegration of Nanostructured Calcium-Incorporated Titanium Implant Surface Treatment (XPEED ®). MATERIALS (BASEL, SWITZERLAND) 2024; 17:2707. [PMID: 38893971 PMCID: PMC11173531 DOI: 10.3390/ma17112707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.
Collapse
Affiliation(s)
- Kyung Ran Yang
- Daegu Mir Dental Hospital, Jung-gu, Daegu 41934, Republic of Korea;
| | - Min-Ho Hong
- Department of Dental Laboratory Science, College of Health Sciences, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan 46252, Republic of Korea
| |
Collapse
|
2
|
Lv PX, Zhong JS, Ouyang XY, Iao S, Liu J, Xie Y. Investigation of peri-implant diseases prevalence and related risk indicators in patients with treated severe periodontitis over 4 years after restoration. J Dent Sci 2024; 19:894-899. [PMID: 38618128 PMCID: PMC11010623 DOI: 10.1016/j.jds.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/11/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose History of periodontitis is a well-documented risk indicator of peri-implantitis. However, the influence of severity of periodontitis is still unclear, especially for severe periodontitis. This study was aimed to investigate the prevalence of peri-implant disease and analyze the risk indicators in patients with treated severe periodontitis. Materials and methods A total of 182 implants from 88 patients (44 males and 44 females) with severe periodontitis with a mean fellow-up period of 76.5 months were enrolled in this study. Patient and implant information, and periodontal and peri-implant conditions were collected to evaluate the prevalence of peri-implant disease and risk indicators. Results The prevalence of peri-implantitis was 9.1% and 6.6% at the patient-level and implant-level. The prevalence of peri-implant mucositis was 76.1% and 51.1% at the patient-level and implant-level. Risk indicators of peri-implantitis included older age (OR: 1.132), poor proximal cleaning habits (OR: 14.218), implants in anterior area (OR: 10.36), poor periodontal disease control (OR: 12.76), high peri-implant plaque index (OR: 4.27), and keratinized tissue width (KTW)<2 mm (OR: 19.203). Conclusion Implants in patients with severe periodontitis after periodontal treatment and maintenance show a low prevalence (9.1%) of peri-implantitis and a relatively high prevalence (76.2%) of peri-implant mucositis. Patient age, peri-implant proximal cleaning habits, implant position, periodontal disease control, peri-implant plaque index, and KTW are associated with prevalence of peri-implantitis.
Collapse
Affiliation(s)
| | | | - Xiang-Ying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology Beijing, China
| | - Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology Beijing, China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology Beijing, China
| | - Ying Xie
- Department of Periodontology, Peking University School and Hospital of Stomatology Beijing, China
| |
Collapse
|
3
|
Retrospective Study of the Association between Peri-Implantitis and Keratinized Mucosa. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12146980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
1. Background: Peri-implantitis affects a high percentage of patients treated with dental implants. Among the risk factors that can cause this pathology, limited evidence exists regarding the absence of keratinized mucosa. The main objective of this study was to compare the amount of keratinized mucosa around healthy implants versus implants in patients with peri-implantitis, in order to analyze its influence on esthetics and the development of this pathology, and to study the possible influence of keratinized mucosa on various clinical parameters. 2. Methods: A retrospective case-control study was carried out in which 203 implants were evaluated, 103 of which presented a healthy peri-implant state, versus 100 which had peri-implantitis. The following elements were recorded: keratinized mucosa, recession, plaque index, bleeding, suppuration, probing depth, and bone level. 3. Results: Keratinized mucosa was present in 51% of the peri-implantitis group versus 97.1% of the healthy implants. In implants without keratinized mucosa, both recession and plaque index, bleeding on probing (96.2%), suppuration (57.7%), mean probing depth and bone level were higher. Implants without keratinized mucosa presented worse esthetics. 4. Conclusions: Absence of Keratinized mucosa around dental implants seems to be associated with the appearance of peri-implantitis modifying certain clinical parameters: there is a greater probability of recession, bleeding, suppuration, deficient hygiene, greater probing depth and greater bone loss in implants without keratinized mucosa.
Collapse
|
4
|
Serrano B, Sanz-Sánchez I, Serrano K, Montero E, Sanz M. One-year outcomes of dental implants with a hybrid surface macro-design placed in patients with history of periodontitis: A randomized clinical trial. J Clin Periodontol 2021; 49:90-100. [PMID: 34881442 DOI: 10.1111/jcpe.13575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the radiological, clinical, and microbiological outcomes of implants with a hybrid surface macro-design in patients with a history of periodontitis. MATERIAL AND METHODS The study was designed as a 12-month, parallel-arm, randomized controlled trial where patients with a history of treated periodontitis in need of dental implants for single-unit or short-span prosthesis were randomly allocated to a test [implants with a machined titanium surface in the coronal collar (hybrid; HS)] or a control group [conventional implants with moderately rough surface up to the implant shoulder (RS)]. Patients were followed at 3, 6, and 12 months after loading with assessment of radiological, clinical, and microbiological outcomes, as well as patient-related outcome measures (PROMs). RESULTS Forty patients were randomly assigned to either the RS group (n = 20) or the HS (n = 20) group. At 1 year, the mean marginal bone level changes were 0.22 [standard deviation (SD) 0.36] mm for the HS group and 0.22 (SD 0.29) mm for the RS group, with no significant differences between them (p = .961). Similarly, no significant differences in clinical, microbiological, or PROMs were observed between groups. CONCLUSIONS HS implants demonstrated radiographic, clinical, and microbiological characteristics equal to RS implants in patients with a history of periodontitis. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (identifier NCT05010382).
Collapse
Affiliation(s)
- Benjamín Serrano
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Katherine Serrano
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain
| | - Eduardo Montero
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| |
Collapse
|
5
|
Sommer U, Laurich S, de Azevedo L, Viehoff K, Wenisch S, Thormann U, Alt V, Heiss C, Schnettler R. In Vitro and In Vivo Biocompatibility Studies of a Cast and Coated Titanium Alloy. Molecules 2020; 25:E3399. [PMID: 32727093 PMCID: PMC7436028 DOI: 10.3390/molecules25153399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/13/2022] Open
Abstract
The biocompatibility of a cast porous and with a calcium titanate reaction layer functionalized titanium alloy (Ti-6Al-7Nb) was tested by means of cell culture, and a small (rat) and large animal (sheep) model. The uncoated titanium material served as a control. In-vitro tests included the validation of osteoblast-like cells attached to the surface of the material with scanning electron microscopy and immunofluorescence of cytoskeletal actin as well as their osteogenic development, the ability to mineralize, and their vitality. Following the in-vitro tests a small animal (rat) and big animal (sheep) model were accomplished by inserting a cylindrical titanium implant into a drill hole defect in the femoral condyle. After 7, 14, and 30 days (rat) and 6 months (sheep) the condyles were studied regarding histological and histomorphometrical characteristics. Uncoated and coated material showed a good biocompatibility both in cell culture and animal models. While the defect area in the rat is well consolidated after 30 days, the sheep show only little bone inside the implant after 6 months, possibly due to stress shielding. None of the executed methods indicated a statistically significant difference between coated and uncoated material.
Collapse
Affiliation(s)
- Ursula Sommer
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
| | - Stephan Laurich
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
| | - Lucie de Azevedo
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
| | - Katharina Viehoff
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
| | - Sabine Wenisch
- Clinic of Small Animals, c/o Institute of Veterinary Anatomy, Histology and Embryology, Justus-Liebig-University Giessen, Frankfurter Strasse 98, 35392 Giessen, Germany;
| | - Ulrich Thormann
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany;
| | - Christian Heiss
- Experimental Trauma Surgery, Justus-Liebig-University Giessen, Aulweg 128 (ForMED), 35392 Giessen, Germany; (S.L.); (L.d.A.); (K.V.); (U.T.); (C.H.)
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen-Marburg GmbH, Campus Giessen, Rudolf-Buchheim-Str. 7, 35385 Giessen, Germany
| | - Reinhard Schnettler
- Department of Oral and Maxillofacial Surgery, Division for Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| |
Collapse
|
6
|
Enhancement of Bone Ingrowth into a Porous Titanium Structure to Improve Osseointegration of Dental Implants: A Pilot Study in the Canine Model. MATERIALS 2020; 13:ma13143061. [PMID: 32650581 PMCID: PMC7412235 DOI: 10.3390/ma13143061] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022]
Abstract
A porous titanium structure was suggested to improve implant stability in the early healing period or in poor bone quality. This study investigated the effect of a porous structure on the osseointegration of dental implants. A total of 28 implants (14 implants in each group) were placed in the posterior mandibles of four beagle dogs at 3 months after extraction. The control group included machined surface implants with an external implant–abutment connection, whereas test group implants had a porous titanium structure added to the apical portion. Resonance frequency analysis (RFA); removal torque values (RTV); and surface topographic and histometric parameters including bone-to-implant contact length and ratio, inter-thread bone area and ratio in total, and the coronal and apical parts of the implants were measured after 4 weeks of healing. RTV showed a significant difference between the groups after 4 weeks of healing (p = 0.032), whereas no difference was observed in RFA. In the test group, surface topography showed bone tissue integrated into the porous structures. In the apical part of the test group, all the histometric parameters exhibited significant increases compared to the control group. Within the limitations of this study, enhanced bone growth into the porous structure was achieved, which consequently improved osseointegration of the implant.
Collapse
|
7
|
Monje A, Blasi G. Significance of keratinized mucosa/gingiva on peri‐implant and adjacent periodontal conditions in erratic maintenance compliers. J Periodontol 2018; 90:445-453. [DOI: 10.1002/jper.18-0471] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/05/2018] [Accepted: 11/18/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Alberto Monje
- Department of Oral Surgery and StomatologyZMK School of Dental MedicineUniversity of Bern Bern Switzerland
- Department of PeriodontologyInternational University of Catalonia Barcelona Spain
| | - Gonzalo Blasi
- Department of PeriodontologyInternational University of Catalonia Barcelona Spain
- Division of PeriodontologyUniversity of Maryland School of Dentistry Baltimore MD USA
| |
Collapse
|
8
|
Spinato S, Bernardello F, Sassatelli P, Zaffe D. Hybrid and fully-etched surface implants in periodontally healthy patients: A comparative retrospective study on marginal bone loss. Clin Implant Dent Relat Res 2017; 19:663-670. [DOI: 10.1111/cid.12504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/12/2017] [Accepted: 05/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Paolo Sassatelli
- Department of Engineering “Enzo Ferrari”; University of Modena and Reggio Emilia; Modena Italy
| | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences; University of Modena and Reggio Emilia; Modena Italy
| |
Collapse
|
9
|
Bellone G, Vizio B, Scirelli T, Emanuelli G. A Xenogenic Bone Derivative as a Potential Adjuvant for Bone Regeneration and Implant Osseointegration: An In Vitro Study. Tissue Eng Regen Med 2017; 14:243-251. [PMID: 30603481 DOI: 10.1007/s13770-017-0029-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/31/2016] [Accepted: 06/04/2016] [Indexed: 12/18/2022] Open
Abstract
Several clinical conditions may limit the success of bone regeneration and/or implant osseointegration. For this reason, many compounds have been tested for their ability to stimulate this biological process. Synthetic hydroxyapatite (HA), mimicking natural bone hydroxyapatite, and extra-cellular matrix proteins, such as type I collagen, are potential candidates. However, the synthetic origin of HA and the denaturing conditions required for extracting collagen from skin and derma are sources of potential drawbacks. This study examines the in vitro effects of a natural bone derivative (NBD) extracted from equine bone and containing both natural, non-synthetic bone hydroxyapatite and native, non-denatured, type I bone collagen as a possible active compound for stimulating bone regeneration and implant osseointegration. The activity of NBD was tested on bone marrow stromal cells (BMSCs), evaluating their growth/viability by the methylthiazol tetrazolium (MTT) assay and their migration potential by a scratch assay. Moreover, expression of the hyaluronic acid receptor (CD44) and the C-X-C chemokine receptor type 4 (CXCR4, CD184) on the surface of BMSCs was assessed by flow cytometry, and the release of Transforming Growth Factor (TGF)-β, Interleukin (IL)-1α and IL-6 was quantified using an enzyme-linked immunosorbent assay (ELISA). The effect of NBD-coated implants on human osteoblasts was tested by measuring alkaline phosphatase (ALP) activity with the p-nitrophenyl phosphate (pNPP) degradation test. NBD stimulated BMSC growth/viability, migration, CD184 surface expression and the release of TGF-β1. NBD-coated implants increased ALP activity of human osteoblasts. These results indicate that NBD may be an adjuvant to accelerate both bone regeneration and osseointegration.
Collapse
Affiliation(s)
- Graziella Bellone
- Department of Medical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy
| | - Barbara Vizio
- Department of Medical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy
| | - Tiziana Scirelli
- Department of Medical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy
| | - Giorgio Emanuelli
- Department of Medical Sciences, University of Turin, Via Genova 3, 10126 Turin, Italy
| |
Collapse
|
10
|
Schwarz F, Sculean A, Engebretson SP, Becker J, Sager M. Animal models for peri-implant mucositis and peri-implantitis. Periodontol 2000 2017; 68:168-81. [PMID: 25867986 DOI: 10.1111/prd.12064] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2014] [Indexed: 11/30/2022]
Abstract
The treatment of infectious diseases affecting osseointegrated implants in function has become a demanding issue in implant dentistry. Since the early 1990s, preclinical data from animal studies have provided important insights into the etiology, pathogenesis and therapy of peri-implant diseases. Established lesions in animals have shown many features in common with those found in human biopsy material. The current review focuses on animal studies, employing different models to induce peri-implant mucositis and peri-implantitis.
Collapse
|
11
|
Valente NA, Andreana S. Peri-implant disease: what we know and what we need to know. J Periodontal Implant Sci 2016; 46:136-51. [PMID: 27382503 PMCID: PMC4928203 DOI: 10.5051/jpis.2016.46.3.136] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/14/2016] [Indexed: 12/31/2022] Open
Abstract
Peri-implant disease is a serious problem that plagues today's dentistry, both in terms of therapy and epidemiology. With the expansion of the practice of implantology and an increasing number of implants placed annually, the frequency of peri-implant disease has greatly expanded. Its clinical manifestations, in the absence of a globally established classification, are peri-implant mucositis and peri-implantitis, the counterparts of gingivitis and periodontitis, respectively. However, many doubts remain about its features. Official diagnostic criteria, globally recognized by the dental community, have not yet been introduced. The latest studies using metagenomic methods are casting doubt on the assumption of microbial equivalence between periodontal and peri-implant crevices. Research on most of the features of peri-implant disease remains at an early stage; moreover, there is not a commonly accepted treatment for it. In any case, although the evidence so far collected is limited, we need to be aware of the current state of the science regarding this topic to better understand and ultimately prevent this disease.
Collapse
Affiliation(s)
- Nicola Alberto Valente
- Department of Periodontics and Endodontics, State University of New York at Buffalo School of Dental Medicine, Buffalo, NY, USA
| | - Sebastiano Andreana
- Department of Restorative Dentistry, State University of New York at Buffalo School of Dental Medicine, Buffalo, NY, USA
| |
Collapse
|
12
|
Namgoong H, Kim MD, Ku Y, Rhyu IC, Lee YM, Seol YJ, Gu HJ, Susin C, Wikesjö UME, Koo KT. Bone reconstruction after surgical treatment of experimental peri-implantitis defects at a sandblasted/acid-etched hydroxyapatite-coated implant: an experimental study in the dog. J Clin Periodontol 2015; 42:960-6. [DOI: 10.1111/jcpe.12457] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Hee Namgoong
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | | | - Young Ku
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | - In-Chul Rhyu
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | - Yong Moo Lee
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | - Yang Jo Seol
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | - Hee jin Gu
- Implant R&D Center; Osstem Implant Inc.; Busan Korea
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University; College of Dental Medicine; Augusta GA USA
| | - Ulf ME Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration (LAPCR); Georgia Regents University; College of Dental Medicine; Augusta GA USA
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| |
Collapse
|
13
|
Robitaille N, Reed D, Walters J, Kumar P. Periodontal and peri-implant diseases: identical or fraternal infections? Mol Oral Microbiol 2015; 31:285-301. [DOI: 10.1111/omi.12124] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 01/04/2023]
Affiliation(s)
- N. Robitaille
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - D.N. Reed
- Division of General Practice and Material Sciences
| | - J.D. Walters
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| | - P.S. Kumar
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
| |
Collapse
|
14
|
Mustafa A, Lung CYK, Mustafa NS, Mustafa BA, Kashmoola MA, Zwahlen RA, Matinlinna JP. EPA-coated titanium implants promote osteoconduction in white New Zealand rabbits. Clin Oral Implants Res 2014; 27:303-9. [PMID: 25393376 DOI: 10.1111/clr.12525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the effect of eicosapentaenoic acid (EPA)-coated Ti implants on osteoconduction in white New Zealand rabbit mandibles. MATERIAL AND METHODS Sandblasted and cleansed planar titanium specimens with a size of 5 × 5 × 1 mm were coated on one side with 0.25 vol% eicosapentaenoic acid (EPA). The other side of the specimens was kept highly polished (the control side). These specimens were inserted in rabbit mandibles. Twelve rabbits were randomly assigned into three study groups (n = 4). The rabbits were sacrificed at 4, 8, and 12 weeks. The harvested specimens with the implants were assessed for new bone formation on both sides of the implant using CBCT, conventional radiographs, and the biaxial pullout test. The results were statistically analyzed by a nonparametric Kruskal-Wallis test and Friedman's test as multiple comparisons and by Brunner-Langer nonparametric mixed model approach (R Software). RESULTS A significant osteoconductive bone formation was found on the EPA-coated Ti implant surface (P < 0.05) at 8 weeks when compared to the polished surface (control). Biaxial pullout test results showed a significant difference (P < 0.05) after 8 and 12 weeks with a maximum force of 243.8 N, compared to 143.25 N after 4 week. CONCLUSION EPA implant coating promoted osteoconduction on the Ti implant surfaces, enhancing the anchorage of the implant to the surrounding bone in white New Zealand rabbits.
Collapse
Affiliation(s)
- Ammar Mustafa
- Dental Materials Science, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Dental Materials Science, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia.,ISF Medical Unit, Doha, Qatar
| | - Christie Y K Lung
- Dental Materials Science, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Dental Materials Science, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Nazih S Mustafa
- Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Besma A Mustafa
- Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Muhannad A Kashmoola
- Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Roger A Zwahlen
- Oral and Maxillo-Facial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Jukka P Matinlinna
- Dental Materials Science, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Dental Materials Science, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| |
Collapse
|
15
|
Hwang JW, Lee EU, Lee JS, Jung UW, Lee IS, Choi SH. Dissolution behavior and early bone apposition of calcium phosphate-coated machined implants. J Periodontal Implant Sci 2013; 43:291-300. [PMID: 24455442 PMCID: PMC3891861 DOI: 10.5051/jpis.2013.43.6.291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 10/09/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose Calcium phosphate (CaP)-coated implants promote osseointegration and survival rate. The aim of this study was to (1) analyze the dissolution behavior of the residual CaP particles of removed implants and (2) evaluate bone apposition of CaP-coated machined surface implants at the early healing phase. Methods Mandibular premolars were extracted from five dogs. After eight weeks, the implants were placed according to drilling protocols: a nonmobile implant (NI) group and rotational implant (RI) group. For CaP dissolution behavior analysis, 8 implants were removed after 0, 1, 2, and 4 weeks. The surface morphology and deposition of the coatings were observed. For bone apposition analysis, block sections were obtained after 1-, 2-, and 4-week healing periods and the specimens were analyzed. Results Calcium and phosphorus were detected in the implants that were removed immediately after insertion, and the other implants were composed mainly of titanium. There were no notable differences between the NI and RI groups in terms of the healing process. The bone-to-implant contact and bone density in the RI group showed a remarkable increase after 2 weeks of healing. Conclusions It can be speculated that the CaP coating dissolves early in the healing phase and chemically induces early bone formation regardless of the primary stability.
Collapse
Affiliation(s)
- Ji-Wan Hwang
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Eun-Ung Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - In-Seop Lee
- Institute of Physics & Applied Physics, Atomic-Scale Surface Science Research Center, Yonsei University, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
16
|
Lin GH, Chan HL, Wang HL. The Significance of Keratinized Mucosa on Implant Health: A Systematic Review. J Periodontol 2013; 84:1755-67. [DOI: 10.1902/jop.2013.120688] [Citation(s) in RCA: 256] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
17
|
Brito C, Tenenbaum HC, Wong BKC, Schmitt C, Nogueira-Filho G. Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature. J Biomed Mater Res B Appl Biomater 2013; 102:643-50. [DOI: 10.1002/jbm.b.33042] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/19/2013] [Accepted: 08/28/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Carlos Brito
- Department of Preventive; University of Toronto; Toronto Ontario Canada
| | | | | | - Christian Schmitt
- Department of Oral and Maxillofacial Surgery; University of Erlangen-Nuremberg; Erlangen Germany
| | | |
Collapse
|
18
|
Implant surface factors and bacterial adhesion: a review of the literature. Int J Artif Organs 2013; 35:762-72. [PMID: 23138699 DOI: 10.5301/ijao.5000154] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2012] [Indexed: 12/22/2022]
Abstract
The microbiota that forms on implant surfaces placed in the human body can be highly resistant to antimicrobial agents and in some cases cause life-threatening infections. Consequently, to limit bacterial attachment to these surfaces and thereby minimize the risk of implant infection, the process of biofilm formation and bacterial attachment must be well-understood. The oral environment is considered to be an excellent model for research into biofilm formation and implant infection, accounting for many studies carried out in the field of dental medicine. Those studies show that the roughness, free energy, and material characteristics of the implant surface largely determine initial bacterial adhesion. This article reviews the relevant literature on these aspects of biofilm formation.
Collapse
|
19
|
Buyukozdemir Askin S, Berker E, Akincibay H, Uysal S, Erman B, Tezcan İ, Karabulut E. Necessity of keratinized tissues for dental implants: a clinical, immunological, and radiographic study. Clin Implant Dent Relat Res 2013; 17:1-12. [PMID: 23631746 DOI: 10.1111/cid.12079] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Necessity of keratinized tissues (KTs) for maintaining health around dental implants (DIs) remains as a controversial issue. PURPOSE The aim of this study was to investigate the effects of KT width (KTW) on peri-implant tissues by evaluating peri-implant clinical and inflammatory parameters. MATERIALS AND METHODS Sixty DIs were included in this 6-month longitudinal study. After classifying DI based on the presence of KTs at the buccal aspect as with adequate/inadequate KTW, DIs were randomly assigned into three study groups. In the first group, while free gingival graft (FGG) was performed, DIs in maintenance (M) group were followed up by standardized maintenance procedures at baseline, first, third, and sixth months as with DI with adequate KTW (Control). Clinical parameters, peri-implant sulcular fluid (PISF) volume, PISF Interleukin 1β concentration, and bone loss were analyzed. RESULTS Significant improvements in clinical and immunological parameters were noted only for FGG for the whole study period. Statistical differences detected between the treatment groups (FGG vs M) were for gingival index at all time points and for PISF volume at sixth month. For the other parameters evaluated, while lower values were observed for FGG, statistically no differences were noted between the groups. CONCLUSIONS Based on the results of this study, it can be suggested that FGG performed around DIs lacking KT is a reliable method, leading to significant improvements in clinical and inflammatory parameters. Further long-term studies including more DIs are needed to clarify the role of KT on maintenance of DIs.
Collapse
|
20
|
Wennström JL, Derks J. Is there a need for keratinized mucosa around implants to maintain health and tissue stability? Clin Oral Implants Res 2012; 23 Suppl 6:136-46. [DOI: 10.1111/j.1600-0501.2012.02540.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jan L. Wennström
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
| | - Jan Derks
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg; Sweden
| |
Collapse
|
21
|
Haenle M, Lindner T, Ellenrieder M, Willfahrt M, Schell H, Mittelmeier W, Bader R. Bony integration of titanium implants with a novel bioactive calcium titanate (Ca4Ti3O10) surface treatment in a rabbit model. J Biomed Mater Res A 2012; 100:2710-6. [DOI: 10.1002/jbm.a.34186] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 03/03/2012] [Accepted: 03/12/2012] [Indexed: 11/09/2022]
|
22
|
Schwarz F, Iglhaut G, Becker J. Quality assessment of reporting of animal studies on pathogenesis and treatment of peri-implant mucositis and peri-implantitis. A systematic review using the ARRIVE guidelines. J Clin Periodontol 2012; 39 Suppl 12:63-72. [DOI: 10.1111/j.1600-051x.2011.01838.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| | | | - Jürgen Becker
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf; Germany
| |
Collapse
|
23
|
Esper LA, Ferreira SB, de Oliveira Fortes Kaizer R, de Almeida ALPF. The Role of Keratinized Mucosa in Peri-Implant Health. Cleft Palate Craniofac J 2012; 49:167-70. [DOI: 10.1597/09-022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants. Design Cross-section. Setting Institutional tertiary referral hospital. Patients A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites). Main Outcome Measures All clinical parameters were correlated with the width of keratinized mucosa around the implants. Results The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width. Conclusion Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.
Collapse
Affiliation(s)
- Luis Augusto Esper
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Samuel Barros Ferreira
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | | | | |
Collapse
|
24
|
Lee SY, Yang DJ, Yeo S, An HW, Ryoo KH, Park KB. The cytocompatibility and osseointegration of the Ti implants with XPEED® surfaces. Clin Oral Implants Res 2011; 23:1283-9. [PMID: 22093072 DOI: 10.1111/j.1600-0501.2011.02304.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study evaluated cytocompatibility and osseointegration of the titanium (Ti) implants with resorbable blast media (RBM) surfaces produced by grit-blasting or XPEED(®) surfaces by coating of the nanostructured calcium. MATERIAL AND METHODS Ti implants with XPEED(®) surfaces were hydrothermally prepared from Ti implants with RBM surfaces in a solution containing alkaline calcium. The surface characteristics were evaluated by using a scanning electron microscope (SEM) and surface roughness measuring system. Apatite formation was measured with SEM after immersion in modified-simulated body fluid and the amount of calcium released was measured by inductively coupled plasma optical emission. The cell proliferation was investigated by MTT assay and the cell attachment was evaluated by SEM in MC3T3-E1 pre-osteoblast cells. Thirty implants with RBM surfaces and 30 implants with XPEED(®) surfaces were placed in the proximal tibiae and in the femoral condyles of 10 New Zealand White rabbits. The osseointegration was evaluated by a removal torque test in the proximal tibiae and by histomorphometric analysis in the femoral condyles 4 weeks after implantation. RESULTS The Ti implants with XPEED(®) surfaces showed a similar surface morphology and surface roughness to those of the Ti implants with RBM surfaces. The amount of calcium ions released from the surface of the Ti implants with XPEED(®) surfaces was much more than the Ti implants with RBM surfaces (P < 0.05). The cell proliferation and cell attachment of the Ti implants showed a similar pattern to those of the Ti implants with RBM surfaces (P > 0.1). Apatite deposition significantly increased in all surfaces of the Ti implants with XPEED(®) surfaces. The removable torque value (P = 0.038) and percentage of bone-to-implant contact (BIC%) (P = 0.03) was enhanced in the Ti implants with XPEED(®) surfaces. CONCLUSION The Ti implants with XPEED(®) surfaces significantly enhanced apatite formation, removal torque value, and the BIC%. The Ti implants with XPEED(®) surfaces may induce strong bone integration by improving osseointegration of grit-blasted Ti implants in areas of poor quality bone.
Collapse
Affiliation(s)
- Sun-Young Lee
- Department of Biobusiness, Megagen Implant, Gyeongsan si, Gyeongsangbuk-do, South Korea
| | | | | | | | | | | |
Collapse
|
25
|
Zetterqvist L, Feldman S, Rotter B, Vincenzi G, Wennström JL, Chierico A, Stach RM, Kenealy JN. A Prospective, Multicenter, Randomized-Controlled 5-Year Study of Hybrid and Fully Etched Implants for the Incidence of Peri-Implantitis. J Periodontol 2010; 81:493-501. [DOI: 10.1902/jop.2009.090492] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
26
|
Wikesjö UME, Qahash M, Huang YH, Xiropaidis A, Polimeni G, Susin C. Bone morphogenetic proteins for periodontal and alveolar indications; biological observations - clinical implications. Orthod Craniofac Res 2009; 12:263-70. [PMID: 19627529 DOI: 10.1111/j.1601-6343.2009.01461.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Surgical placement of endosseous oral implants is governed by the prosthetic design and by the morphology and quality of the alveolar bone. Nevertheless, often implant placement may be complexed, if at all possible, by alveolar ridge irregularities resulting from periodontal disease, and chronic and acute trauma. In consequence, implant positioning commonly necessitates bone augmentation procedures. One objective of our laboratory is to evaluate the biologic potential of bone morphogenetic proteins (BMP) and other candidate biologics, bone biomaterials, and devices for alveolar ridge augmentation and implant fixation using discriminating large animal models. This focused review illustrates the unique biologic potential, the clinical relevance and perspectives of recombinant human BMP-2 (rhBMP-2) using a variety of carrier technologies to induce local bone formation and implant osseointegration for inlay and onlay indications. Our studies demonstrate a clinically relevant potential of a purpose-designed titanium porous oxide implant surface as stand-alone technology to deliver rhBMP-2 for alveolar augmentation. In perspective, merits and shortcomings of current treatment protocol including bone biomaterials and guided bone regeneration are addressed and explained. We demonstrate that rhBMP-2 has unparalleled potential to augment alveolar bone, and support implant osseointegration and long-term functional loading. Inclusion of rhBMP-2 for alveolar augmentation and osseointegration will not only enhance predictability of existing clinical protocol but also radically change current treatment paradigms.
Collapse
Affiliation(s)
- U M E Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Department of Periodontics, Medical College of Georgia School of Dentistry, Augusta, GA 30912, USA.
| | | | | | | | | | | |
Collapse
|
27
|
Yoon HJ, Song JE, Um YJ, Chae GJ, Chung SM, Lee IS, Jung UW, Kim CS, Choi SH. Effects of calcium phosphate coating to SLA surface implants by the ion-beam-assisted deposition method on self-contained coronal defect healing in dogs. Biomed Mater 2009; 4:044107. [PMID: 19671954 DOI: 10.1088/1748-6041/4/4/044107] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to evaluate the healing of self-contained coronal defects on a sand-blasted, large-grit, acid-etched (SLA) surface implant, which had a calcium phosphate (CaP) coating applied by ion-beam-assisted deposition (IBAD). We also evaluated the effect of heating the coating to different temperatures. The CaP-coated SLA implants exhibited a slightly larger bone healing capacity in the self-contained coronal defect than SLA implants, indicating that combining SLA surface implants and a CaP coating by the IBAD method had synergistic effects on bone healing. There was no difference in the healing capacity between 350 degrees C and 450 degrees C heat treatment of the coating layer.
Collapse
Affiliation(s)
- Heun-Joo Yoon
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, 134 Shinchon-Dong, Seodaemun-gu, Seoul 120-752, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Alexander F, Christian U, Stefan T, Christoph V, Reinhard G, Georg W. Long-term effects of magnetron-sputtered calcium phosphate coating on osseointegration of dental implants in non-human primates. Clin Oral Implants Res 2009; 20:183-8. [DOI: 10.1111/j.1600-0501.2008.01635.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
29
|
Park JW, Suh JY, Chung HJ. Effects of calcium ion incorporation on osteoblast gene expression in MC3T3-E1 cells cultured on microstructured titanium surfaces. J Biomed Mater Res A 2008; 86:117-26. [PMID: 17941022 DOI: 10.1002/jbm.a.31618] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The surface characteristics of a calcium ion (Ca)-incorporated titanium (Ti) surface, produced by hydrothermal treatment using an alkaline Ca-containing solution, and its effects on osteoblastic differentiation were investigated. MC3T3-E1 pre-osteoblastic cells were cultured on machined or grit-blasted Ti surfaces with and without Ca incorporation. The MTT assay was used to determine cell proliferation, and real-time PCR was used for quantitative analysis of osteoblastic gene expression. Hydrothermal treatment with a Ca-containing solution produced a crystalline CaTiO(3) nanostructure of approximately 100 nm in dimension, preserving original micron-scaled surface topographies and microroughness caused by machining, blasting, or blasting and etching treatments. After immersion in Hank's balanced salt solution, considerable apatite formation was observed on all surfaces of the Ca-incorporated samples. Significantly more cell proliferation was found on Ca-incorporated Ti surfaces than on untreated Ti surfaces (p < 0.001). Quantitative real-time PCR analysis showed notably higher alkaline phosphatase, osteopontin, and osteocalcin mRNA levels in cells grown on Ca-incorporated blasted surfaces than on other surfaces at an early time point. Thus, Ca incorporation may have a beneficial effect on osseointegration of microstructured Ti implants by accelerating osteoblast proliferation and differentiation during the early healing phase following implantation.
Collapse
Affiliation(s)
- Jin-Woo Park
- Department of Periodontology, School of Dentistry, Kyungpook National University, 188-1, Samduk 2Ga, Jung-Gu, Daegu 700-412, Korea.
| | | | | |
Collapse
|
30
|
Zigdon H, Machtei EE. The dimensions of keratinized mucosa around implants affect clinical and immunological parameters. Clin Oral Implants Res 2008; 19:387-92. [PMID: 18266873 DOI: 10.1111/j.1600-0501.2007.01492.x] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the association between keratinized mucosa (KM) width and mucosal thickness (MTh) with clinical and immunological parameters around dental implants. METHODS Sixty-three functioning dental implants (3I osseotite) were examined. Clinical examinations included plaque index (PI), probing depth (PD), bleeding on probing (BOP), KM width, MTh and buccal mucosal recession (MR). Peri-implant crevicular fluid (PICF) samples were collected for PgE2 assay. RESULTS KM width ranged from 0 to 7 mm (mean 2.5+/-2), MTh ranged from 0.38 to 2.46 mm (mean 1.11+/-0.4) and the mean MR was 0.62 mm, ranging from 0 to 3 mm. A negative correlation was found between MTh and MR (r=-0.32, P=0.01); Likewise, KM width showed a negative correlation with MR, periodontal attachment level (PAL) and PgE2 levels (r=-0.41, P<0.001; r=-0.26, P=0.04; r=-0.26, P=0.04, respectively). In contrast, a positive correlation was found between KM width and PD (r=0.27, P=0.03). When data were dichotomized by KM width, a wider mucosal band (>1 mm) was associated with less MR compared with narrow (<or=1 mm) band (0.27 and 0.9 mm, respectively, P=0.001). A wider KM band was also associated with a greater PD (3.13 mm) compared with a narrow band (2.66 mm, P=0.04). Similarly, a thick mucosa (>or=1 mm) was associated with lesser recession compared with a thin (<1 mm) mucosa (0.45 and 0.9 mm, respectively, P=0.04). CONCLUSION The KM around dental implants affects both the clinical and the immunological parameters at these sites. These findings are of special importance in the esthetic zone, where thin and narrow KM may lead to a greater MR.
Collapse
Affiliation(s)
- Hadar Zigdon
- Unit of Periodontology, Department of Oral and Dental Sciences, Rambam Medical Center, Haifa, Israel
| | | |
Collapse
|
31
|
Park JW, Jang IS, Suh JY. Bone response to endosseous titanium implants surface-modified by blasting and chemical treatment: A histomorphometric study in the rabbit femur. J Biomed Mater Res B Appl Biomater 2008; 84:400-7. [PMID: 17595031 DOI: 10.1002/jbm.b.30884] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study evaluated the effects of the addition of oxide structure with submicron-scale porous morphology on the periimplant bone response around titanium (Ti) implants with microroughened surfaces. Hydroxyapatite-blasted Ti implants with (experimental) and without (control) a porous oxide structure produced by chemical treatment were investigated in a rabbit femur model. Surface characterizations and in vivo bone response at 4 and 8 weeks after implantation were compared. The experimental implants had submicron-scale porous surface structure consisted of anatase and rutile phase, and the original R(a) values produced by blasting were preserved. The histomorphometric evaluation demonstrated statistically significantly increased bone-to-implant contact (BIC) for experimental implants, both in the three best consecutive threads (p < 0.01) and all threads (p < 0.05) at 4 weeks. There was no remarkable difference in the BIC% or bone area percentage between the two groups at 8 weeks. The porous Ti oxide surface enhanced periimplant bone formation around the Ti implants with microroughened surfaces at the early healing stage. Based on the results of this study, the addition of crystalline Ti oxide surface with submicron-sized porous morphology produced by chemical treatment may be an effective approach for enhancing the osseointegration of Ti implants with microroughened surfaces by increasing early bone-implant contact.
Collapse
Affiliation(s)
- Jin-Woo Park
- Department of Periodontology, College of Dentistry, Kyungpook National University, 188-1, Samduk 2Ga, Jung-Gu, Daegu 700-412, South Korea.
| | | | | |
Collapse
|
32
|
Chae GJ, Jung UW, Jung SM, Lee IS, Cho KS, Kim CK, Choi SH. Healing of surgically created circumferential gap around Nano-coating surface dental implants in dogs. SURF INTERFACE ANAL 2008. [DOI: 10.1002/sia.2745] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
33
|
Kozlovsky A, Tal H, Laufer BZ, Leshem R, Rohrer MD, Weinreb M, Artzi Z. Impact of implant overloading on the peri-implant bone in inflamed and non-inflamed peri-implant mucosa. Clin Oral Implants Res 2007; 18:601-10. [PMID: 17655715 DOI: 10.1111/j.1600-0501.2007.01374.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the impact of overloading on peri-implant bone level and the bone-to-implant contact (BIC) in the presence of healthy or inflamed peri-implant tissues. MATERIALS AND METHODS Four screw-shaped machined implants were placed bilaterally in the mandible of four beagle dogs and left submerged for 3 months. Prosthetic abutments were connected either in supra-occlusal contact with the opposite teeth (overloaded) or in infra-occlusal position (unloaded). In each dog, cotton floss ligatures were placed unilaterally around abutments to promote plaque accumulation; the contralateral side was brushed three times a week. There were four experimental sites, two implants in each: loaded uninflamed (LU), loaded inflamed (LI), unloaded uninflamed (UU), and unloaded inflamed (UI). Clinical and radiographic parameters were recorded at baseline and every 3 months throughout the observation period. At 12 months, the dogs were sacrificed and histomorphometric analysis was performed. RESULTS Implants with ligature-induced peri-implantitis presented high inflammatory indices throughout the observation period. Clinical parameters did not change from baseline for both LU and UU. Loading significantly increased the percentage of BIC (BIC%) (P<0.05) and slightly increased crestal bone resorption, but not apical to the implant neck. Both LI and UI groups showed significant peri-implant bone loss (P<0.01), mostly horizontal on the buccal aspect and angular on the lingual aspect, which exposed implant threads. Loading significantly (P<0.05) increased implant thread exposure due to buccal and lingual vertical bone resorption. CONCLUSIONS In the presence of uninflamed peri-implant mucosa, overloading of implants in the dog model increased BIC% and slightly reduced marginal bone level. However, resorption did not progress beyond the implant neck. Overloading aggravated the plaque-induced bone resorption when peri-implant inflammation was present.
Collapse
Affiliation(s)
- Avital Kozlovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | | | | | | |
Collapse
|
34
|
Suh JY, Jeung OC, Choi BJ, Park JW. Effects of a novel calcium titanate coating on the osseointegration of blasted endosseous implants in rabbit tibiae. Clin Oral Implants Res 2007; 18:362-9. [PMID: 17298490 DOI: 10.1111/j.1600-0501.2006.01323.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of a nanostructured calcium coating on the surfaces of blasted Ti implants on peri-implant bone formation in the rabbit tibiae. MATERIAL AND METHODS Threaded implants (3.75 mm in diameter, 6 mm in length) were roughened by hydroxyapatite (HA) blasting (control; blasted implants). The implants were then hydrothermally treated in a Ca-containing solution for 24 h to prepare Ca-incorporated Ti surfaces (experimental; blasted/Ca implants). Surface characterizations were performed by scanning electron microscopy and stylus profilometry before and after Ca coating. Forty-two implants (21 control and 21 experimental) were placed in the proximal tibiae of seven New Zealand White rabbits. Each rabbit received six implants. To evaluate the effects of the nanostructured Ca coating on the peri-implant bone-healing response, removal torque tests and histomorphometric analyses were performed 6 weeks after surgery. RESULTS The Ca coating did not significantly change the surface properties produced by blasting at the micron level. Histologically, active bone apposition was observed in the blasted/Ca implants in the marrow space. Compared with the blasted implants, the blasted/Ca implants showed significantly increased bone-to-implant contact over the total implant length (P<0.01) and greater mean removal torque values (P<0.05). DISCUSSION AND CONCLUSION The nanostructured, Ca-incorporated surface significantly enhanced the peri-implant bone-healing response of HA-blasted Ti implants. It may be concluded that the use of nanostructured, Ca-coated surfaces may have synergic effects in enhancing osseointegration of blasted Ti implants due to their micron-scaled surface properties and biologically active surface chemistry.
Collapse
Affiliation(s)
- Jo-Young Suh
- Department of Periodontology, College of Dentistry, Kyungpook National University, Daegu, South Korea
| | | | | | | |
Collapse
|
35
|
Martins MC, Shibli JA, Abi-Rached RSG, Marcantonio E. Progression of Experimental Chronic Peri-Implantitis in Dogs: Clinical and Radiographic Evaluation. J Periodontol 2005; 76:1367-73. [PMID: 16101371 DOI: 10.1902/jop.2005.76.8.1367] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the progression of experimental peri-implantitis in dogs using implants with different surface coatings. METHODS Thirty-six dental implants with four different surface coatings, commercially pure titanium (cpTi), titanium plasma sprayed (TPS), hydroxyapatite (HA), and acid-etched (AE), were placed in six mongrel dogs. Five months after implantation, peri-implantitis was induced by cotton ligatures to facilitate plaque accumulation for 60 days. After 60 days, the ligatures were removed and supragingival plaque control was initiated for 12 months. Probing depth (PD), clinical attachment level (CAL), vertical bone level (VBL), horizontal bone level (HBL), and mobility were obtained at baseline, and 20, 40, 60 (acute phase), and 425 days (chronic phase) after ligature removal. RESULTS PD and CAL changed around all implant surfaces after ligature placement (P<0.0001). However, the means of PD and CAL were not statistically significant among the different surfaces (P>0.05). The range of CAL variation, calculated between baseline and 60 days (acute phase) and between 60 and 425 days (chronic phase), decreased (P<0.05). Bone loss increased during the entire experiment (P<0.0001). The HA surface showed the greatest bone loss measurement (5.06+/- 0.38 mm) and the TPS showed the smallest bone loss (4.27+/- 0.62 mm). However, statistical significance was not assessed for different coatings (P>0.05). CONCLUSIONS The clinical data at the initial phase showed rapid and severe peri-implant tissue breakdown. However, removal of ligatures did not convert the acute destructive peri-implant phase to a non-aggressive lesion and the progression of peri-implantitis was observed at chronic phase. The experimental peri-implantitis in dogs may be a useful model to evaluate the progression of peri-implantitis.
Collapse
Affiliation(s)
- Marilia Compagnoni Martins
- Department of Periodontology, Dental School of Araraquara, State University of São Paulo (UNESP), Araraquara, São Paulo, Brazil
| | | | | | | |
Collapse
|
36
|
Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res 2002; 13:1-19. [PMID: 12005139 DOI: 10.1034/j.1600-0501.2002.130101.x] [Citation(s) in RCA: 414] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The use of oral implants in the rehabilitation of partially and fully edentulous patients is widely accepted even though failures do occur. The chance for implants to integrate can for example be jeopardised by the intra-oral presence of bacteria and concomitant inflammatory reactions. The longevity of osseointegrated implants can be compromised by occlusal overload and/or plaque-induced peri-implantitis, depending on the implant geometry and surface characteristics. Animal studies, cross-sectional and longitudinal observations in man, as well as association studies indicate that peri-implantitis is characterised by a microbiota comparable to that of periodontitis (high proportion of anaerobic Gram-negative rods, motile organisms and spirochetes), but this does not necessarily prove a causal relationship. However, in order to prevent such a bacterial shift, the following measures can be considered: periodontal health in the remaining dentition (to prevent bacterial translocation), the avoidance of deepened peri-implant pockets, and the use of a relatively smooth abutment and implant surface. Finally, periodontitis enhancing factors such as smoking and poor oral hygiene also increase the risk for peri-implantitis. Whether the susceptibility for periodontitis is related to that for peri-implantitis may vary according to the implant type and especially its surface topography.
Collapse
Affiliation(s)
- Marc Quirynen
- Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-Facial Surgery, Catholic University Leuven, Belgium.
| | | | | |
Collapse
|
37
|
Quirynen M, Peeters W, Naert I, Coucke W, van Steenberghe D. Peri-implant health around screw-shaped c.p. titanium machined implants in partially edentulous patients with or without ongoing periodontitis. Clin Oral Implants Res 2001; 12:589-94. [PMID: 11737102 DOI: 10.1034/j.1600-0501.2001.120606.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The relationship between periodontitis and peri-implantitis remains a matter of debate. The present study compared, "within" randomly chosen partially edentulous patients (n=84 subjects, 97 jaws), the marginal bone loss around teeth and implants during 5 years (range 3 to 11 years) following the first year of bone remodelling. The patients had all been rehabilitated by means of screw-shape c.p. titanium implants with a machined surface (Brånemark system). During the 5 years observation interval, periodontal parameters (marginal bone and attachment loss, the latter for teeth only) were collected together with data on confounding factors (smoking, oral hygiene, tooth loss). Marginal bone loss was measured through long-cone intra-oral radiographs. The mean "interval" bone loss was significantly (P=0.0001) higher around teeth (0.48+/-0.95 mm) than around implants (0.09+/-0.28 mm). The corresponding data for the "worst" performing tooth (0.99+/-1.25 mm) and implant (0.19+/-0.32 mm) per subject showed the same tendency. Neither attachment nor bone loss around teeth correlated with marginal bone loss around implants. This study indicated that the rate of bone loss around screw-shape c.p. titanium implants with a machined surface (Brånemark system implants) was not influenced by the progression rate of periodontal destruction around the remaining teeth within the same jaw.
Collapse
Affiliation(s)
- M Quirynen
- Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 33, B-3000 Leuven, Belgium.
| | | | | | | | | |
Collapse
|
38
|
Comut AA, Weber HP, Shortkroff S, Cui FZ, Spector M. Connective tissue orientation around dental implants in a canine model. Clin Oral Implants Res 2001; 12:433-40. [PMID: 11564102 DOI: 10.1034/j.1600-0501.2001.120502.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of this study was to evaluate the orientation of collagen in the canine gingival connective tissue to a titanium surface (TI), and to hydroxyapatite coatings applied by plasma-spraying (HAPS) and ion beam assisted deposition (IBAD), on the supracrestal region of dental implants after 3 and 4 months. The effects of induced peri-implantitis on the soft connective tissue apposed to the implant were also evaluated. The use of these three surface types allowed for the evaluation of the effects of chemical composition (TI vs. IBAD; same topography) and topography (HAPS vs. IBAD; similar chemical composition) on the collagen fiber orientation. The majority of collagen fibers were found to be parallel to the implant surface, and there was no significant effect of surface type on orientation. There was a significant effect of inflammation on the connective tissue attachment length. The loss of bone height and concomitant gingival recession reduced the length of soft connective tissue apposed to the implant zone designed for collagen fiber attachment.
Collapse
Affiliation(s)
- A A Comut
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, MA, USA
| | | | | | | | | |
Collapse
|
39
|
Abstract
A review of the literature on the use of growth-regulatory molecules in the oral cavity permits a model in which to consider approaches to oral tissue engineering. These concepts apply to periodontal regeneration and to regeneration of alveolar bone. In either case, the formation of tissues is complex but proceeds in a deliberate and orderly sequence. In these sequence of events resulting in either bone or cementum formation, periodontal ligament and bone can be stimulated at various points. Different signals can apparently be used to stimulate tissue formation including mitogenic signals and differentiation factors. Additionally, both hard and soft tissue stimulatory molecules appear to be permissive. Classic receptor-mediated peptides or extracellular matrix molecules for soft and hard tissues appear to allow stimulation of tissue formation cascades. Importantly, it also appears that the stimulatory event is transitory (that is, short-lived) and leads itself to a sequence of cellular events. These cellular events in turn stimulate a number of subsequent events (such as chemotaxis, proliferation, differentiation or angiogenesis), which lead to further progression of tissue formation. While a solid scientific rationale exists for the use of a variety of growth and attachment factors in regeneration of oral tissues, only a small number are being pursued clinically. Many therapeutic regimens have failed in preclinical testing or have resulted in limited regenerative capacity. The mitogenic polypeptides that stimulate soft tissue growth (such as platelet-derived growth factor) and both hard and soft tissue growth (such as transforming growth factor-beta) appear to have not led to successful enough outcomes to facilitate further work towards regulatory approval. The demonstrated ability of bone morphogenetic proteins to generate substantial quantities of bone suggest many applications in the oral cavity where this is the only tissue desired. Another therapeutic candidate is enamel matrix derivative, a set of matrix proteins. Enamel matrix derivative appears to stimulate first acellular cementum formation, which may allow for functional periodontal ligament formation. It will be of interest in the future to determine whether the protein matrix contains classic mitogenic or differentiation factors as well as the amelogenins. It is also evident that the bone morphogenetic proteins permit periodontal ligament formation. The conditions for stimulating predictable periodontal ligament tissues with bone morphogenetic proteins however are not known. It is clear that the bone morphogenetic proteins are excellent molecules for stimulating oral bone formation. The results of all these studies will determine the future therapeutic potential for these growth molecules such that they may be used to optimally stimulate and direct specific points along tissue formation cascades.
Collapse
Affiliation(s)
- D L Cochran
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center, San Antonio, USA
| | | |
Collapse
|