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Kundakcioglu A, Ayhan M. Evaluation of Different Subperiosteal Implant Thicknesses on Mechanical Strength and Stress on Bone by Finite Element Analysis. Int J Med Sci 2024; 21:1672-1680. [PMID: 39006845 PMCID: PMC11241093 DOI: 10.7150/ijms.91620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/28/2024] [Indexed: 07/16/2024] Open
Abstract
Implants have always been within the interest of both clinicians and material scientists due to their places in reconstructive and prosthetics surgery. Excessive bone loss or resorption in some patients makes it difficult to design and manufacture the implants that bear the necessary loads to carry the final prosthetics. With this study; we tried to determine the minimum material thickness of the subperiosteal implants that can withstand the physiological forces. We have created a digital average bone structure based on actual patient data and designed different subperiosteal implants with 1, 1.5, and 2mm material thicknesses (M1, M2, M3) for this digital model. The designed implant models are subjected to 250 Newtons (N) of force, and the implant and bone are tested for the stress they are exposed to, the pressure they transmit to, and their mechanical strength with Finite Element Analysis with the physical parameters boot for the implant material and human bone. Results show us that under specific design parameters and thicknesses, the 1mm thickness design failed due to exceeding the yield stress limit of 415MPa with a 495,44MPa value. The thinnest implant showed plastic deformation and transmitted excessive forces, which may cause bone resorption due to residual stress. We determined that thinner subperiosteal implants down to 1.5mm that have the necessary material parameters for function and tissue support can be designed and manufactured with current technologies.
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Affiliation(s)
- Abdulsamet Kundakcioglu
- Istanbul University Faculty of Dental Medicine Department of Oral and Maxillofacial Surgery, Istanbul, Turkey
| | - Mustafa Ayhan
- Istanbul University Faculty of Dental Medicine Department of Oral and Maxillofacial Surgery, Istanbul, Turkey
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Matos FG, Stremel ACA, Lipinski LC, Cirelli JA, Dos Santos FA. Dental implants in large animal models with experimental systemic diseases: A systematic review. Lab Anim 2023; 57:489-503. [PMID: 37021606 DOI: 10.1177/00236772221124972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
This systematic review aims to identify and discuss the most used methodologies in pre-clinical studies for the evaluation of the implementation of dental implants in systemically compromised pigs and sheep. This study provides support and guidance for future research, as well as for the prevention of unnecessary animal wastage and sacrifice. Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) was used as a guideline; electronic searches were performed in PubMed, Scopus, Scielo, Web of Science, Embase, Science Direct, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Directory of Open Access Journals, Database of Abstracts of Reviews of Effects, and gray literature until January 2022 (PROSPERO/CRD42021270119). Sixty-eight articles were chosen from the 2439 results. Most studies were conducted in pigs, mainly the Göttinger and Domesticus breeds. Healthy animals with implants installed in the jaws were predominant among the pig studies. Of the studies evaluating the effect of systemic diseases on osseointegration, 42% were performed in osteoporotic sheep, 32% in diabetic sheep, and 26% in diabetic pigs. Osteoporosis was primarily induced by bilateral ovariectomy and mainly assessed by X-ray densitometry. Diabetes was induced predominantly by intravenous streptozotocin and was confirmed by blood glucose analysis. Histological and histomorphometric analyses were the most frequently employed in the evaluation of osseointegration. The animal models presented unique methodologies for each species in the studies that evaluated dental implants in the context of systemic diseases. Understanding the most commonly used techniques will help methodological choices and the performance of future studies in implantology.
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Affiliation(s)
| | | | | | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of São Paulo (Unesp), Brazil
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Putri A, Pramanik F, Azhari A. Micro Computed Tomography and Immunohistochemistry Analysis of Dental Implant Osseointegration in Animal Experimental Model: A Scoping Review. Eur J Dent 2023; 17:623-628. [PMID: 36977479 PMCID: PMC10569876 DOI: 10.1055/s-0042-1757468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Osseointegration is a complex process that involves the interaction of dental implants, bone, and the immune system. Preclinical testing was carried out to develop a better understanding of the mechanism. Micro-computed tomography (micro-CT) imaging techniques and immunohistochemistry are excellent tools for this objective as both enable quantitative assessment of bone microarchitecture and intercellular interaction. An extensive literature search was conducted using the databases PubMed, Science Direct, Wiley Online, Proquest and Ebscohost from January 2011 to January 2021. Among the publications retrieved, the rat model was the most frequently used experimental protocol, with the tibia being the most frequently implanted site. The region of interest demonstrates a high degree of homogeneity as measured by trabecula but varies in size and shape. The most frequently mentioned micro-CT bone parameter and immunohistochemistry bone markers were bone volume per total volume (BV/TV) and runt-related transcription factors (RUNX). Animal models, micro-CT analysis methods, and immunohistochemistry biomarkers yielded a variety of results in the studies. Understanding bone architecture and the remodeling process will aid in the selection of a viable model for a specific research topic.
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Affiliation(s)
- Annisa Putri
- Dentomaxillofacial Radiology Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Farina Pramanik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Azhari Azhari
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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5
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Dai X, Heng BC, Bai Y, You F, Sun X, Li Y, Tang Z, Xu M, Zhang X, Deng X. Restoration of electrical microenvironment enhances bone regeneration under diabetic conditions by modulating macrophage polarization. Bioact Mater 2020; 6:2029-2038. [PMID: 33474514 PMCID: PMC7787955 DOI: 10.1016/j.bioactmat.2020.12.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/29/2022] Open
Abstract
Macrophage-mediated inflammation compromises bone repair in diabetic patients. Electrical signaling cues are known to regulate macrophage functions. However, the biological effects of electrical microenvironment from charged biomaterials on the immune response for regulating osteogenesis under diabetic conditions remain to be elucidated. Herein the endogeneous electrical microenvironment of native bone tissue was recapitulated by fabricating a ferroelectric BaTiO3/poly (vinylidene fluoridetrifluoroethylene) (BTO/P(VDF-TrFE)) nanocomposite membrane. In vitro, the polarized BaTiO3/poly (vinylidene fluoridetrifluoroethylene) (BTO/P(VDF-TrFE)) nanocomposite membranes inhibited high glucose-induced M1-type inflammation, by effecting changes in cell morphology, M1 marker expression and pro-inflammatory cytokine secretion in macrophages. This led to enhanced osteogenic differentiation of human bone marrow mesenchymal stem cells (BM-MSCs). In vivo, the biomimetic electrical microenvironment recapitulated by the polarized nanocomposite membranes switched macrophage phenotype from the pro-inflammatory (M1) into the pro-healing (M2) phenotype, which in turn enhanced bone regeneration in rats with type 2 diabetes mellitus. Mechanistic studies revealed that the biomimetic electrical microenvironment attenuated pro-inflammatory M1 macrophage polarization under hyperglycemic conditions by suppressing expression of AKT2 and IRF5 within the PI3K-AKT signaling pathway, thereby inducing favorable osteo-immunomodulatory effects. Our study thus provides fundamental insights into the biological effects of restoring the electrical microenvironment conducive for osteogenesis under DM conditions, and offers an effective strategy to design functionalized biomaterials for bone regeneration therapy in diabetic patients. Electrical microenvironment recapitulated by BTO membranes switched pro-inflammatory M1 into pro-healing M2 phenotype. The macrophage phenotype transformation from M1 to M2 promotes bone regeneration in rats with type 2 diabetes mellitus. Restored electrical microenvironment attenuated M1 macrophage polarization via downregulation of AKT2-IRF5.
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Affiliation(s)
- Xiaohan Dai
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, PR China.,Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China.,Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Boon Chin Heng
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Yunyang Bai
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Fuping You
- Institute of Systems Biomedicine, Department of Immunology, School of Basic Medical Sciences, Beijing Key Laboratory of Tumor Systems Biology, Peking University Health Science Center, Beijing, 100191, PR China
| | - Xiaowen Sun
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Yiping Li
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, PR China
| | - Zhangui Tang
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, PR China
| | - Mingming Xu
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Xuehui Zhang
- Department of Dental Materials & Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Xuliang Deng
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, NMPA Key Laboratory for Dental Materials, Beijing Laboratory of Biomedical Materials & Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
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Zhang H, Liu K, Lu M, Liu L, Yan Y, Chu Z, Ge Y, Wang T, Qiu J, Bu S, Tang C. Micro/nanostructured calcium phytate coating on titanium fabricated by chemical conversion deposition for biomedical application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 118:111402. [PMID: 33255005 DOI: 10.1016/j.msec.2020.111402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/26/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023]
Abstract
A bioactive micro/nanostructured calcium phytate coating was successfully prepared on titanium surfaces by chemical conversion deposition, mainly through hydrothermal treatment of a mixed solution of phytic acid and saturated calcium hydroxide solution. Ultraviolet radiation was carried out to improve the adhesion of the coating to the titanium substrate. Pure titanium with a sandblasted/acid-etched surface was used as the control group. The topography and chemical composition of the modified surfaces were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), energy-dispersive X-ray spectroscopy (EDX), and static water contact angle measurement. A pull-off test was performed to measure the coating-to-substrate adhesion strength. Bovine serum albumin was used as a model to study the protein adsorption effect. Cells were cultured on titanium surfaces for 7 days in osteogenic differentiation medium, then the osteoblast compatibility in vitro were explored by alkaline phosphatase and alizarin red staining. After 1, 2, 4 and 8 wks of immediate implantation of titanium implants into the mandibles of New Zealand white rabbits, biological effects in vivo were researched by microcomputed tomography analysis and histological evaluation. The results indicated that the roughness and hydrophilicity of the modified surfaces with micro/nanostructure remarkably increased compared to those of the control group. The pull-off test showed the average adhesion strength at the coating-substrate interface to be higher than 13.56 ± 1.71 MPa. In addition, approximately 4.41 mg/L calcium ion was released from the calcium phytate micro/nano coatings to the local environment after 48 h of immersion. More importantly, the micro/nanostructure titanium substrates significantly promoted cellular differentiation in vitro and in vivo. After 8 wks, the bone implant contact ratio (BIC, %) of the modified implants was higher than that of the control group, at 94.09 ± 0.55% and 86.18 ± 1.99% (p < 0.05). Overall, this study provided new insights into the factors promoting early osseointegration of titanium alloys, which had great potential not only for dental implants but also for various other biomaterial applications.
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Affiliation(s)
- Hao Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Kun Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Implantology, Hefei Stomatological Hospital, Hefei Clinical School of Stomatology, Anhui Medical University, Hefei 230001, China
| | - Mengmeng Lu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lin Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yanzhe Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Zhuangzhuang Chu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Yuran Ge
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Tao Wang
- College of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Jing Qiu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shoushan Bu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chunbo Tang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China.
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Maiborodin IV, Shevela AA, Toder MS, Shevela AI. [Current trends of the choice and processing of materials for dental implantation]. STOMATOLOGII︠A︡ 2018; 97:68-76. [PMID: 30199073 DOI: 10.17116/stomat20189704168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For assessment of the modern situation about the choice of materials for manufacture of dental implants and the processing of their surface the scientific literature for the last 2 years was study. On the basis of a large number of contradictory results of the researches devoted to each of dental implantation problems it is possible to draw a conclusion that any of primal problems of implantology is finally not solved. There is no unique opinion at the choice of optimum material for manufacture of dental implants, at the way of processing and modification of their surface. The problem of improvement of quality of dental implantation and fight against complications of this procedure cannot be solved simple drawing other substances on the implanted material surface, this task more easily and more successfully is solved via changes of product structure and various modification of implant surface. Up to the present the researches of an opportunity to influence on characteristics of the implanted materials, changing their structure and character of a surface, continue. And the publications reporting about the considerable positive effect of artificially created roughnesses on product surfaces, and the articles claiming that there are no big differences between the rough and polished implants are confirmed by objective measurements with statistical processing of the obtained data. It should be noted that among articles there are very many works of the doubtful plan or with insufficiently valid conclusions. This review leads to the conclusion that further clinical and experimental studies and about the choice of materials for manufacture of implants and at the ways of processing of their surface are necessary.
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Affiliation(s)
- I V Maiborodin
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
| | - A A Shevela
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - M S Toder
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - A I Shevela
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
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Tavakoli M, Yaghini J, Abed AM, Malekzadeh M, Maleki D. Evaluation of Effect of Low-Dose Methotrexate on Osseointegration of Implants: A Biomechanical Study on Dogs. Open Dent J 2018; 12:546-554. [PMID: 30197693 PMCID: PMC6110076 DOI: 10.2174/1874210601812010546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/20/2018] [Accepted: 07/16/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Methotrexate (MTX) is an immunosuppressive drug, widely used in inflammatory disturbances including rheumatoid arthritis. However, there is no consensus regarding the effect of MTX on implant osseointegration. Objective: The purpose of this experimental study was to investigate the effect of low dose MTX on Bone-Implant Contact (BIC) of dogs. Methods: Six mandibular premolar teeth (bilateral) of 8 mature dogs were extracted. After 3 months of healing, 6 implants (bone level, resorbable blast media surface) were inserted into the mandible of each dog (3 in each side). Dogs were randomly divided into a study group (receiving 2.5 mg/week MTX orally, 3 times per week for 4 weeks) and a control group each containing 4 dogs. In the 1st week, postoperative BIC was evaluated in 4 dogs, two from each group. In the 4th week, reverse torque and BIC were evaluated in the remaining 4 dogs. Data were analyzed with two-way ANOVA test for 95% confidence interval. Results: The reverse torque test of the 4th week, showed a satisfying osseointegration. Histopathologic evaluation revealed that the BIC was significantly higher in the control group in comparison to the MTX group in the 1st and 4th week. In addition, the BIC of both groups were significantly increased in the 4th week in comparison to the 1st week in both groups. Conclusion: MTX has the potential to interfere with osseointegration process.
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Affiliation(s)
- Mohamad Tavakoli
- Department of Periodontics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaber Yaghini
- Department of Periodontics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Moghare Abed
- Department of Periodontics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Meisam Malekzadeh
- Department of Periodontics and Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Dina Maleki
- Department of Periodontics and Dental Sciences Research Center, Faculty of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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