1
|
Colepícolo LS, Mourão Martinez MA, Rodrigues AA, Baeta LS, Costa FO. The innovative double or triple dental abutment-implant: Case study with a 3-to-12-year follow-up. Clin Adv Periodontics 2024. [PMID: 39037121 DOI: 10.1002/cap.10300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND The aim of this case study is to present the rationality and scientific evidence of a new design for a double (DA) and triple (TA) dental abutment-implant with their specific new concept of biodynamic optimized peri-implant tissue (BOPiT). METHODS The innovative design of these abutments with a paraboloid geometry was based on BOPiT, simultaneously involving the principles of mechanobiology, biotensegrity, and mechanotransduction. Thus, 37 consecutive individuals/43 cases rehabilitated with single dental implant using the innovative DA (n = 28) and TA (n = 15) on 43 implants were included in this case study. The DA and TA support 2 or 3 dental crowns on a single implant, respectively. Clinic and radiographic examinations were presented at T1 (loading after 4 months) and T2 [final examination with an average follow-up time of 7.2 years (>3 to 12 years)]. RESULTS At T2, mean scores for plaque index, peri-implant bleeding on probing, and peri-implant probing depth were low, depicting healthy peri-implant conditions. All radiographic images showed insignificant annual marginal bone loss (0.022 ± 0.05 mm) when compared to T1, reflecting great bone stability. CONCLUSION DA and TA, based on the BOPiT concept, represent an advantageous, simple and non-invasive mechanism for the longevity and healthy regulation of the peri-implant tissues.
Collapse
Affiliation(s)
- Luciana Silva Colepícolo
- Federal University of Minas Gerais, Institute of Technology and Research (ITP), Belo Horizonte, Minas Gerais, Brazil
- Instituto Universitário Italiano de Rosario, Santa Fé, Argentina
| | - Maria Auxiliadora Mourão Martinez
- Federal University of Minas Gerais, Institute of Technology and Research (ITP), Belo Horizonte, Minas Gerais, Brazil
- Instituto Universitário Italiano de Rosario, Santa Fé, Argentina
| | | | | | - Fernando Oliveira Costa
- School of Dentistry, Department of Periodontology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
2
|
Bingül MB, Gul M, Dündar S, Sökmen K, Artas G, Polat ME, Tanrisever M, Ozcan EC. Effect of Different Administered Doses of Capsaicin and Titanium Implant Osseointegration. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1094. [PMID: 39064523 DOI: 10.3390/medicina60071094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/24/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: This study aimed to evaluate the histological and biochemical effects of capsaicin on implant osseointegration and oxidative stress. Materials and Methods: Male Wistar albino rats weighing between 250 and 300 g were used in this study. Twenty-four rats were randomly divided into three equal groups: implant + control (n = 8), implant + capsaicin-1 (n = 8), and implant + capsaicin-2 (n = 8). Additionally, 2.5 mm diameter and 4 mm length titanium implants were surgically integrated into the corticocancellous bone parts of the femurs. In the treatment groups, rats were injected intraperitoneally with 25 mg/kg (implant + capsaicin-1) and 50 mg/kg (implant + capsaicin-2) of capsaicin. No additional applications were made in the control group. Three rats in total died during and after the experiment as a result of the analyses performed on 21 animals. Results: The highest total antioxidant status value was found in capsaicin dose 2, according to the analysis. The control group had the highest total oxidant status and oxidative stress index values, while group 2 of capsaicin had the lowest. After analysis, we found that there was no observed positive effect on osteointegration in this study (p > 0.05), although the bone implant connection was higher in the groups treated with capsaicin. Conclusions: A positive effect on osteointegration was not observed in this study. This may be due to osteoclast activation. However, it was found that it has a positive effect on oxidative stress. Osteoclast activation may be the cause of this phenomenon. Capsaicin was found to have a positive effect on oxidative stress (p < 0.05). It was also observed to have a positive effect on oxidative stress.
Collapse
Affiliation(s)
- Muhammet Bahattin Bingül
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, Sanliurfa 63300, Turkey
| | - Mehmet Gul
- Department of Periodontology, Faculty of Dentistry, Harran University, Sanliurfa 63300, Turkey
| | - Serkan Dündar
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig 23119, Turkey
| | - Kevser Sökmen
- Department of Periodontology, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya 07070, Turkey
| | - Gökhan Artas
- Department of Medical, Faculty of Medicine, Pathology Firat University, Elazig 23119, Turkey
| | - Mehmet Emrah Polat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, Sanliurfa 63300, Turkey
| | - Murat Tanrisever
- Department of Surgery, Faculty of Veterinary Medicine, Firat University, Elazig 23119, Turkey
| | - Erhan Cahit Ozcan
- Department of Esthetic, Faculty of Medicine, Plastic and Reconstructive Surgery, Elazig 44090, Turkey
| |
Collapse
|
3
|
Colabella L, Naili S, Le Cann S, Haiat G. Effect of collagen fibril orientation on the anisotropic properties of peri-implant bone. Biomech Model Mechanobiol 2024; 23:879-891. [PMID: 38300439 DOI: 10.1007/s10237-023-01811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/22/2023] [Indexed: 02/02/2024]
Abstract
In orthopedic and dental surgery, the implantation of biomaterials within the bone to restore the integrity of the treated organ has become a standard procedure. Their long-term stability relies on the osseointegration phenomena, where bone grows onto and around metallic implants, creating a bone-implant interface. Bone is a highly hierarchical material that evolves spatially and temporally during this healing phase. A deeper understanding of its biomechanical characteristics is needed, as they are determinants for surgical success. In this context, we propose a multiscale homogenization model to evaluate the effective elastic properties of bone as a function of the distance from the implant, based on the tissue's structure and composition at lower scales. The model considers three scales: hydroxyapatite foam (nanoscale), ultrastructure (microscale), and tissue (mesoscale). The elastic properties and the volume fraction of the elementary constituents of bone matrix (mineral, collagen, and water), the orientation of the collagen fibril relative to the implant surface, and the mesoscale porosity constitute the input data of the model. The effect of a spatiotemporal variation in the collagen fibrils' orientation on the bone anisotropic properties in the proximity of the implant was investigated. The findings revealed a strong variation of the components of the effective elasticity tensor of the bone as a function of the distance from the implant. The effective elasticity appears to be primarily sensitive to the porosity (mesoscale) rather than to the collagen fibrils' orientation (sub-micro scale). However, the orientation of the fibrils has a significant influence on the isotropy of the bone. When analyzing the symmetry properties of the effective elasticity tensor, the ratio between the isotropic and hexagonal components is determined by a combination of the porosity and the fibrils' orientation. A decrease in porosity leads to a decrease in bone isotropy and, in turn, an increase in the impact of the fibrils' orientation. These results demonstrate that the collagen fibril orientation should be taken into account to properly describe the effective elastic anisotropy of bone at the organ scale.
Collapse
Affiliation(s)
- Lucas Colabella
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France
- INTEMA, CONICET, Av. Cristóbal Colón 10850, B7606BWV, Mar del Plata, Argentina
| | - Salah Naili
- Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, UMR 8208, MSME, F-94010, Creteil, France
| | - Sophie Le Cann
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France
| | - Guillaume Haiat
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, F-94010, Creteil, France.
| |
Collapse
|
4
|
Tao ZS, Ma T, Yang M. Cyclosporine a inhibits bone regeneration and induces bone loss in a rat model. Int Immunopharmacol 2024; 132:111951. [PMID: 38552293 DOI: 10.1016/j.intimp.2024.111951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
Cyclosporine A (CSA) is an immunosuppressant that has been extensively studied for its side effects on inhibiting osseointegration of titanium implants. However, the impact of CSA on bone healing in postmenopausal osteoporosis remains unknown. Therefore, this study aimed to investigate the effect of CSA on bone repair in an ovariectomized (OVX) rat model through both in vitro and in vivo experiments. We examined the interventions of CSA on osteoblast progenitor cells MC3T3-E1 and assessed their effects on biological function using RT-qPCR, CCK-8 assay, alizarin red staining, and alkaline phosphatase staining. Furthermore, we evaluated the effects of CSA on bone regeneration and bone mass in both OVX rat models and femoral diaphysis bone defect models. The results from the CCK-8 experiment indicated a positive influence of experimental doses of CSA on osteogenic differentiation of MC3T3-E1 cells. ALP expression levels and calcified nodules were also evaluated, suggesting that CSA intervention promoted osteogenic differentiation in MC3T3-E1 cells. Additionally, specific gene expressions including OPN, Runx-2, OC, and Col1a1 were up-regulated after CSA intervention. Biomechanical parameters aligned with histological analysis as well as micro-CT scans confirmed worse bone microstructure and strength following CSA intervention. Our findings preliminarily suggest that whether it is normal or osteoporotic bones, CSA has adverse effects on bone health which are associated with elevated-bone turnover.
Collapse
Affiliation(s)
- Zhou-Shan Tao
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu 241001, Anhui, PR China; Anhui Province Key Laboratory of Non-coding RNA Basic and Clinical Transformation, No. 2, Zhe Shan Xi Road, Wuhu 241001, Anhui, PR China.
| | - Tao Ma
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu 241001, Anhui, PR China
| | - Min Yang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu 241001, Anhui, PR China
| |
Collapse
|
5
|
Alssum LR. Repeated implants failure in young patient with idiopathic nephrotic syndrome: a case report with brief review of the literature. BMC Oral Health 2024; 24:25. [PMID: 38183071 PMCID: PMC10770943 DOI: 10.1186/s12903-023-03772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Nephrotic syndrome is a chronic disorder characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Idiopathic minimal-change disease is the most common form encountered in children. Corticosteroids are the cornerstone for the treatment of idiopathic nephrotic syndrome (INS), with different regimens depending on the response to therapy and frequency of relapses. This case report presents complications after implant treatment in patient with INS. CASE PRESENTATION 20 years old female patient presented for implant consultation. Medical history includes INS since early childhood, and she is on different medications to control her condition, including long-term steroid use. Dental history revealed that implant treatment was unsuccessful after multiple attempts. She presented with an implant on the area of lower left first mandibular molar, that shows increased mobility and radiolucency on radiographic examination. A diagnosis of implant failure was made, the implant was removed, and the area was cleaned and sutured. The patient decided to replace her missing teeth with fixed partial denture and was referred for prosthodontist. The potential adverse effect of steroid use and the possible underlying mechanism that could affect bone metabolism and implants osseointegration are reviewed. CONCLUSION Clinical practice guidelines are needed for the management of dental implants in chronic steroid users.
Collapse
Affiliation(s)
- Lamees R Alssum
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
6
|
Pius AK, Toya M, Gao Q, Ergul YS, Chow SKH, Goodman SB. Effects of Aging on Osteosynthesis at Bone-Implant Interfaces. Biomolecules 2023; 14:52. [PMID: 38254652 PMCID: PMC10813487 DOI: 10.3390/biom14010052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
Joint replacement is a common surgery and is predominantly utilized for treatment of osteoarthritis in the aging population. The longevity of many of these implants depends on bony ingrowth. Here, we provide an overview of current techniques in osteogenesis (inducing bone growth onto an implant), which is affected by aging and inflammation. In this review we cover the biologic underpinnings of these processes as well as the clinical applications. Overall, aging has a significant effect at the cellular and macroscopic level that impacts osteosynthesis at bone-metal interfaces after joint arthroplasty; potential solutions include targeting prolonged inflammation, preventing microbial adhesion, and enhancing osteoinductive and osteoconductive properties.
Collapse
Affiliation(s)
- Alexa K. Pius
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
| | - Masakazu Toya
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
| | - Qi Gao
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
| | - Yasemin Sude Ergul
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
| | - Stuart Barry Goodman
- Department of Orthopaedic Surgery, School of Medicine, Stanford University, Stanford, CA 94063, USA (Y.S.E.)
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| |
Collapse
|
7
|
Patil S, Bhandi S, Alzahrani KJ, Alnfiai MM, Testarelli L, Soffe BW, Licari FW, Awan KH, Tanaka E. Efficacy of laser in re-osseointegration of dental implants-a systematic review. Lasers Med Sci 2023; 38:199. [PMID: 37658921 DOI: 10.1007/s10103-023-03860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the treatment of peri-implantitis to achieve re-osseointegration. An electronic literature search was performed supplemented by a manual search to identify studies published until January 2022. Articles that evaluated re-osseointegration in peri-implantitis sites in animal models following laser therapy or antimicrobial photodynamic therapy (aPDT) were included. Case reports, case series, systematic reviews, and letters to the editor were excluded. Risk of bias and GRADE assessment were followed to evaluate the quality of the evidence. Six studies out of 26 articles identified on electronic search were included in this review. The studies included animal studies conducted on canine models. Four out of six studies reported a higher degree of re-osseointegration following treatment of implants with laser therapy. The findings suggest that laser decontamination shows potential in enhancing re-osseointegration, particularly with the Er: YAG laser, which effectively decontaminated implant surfaces. However, conflicting outcomes and limitations in the evidence quality warrant caution in drawing definitive conclusions. Based on the limited available evidence, laser therapy may show a higher degree of re-osseointegration of implants than mechanical debridement.
Collapse
Affiliation(s)
- Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA.
- Centre of Molecular Medicine and Diagnostics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
| | - Shilpa Bhandi
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
- Department of Cariology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Khalid J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Mrim M Alnfiai
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Burke W Soffe
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Frank W Licari
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Kamran H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| |
Collapse
|
8
|
Garmendia Urdalleta A, Van Poll M, Fahy N, Witte-Bouma J, Van Wamel W, Apachitei I, Zadpoor AA, Fratila-Apachitei LE, Farrell E. The response of human macrophages to 3D printed titanium antibacterial implants does not affect the osteogenic differentiation of hMSCs. Front Bioeng Biotechnol 2023; 11:1176534. [PMID: 37415788 PMCID: PMC10319998 DOI: 10.3389/fbioe.2023.1176534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
Macrophage responses following the implantation of orthopaedic implants are essential for successful implant integration in the body, partly through intimate crosstalk with human marrow stromal cells (hMSCs) in the process of new bone formation. Additive manufacturing (AM) and plasma electrolytic oxidation (PEO) in the presence of silver nanoparticles (AgNPs) are promising techniques to achieve multifunctional titanium implants. Their osteoimmunomodulatory properties are, however, not yet fully investigated. Here, we studied the effects of implants with AgNPs on human macrophages and the crosstalk between hMSCs and human macrophages when co-cultured in vitro with biofunctionalised AM Ti6Al4V implants. A concentration of 0.3 g/L AgNPs in the PEO electrolyte was found to be optimal for both macrophage viability and inhibition of bacteria growth. These specimens also caused a decrease of the macrophage tissue repair related factor C-C Motif Chemokine Ligand 18 (CCL18). Nevertheless, co-cultured hMSCs could osteogenically differentiate without any adverse effects caused by the presence of macrophages that were previously exposed to the PEO (±AgNPs) surfaces. Further evaluation of these promising implants in a bony in vivo environment with and without infection is highly recommended to prove their potential for clinical use.
Collapse
Affiliation(s)
- Amaia Garmendia Urdalleta
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mathijs Van Poll
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Niamh Fahy
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Orthopaedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Applied Science, Technological University of the Shannon: Midlands Midwest, Limerick, Ireland
| | - Janneke Witte-Bouma
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Willem Van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Iulian Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Amir A. Zadpoor
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Lidy E. Fratila-Apachitei
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, TU Delft, Delft, Netherlands
| | - Eric Farrell
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
9
|
Albrektsson T, Tengvall P, Amengual-Peñafiel L, Coli P, Kotsakis G, Cochran DL. Implications of considering peri-implant bone loss a disease, a narrative review. Clin Implant Dent Relat Res 2022; 24:532-543. [PMID: 35639515 PMCID: PMC9542069 DOI: 10.1111/cid.13102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022]
Abstract
Background Peri‐implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time. Purpose To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri‐implantitis. Material and Methods This paper is written as a narrative review of the long‐term clinical investigations available in the literature. Results Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10–15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20–30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20–30 years of follow up. Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re‐evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment. Conclusions Oral implant systems have been found to function with very good clinical outcome over follow‐up times of 20–30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri‐implantitis.
Collapse
Affiliation(s)
- Tomas Albrektsson
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pentti Tengvall
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Pierluigi Coli
- Specialist in Periodontics and Prosthodontics, Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Georgios Kotsakis
- Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - David L Cochran
- Department of Periodontology, University of Texas, San Antonio, USA
| |
Collapse
|
10
|
Nrf2 in the Field of Dentistry with Special Attention to NLRP3. Antioxidants (Basel) 2022; 11:antiox11010149. [PMID: 35052653 PMCID: PMC8772975 DOI: 10.3390/antiox11010149] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 02/06/2023] Open
Abstract
The aim of this review article was to summarize the functional implications of the nuclear factor E2-related factor or nuclear factor (erythroid-derived 2)-like 2 (Nrf2), with special attention to the NACHT (nucleotide-binding oligomerization), LRR (leucine-rich repeat), and PYD (pyrin domain) domains-containing protein 3 (NLRP3) inflammasome in the field of dentistry. NLRP3 plays a crucial role in the progression of inflammatory and adaptive immune responses throughout the body. It is already known that this inflammasome is a key regulator of several systemic diseases. The initiation and activation of NLRP3 starts with the oral microbiome and its association with the pathogenesis and progression of several oral diseases, including periodontitis, periapical periodontitis, and oral squamous cell carcinoma (OSCC). The possible role of the inflammasome in oral disease conditions may involve the aberrant regulation of various response mechanisms, not only in the mouth but in the whole body. Understanding the cellular and molecular biology of the NLRP3 inflammasome and its relationship to Nrf2 is necessary for the rationale when suggesting it as a potential therapeutic target for treatment and prevention of oral inflammatory and immunological disorders. In this review, we highlighted the current knowledge about NLRP3, its likely role in the pathogenesis of various inflammatory oral processes, and its crosstalk with Nrf2, which might offer future possibilities for disease prevention and targeted therapy in the field of dentistry and oral health.
Collapse
|
11
|
Liang B, Wang H, Wu D, Wang Z. Macrophage M1/M2 polarization dynamically adapts to changes in microenvironment and modulates alveolar bone remodeling after dental implantation. J Leukoc Biol 2021; 110:433-447. [PMID: 34254348 DOI: 10.1002/jlb.1ma0121-001r] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/01/2021] [Accepted: 04/18/2021] [Indexed: 12/27/2022] Open
Abstract
As one of the first arriving immune cells after dental implantation, Mϕs own the abilities to polarize into to a spectrum of diverse phenotypes, from "classically activated" M1 Mϕs to "alternatively activated" M2 Mϕs. Herein, it was hypothesized that Mϕ phenotypes dynamically adapt after dental implantation, and the changes ensue a cascade of coordinated interplay with the bone-forming osteoblast and the bone-resorbing osteoclast. Results showed that the remodelling process after dental implantation was similar with the standard response to tissue injury (exampled by tooth extraction models), only with the delay of bone regeneration phases. Additionally, Mϕ activation in both groups underwent a transition from M1 Mϕs dominated to M2-type dominated stage, but the persistence of M1 Mϕs occurred in rat model of dental implantation. Further research in vitro showed that M1 Mϕs are involved in osteoclast activities via secreting the highest levels of TNF-α and IL-1β, as well as being the potential precursor of osteoclasts. Besides, they also recruited BMSCs by secreting the highest levels of chemoattractants, CCL2 and VEGF. M2 Mϕs accelerated osteogenesis in the subsequent stage via their capability to secrete osteogenesis-related proteins, BMP-2 and TGF-β1. However, the osteogenic differentiation of BMSCs was inhibited when cultured in a high concentration of conditioned media from each Mϕ phenotype, meaning that the immune strategies should be controlled within the proper ranges. These results suggest that coordinated efforts by both M1 and M2 Mϕs for bone remodelling, which may highlight an optimization strategy for tissue engineering implants.
Collapse
Affiliation(s)
- Beilei Liang
- Department of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, P. R. China
| | - Haicheng Wang
- Department of Pathology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, P. R. China
| | - Di Wu
- Department of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, P. R. China
| | - Zuolin Wang
- Department of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, P. R. China
| |
Collapse
|
12
|
Innovative Coatings of Metallic Alloys Used as Bioactive Surfaces in Implantology: A Review. COATINGS 2021. [DOI: 10.3390/coatings11060649] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Metallic implants are widely used in the field of implantology, but there are still problems leading to implant failures due to weak osseointegration, low mechanical strength for the implant, inadequate antibacterial properties, and low patient satisfaction. Implant failure can be caused by bacterial infections and poor osteointegration. To improve the implant functionalization, many researchers focus on surface modifications to prepare the proper physical and chemical conditions able to increase biocompatibility and osteointegration between implant and bone. Improving the antibacterial performance is also a key factor to avoid the inflammation in the human body. This paper is a brief review for the types of coatings used to increase osseointegration and biocompatibility for the successful use of metal alloys in the field of implantology.
Collapse
|
13
|
Amengual-Peñafiel L, Córdova LA, Constanza Jara-Sepúlveda M, Brañes-Aroca M, Marchesani-Carrasco F, Cartes-Velásquez R. Osteoimmunology drives dental implant osseointegration: A new paradigm for implant dentistry. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:12-19. [PMID: 33737990 PMCID: PMC7946347 DOI: 10.1016/j.jdsr.2021.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/30/2020] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
There is a complex interaction between titanium dental implants, bone, and the immune system. Among them, specific immune cells, macrophages play a crucial role in the osseointegration dynamics. Infiltrating macrophages and resident macrophages (osteomacs) contribute to achieving an early pro-regenerative peri-implant environment. Also, multinucleated giant cells (MNGCs) in the bone-implant interface and their polarization ability, maintain a peri-implant immunological balance to preserve osseointegration integrity. However, dental implants can display cumulative levels of antigens (ions, nano and microparticles and bacterial antigens) at the implant–tissue interface activating an immune-inflammatory response. If the inflammation is not resolved or reactivated due to the stress signals and the immunogenicity of elements present, this could lead implants to aseptic loosening, infections, and subsequent bone loss. Therefore, to maintain osseointegration and prevent bone loss of implants, a better understanding of the osteoimmunology of the peri-implant environment would lead to the development of new therapeutic approaches. In this line, depicting osteoimmunological mechanisms, we discuss immunomodulatory strategies to improve and preserve a long-term functional integration between dental implants and the human body. Scientific field of dental science: implant dentistry.
Collapse
Affiliation(s)
| | - Luis A Córdova
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Chile.,Department of Oral and Maxillofacial Surgery, Clínica Las Condes, Santiago, Chile.,Department of Oral and Maxillofacial Surgery, Complejo Hospitalario San José. Craneofacial Translational Research Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
| | | | | | | | | |
Collapse
|
14
|
Le Cann S, Törnquist E, Silva Barreto I, Fraulob M, Albini Lomami H, Verezhak M, Guizar-Sicairos M, Isaksson H, Haïat G. Spatio-temporal evolution of hydroxyapatite crystal thickness at the bone-implant interface. Acta Biomater 2020; 116:391-399. [PMID: 32937205 DOI: 10.1016/j.actbio.2020.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 02/02/2023]
Abstract
A better understanding of bone nanostructure around the bone-implant interface is essential to improve longevity of clinical implants and decrease failure risks. This study investigates the spatio-temporal evolution of mineral crystal thickness and plate orientation in newly formed bone around the surface of a metallic implant. Standardized coin-shaped titanium implants designed with a bone chamber were inserted into rabbit tibiae for 7 and 13 weeks. Scanning measurements with micro-focused small-angle X-ray scattering (SAXS) were carried out on newly formed bone close to the implant and in control mature cortical bone. Mineral crystals were thinner close to the implant (1.8 ± 0.45 nm at 7 weeks and 2.4 ± 0.57 nm at 13 weeks) than in the control mature bone tissue (2.5 ± 0.21 nm at 7 weeks and 2.8 ± 0.35 nm at 13 weeks), with increasing thickness over healing time (+30 % in 6 weeks). These results are explained by younger bone close to the implant, which matures during osseointegration. Thinner mineral crystals parallel to the implant surface within the first 100 µm indicate that the implant affects the ultrastructure of neighbouring bone , potentially due to heterogeneous interfacial stresses, and suggest a longer maturation process of bone tissue and difficulty in binding to the metal. The bone growth kinetics within the bone chamber was derived from the spatio-temporal evolution of bone tissue's nanostructure, coupled with microtomographic imaging. The findings indicate that understanding mineral crystal thickness or plate orientation can improve our knowledge of osseointegration.
Collapse
Affiliation(s)
- Sophie Le Cann
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France.
| | - Elin Törnquist
- Department of Biomedical Engineering, Lund University, 221 00 Lund, Sweden
| | | | - Manon Fraulob
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| | - Hugues Albini Lomami
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| | - Mariana Verezhak
- Paul Scherrer Institut, Forschungsstrasse 111, Villigen 5232, Switzerland
| | | | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, 221 00 Lund, Sweden
| | - Guillaume Haïat
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| |
Collapse
|
15
|
Phenolic-Enriched Collagen Fibrillar Coatings on Titanium Alloy to Promote Osteogenic Differentiation and Reduce Inflammation. Int J Mol Sci 2020; 21:ijms21176406. [PMID: 32899166 PMCID: PMC7504673 DOI: 10.3390/ijms21176406] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 12/13/2022] Open
Abstract
The adsorption of biomolecules on biomaterial surfaces can promote their integration with surrounding tissue without changing their bulk properties. For biomaterials in bone reconstruction, the promotion of osteogenic differentiation and reduction of inflammation are desirable. Fibrillar coatings are interesting because of fibrils’ high surface area-volume ratio, aiding adsorption and adhesion. Fibrils also serve as a matrix for the immobilization of biomolecules with biological activity, such as the phenolic compound phloroglucinol (PG), the subunit of marine polyphenols. The aim of this work was to investigate the influence of PG coatings on fibroblast- and osteoblast-like cells to increase the osseointegration of titanium implants. Collagen fibril coatings, containing PG at low and high concentrations, were produced on titanium alloy (Ti6Al4V) scaffolds generated by additive manufacturing (AM). These coatings, especially PG-enriched coatings, reduced hydrophobicity and modulated the behavior of human osteosarcoma SaOS-2 and mouse embryonic fibroblast 3T3 cell lines. Both osteoblastic and fibroblastic cells spread and adhered well on PG-enriched coatings. Coatings significantly reduced the inflammatory response. Moreover, osteogenic differentiation was promoted by collagen coatings with a high PG concentration. Thus, the enrichment of collagen fibril coatings with PG is a promising strategy to improve Ti6Al4V implants for bone contact in orthopedics and dentistry and is worthy of further investigation.
Collapse
|
16
|
Wang X, Li Y, Feng Y, Cheng H, Li D. The role of macrophages in osseointegration of dental implants: An experimental study in vivo. J Biomed Mater Res A 2020; 108:2206-2216. [PMID: 32363723 DOI: 10.1002/jbm.a.36978] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/26/2020] [Accepted: 04/04/2020] [Indexed: 12/17/2022]
Abstract
To investigate the role of macrophages in the osseointegration of dental implants through induced macrophage reduction in a murine model. Fifty-four Sprague-Dawley rats with bilateral maxillary first molars replaced by titanium implants were randomly assigned into three groups. For the test group, macrophages were depleted by tail-vein injection of clodronate liposome (20 mg/kg) 3 days before implantation and reinjection every 3 days until the sacrifice of the rats (10 mg/kg). Animals treated with Phosphate Buffer saline (PBS) alone or empty liposome were included as controls. Samples contained implants were retrieved after 3, 7, 14, and 28 days, and the alterations of macrophages (CD68) and osteoblasts (Osterix) were evaluated using histology and immunohistochemistry technique. Histological analysis showed that new bone gradually formed within the lateral chamber regions in both the Control group and the Lip group, whereas bone healing was delayed at the first 2-weeks despite of pronounced newly formed peri-implant bone at 4 weeks in the Lipclod group. The bone-to-implant contact was significantly higher in the Lip and Control group than in the Lipclod group after 2 weeks. Immunohistochemical analysis showed that CD68+ cells were present both in the central region and in direct contact with implant surface throughout the healing period. Macrophages depletion reduced osteoblast amounts and new bone formation around implants in the first 2 weeks, and have no adverse impacts on the final formation of osseointegration. Macrophages play a dual role in both regulating the bone healing process and immune response to implant installation during the early stages.
Collapse
Affiliation(s)
- Xin Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, China.,Department of Stomatology, The 901st Hospital of the Joint Logistics Support Force of PLA, Hefei, China
| | - Yu Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, China
| | - Yuan Feng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, China
| | - Haode Cheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, China
| | - Dehua Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, China
| |
Collapse
|
17
|
Albrektsson T. Are Oral Implants the Same As Teeth? J Clin Med 2019; 8:E1501. [PMID: 31546951 PMCID: PMC6781071 DOI: 10.3390/jcm8091501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 02/08/2023] Open
Abstract
Osseointegration of oral implants was initially discovered by Brånemark [...].
Collapse
Affiliation(s)
- Tomas Albrektsson
- Department of Biomaterials, University of Gothenburg, 40530 Gothenburg, Sweden.
| |
Collapse
|
18
|
Functionalization of Ceramic Coatings for Enhancing Integration in Osteoporotic Bone: A Systematic Review. COATINGS 2019. [DOI: 10.3390/coatings9050312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: The success of reconstructive orthopaedic surgery strongly depends on the mechanical and biological integration between the prosthesis and the host bone tissue. Progressive population ageing with increased frequency of altered bone metabolism conditions requires new strategies for ensuring an early implant fixation and long-term stability. Ceramic materials and ceramic-based coatings, owing to the release of calcium phosphate and to the precipitation of a biological apatite at the bone-implant interface, are able to promote a strong bonding between the host bone and the implant. Methods: The aim of the present systematic review is the analysis of the existing literature on the functionalization strategies for improving the implant osteointegration in osteoporotic bone and their relative translation into the clinical practice. The review process, conducted on two electronic databases, identified 47 eligible preclinical studies and 5 clinical trials. Results: Preclinical data analysis showed that functionalization with both organic and inorganic molecules usually improves osseointegration in the osteoporotic condition, assessed mainly in rodent models. Clinical studies, mainly retrospective, have tested no functionalization strategies. Registered trademarks materials have been investigated and there is lack of information about the micro- or nano- topography of ceramics. Conclusions: Ceramic materials/coatings functionalization obtained promising results in improving implant osseointegration even in osteoporotic conditions but preclinical evidence has not been fully translated to clinical applications.
Collapse
|
19
|
Monje A, Insua A, Wang HL. Understanding Peri-Implantitis as a Plaque-Associated and Site-Specific Entity: On the Local Predisposing Factors. J Clin Med 2019; 8:E279. [PMID: 30823574 PMCID: PMC6406659 DOI: 10.3390/jcm8020279] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of implant biological complications has grown enormously over the last decade, in concordance with the impact of biofilm and its byproducts upon disease development. Deleterious habits and systemic conditions have been regarded as risk factors for peri-implantitis. However, little is known about the influence of local confounders upon the onset and progression of the disease. The present narrative review therefore describes the emerging local predisposing factors that place dental implants/patients at risk of developing peri-implantitis. A review is also made of the triggering factors capable of inducing peri-implantitis and of the accelerating factors capable of interfering with the progression of the disease.
Collapse
Affiliation(s)
- Alberto Monje
- Department of Periodontology, Universitat Internacional de Catalunya, 08195 Barcelona, Spain.
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Angel Insua
- Division of Periodontics, CICOM Periodoncia, 06011 Badajoz, Badajoz, Spain Santiago de Compostela, Spain.
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA.
| |
Collapse
|