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Basak SS, Guler Ayyıldız B, Eken S, Karakıs Akcan S. Radiographic evaluation of the distance between the restoration margin and the alveolar bone crest in dental implant patients: A retrospective study. J Dent 2024; 144:104935. [PMID: 38499282 DOI: 10.1016/j.jdent.2024.104935] [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: 12/13/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVES The recently introduced Implant Disease Risk Assessment (IDRA) identifies a restoration margin-alveolar bone crest (RM-AC) distance of less than 1.5 mm as a key risk factor for peri‑implant disease among eight major risk factors. This study evaluated the impact of the RM-AC distance on marginal bone loss (MBL) through radiographic analysis. METHODS This retrospective cross-sectional study included 77 partially edentulous patients (39 females and 38 males, aged 22 to 76 years) with 202 platform-switched conical connection implants, cement-retained, implant-supported fixed restorations, and bone-level implants placed between 2016 and 2021. Dental implants were followed for least 6 to 36 months at follow up functional loading. Study participants were categorized into Group A (RM-AC distance ≤ 1.5 mm, n = 69) and Group B (RM-AC distance > 1.5 mm, n = 133). Twelve patients in Group B and five patients in Group A had no history of periodontal disease. The MBL was measured radiographically from the most coronal point of the implant shoulder to the alveolar bone, and the RM-AC distance was measured from the restoration margin to the alveolar crest. Multinomial logistic regression analysis was used for statistical evaluation. RESULTS The incidence of MBL in Group A was statistically significant and 3.42 times higher than that in Group B. The rate of MBL in periodontitis Stage 4 was found to be 26.31 times higher than that in periodontitis Stage 2. The incidence of MBL was 6.097 and 5.02 times higher with increasing implant diameter and length, respectively. CONCLUSION This study conclusively demonstrates that RM-AC distance ≤ 1.5 significantly increases the risk of MBL, particularly in patients with a history of periodontal disease. CLINICAL SIGNIFICANCE This study highlights the critical role of maintaining an RM-AC distance greater than 1.5 mm in the prevention of MBL, particularly in patients with a history of periodontal disease. Since implant diameter and length have a significant impact on the risk of MBL, it emphasizes that implant demographics should also be carefully evaluated.
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Affiliation(s)
- Suna Selver Basak
- Kutahya Health Sciences University, Faculty of Dentistry, Department of Prosthodontics, Kutahya, Turkey.
| | - Berceste Guler Ayyıldız
- Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey.
| | - Seyma Eken
- Kutahya Health Sciences University, Faculty of Dentistry, Department of Periodontology, Kutahya, Turkey; Kutahya Health Sciences University, Tavsanlı Vocational School of Health Services, Oral Health Department, Kutahya, Turkey.
| | - Serap Karakıs Akcan
- Istanbul Gelısım University, Faculty of Dentistry, Department of Periodontology, Istanbul, Turkey.
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Rugani P, Weingartner K, Jakse N. Influence of the Tube Angle on the Measurement Accuracy of Peri-Implant Bone Defects in Rectangular Intraoral X-ray Imaging. J Clin Med 2024; 13:391. [PMID: 38256525 PMCID: PMC10817073 DOI: 10.3390/jcm13020391] [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: 11/25/2023] [Revised: 12/20/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Intraoral radiography in the right-angle technique is the standard procedure to examine the peri-implant bone level in implant follow-up and implant-related studies. For the implementation of the right-angle or parallel technique, mostly ready-made image receptor holders are used. The aim of this experimental study is to analyze changes in the measurement of standardized peri-implant defects caused by a deviation in the position of the image receptor. METHODS Eleven Xive® implants (Dentsply Sirona, Bensheim, Germany) were placed in bovine bone, and peri-implant defects of varying depths were created. The preparations were fixed in a specially made test stand, and intraoral radiographs were taken using the right-angle technique with standard film holders at various horizontal and vertical projection angles. Defect measurement was carried out with the imaging software Sidexis 4 V 4.3 (Dentsply Sirona, Bensheim, Germany). RESULTS With increasing angular deviation, larger deviations between the measured and the real extent of the defect occurred. Vertical tilting caused significant distortion, while horizontal rotation showed less effect. CONCLUSION Intraoral radiography only provides a valid representation of the peri-implant bone level for follow-up or as a tool in implant-related studies if a reproducible projection direction is assured.
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Affiliation(s)
- Petra Rugani
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria
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Strauch M, Jaghsi AA, Schwahn C, Mundt T. The intra- and inter-rater reproducibility of bone level measurements at strategic mini-implants using dental panoramic radiography. Clinics (Sao Paulo) 2023; 79:100316. [PMID: 38091630 PMCID: PMC10758704 DOI: 10.1016/j.clinsp.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES This experimental study focused on the intra- and inter-rater reproducibility of vertical bone level (VBL) measurements at strategic mini-implants (MI) using digital panoramic radiographs (PR). STUDY DESIGN VBLs of 152 MIs for removable partial denture stabilization at 50 randomly chosen PRs from a clinical trial were digitally evaluated by three ratters. Rater deviations exceeding 0.5 mm were re-examined. The intra-class correlation coefficient (ICC) was applied to estimate reliability. The smallest detectable change (SDC) was interrelated to the minimal clinically important change of 0.2 mm. RESULTS The first measurement round revealed intra- and inter-rater ICCs of > 0.8. However, 28 sites (9 %) were unreadable, and 97 sites (32 %) revealed differences between observers of ≥ 0.5 mm. Following a consensus session and re-training, an additional 8 sites were excluded and all remaining VBL differences were ≤ 0.5 mm. Thus, the SDCs with 95 % credibility were improved from 0.73 to 0.31 mm in the intra-rater and from 1.52 to 0.34 mm in the inter-rater statistics. Given a 50 % credibility for this special setting, both the intra- and inter-rater SDCs were 0.11 mm. CONCLUSIONS Digital PR can be reliably utilized to determine VBLs around MIs under conditions of at least two trained observers, mutual calibration sessions, and exclusion of unquantifiable radiographs. GERMAN CLINICAL TRIALS REGISTER ID DRKS00007589, www.germanctr.de.
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Affiliation(s)
- Martin Strauch
- Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Germany.
| | - Ahmad Al Jaghsi
- Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Germany; Clinical Sciences Department, College of Dentistry, Ajman, United Arab Emirates; Centre of Medical and Bio-Allied Health, Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Christian Schwahn
- Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Germany
| | - Torsten Mundt
- Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Germany
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Menchini Fabris GB, Toti P, Covani U, Crespi G, Luca S, Crespi R. Bone assessment around the delayed dental implant with and without preformed anatomical caps: A 1-year retrospective case-control study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101584. [PMID: 37532083 DOI: 10.1016/j.jormas.2023.101584] [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: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023]
Abstract
PURPOSES To investigate the amount of first-year peri‑implant bone loss and the development of the papillae when delayed dental implants loaded with anatomic cover screw and those underwent conventional healing protocol were compared. METHODS Edentulous healed sites had undergone delayed implants placement. In the anatomical cap group, patients were treated with a guided tissue healing, tooth-like cross-linkable acrylic resin caps had been immediately screwed on dental implants. The marginal loss of the alveolar bone height 1 year after surgery and Jemt's papillae index were obtained. Non-parametric statistics were performed with a level of significance of 1% RESULTS: Forty patients were included in the present retrospective analysis. After a follow-up of 1 year, none of the 40 included implants showed a failure. The Jemt's papilla index was 1.76±0.44 and 1.34±0.50 respectively for guided tissue healing and conventional healing group, without any significant difference. Within the first year of survey a bone loss of -1.27±0.26 mm for conventional healing treatment showed a statistically significant difference (p-value<0.0001) when it was compared to the negligible of the other group (-0.06±0.31 mm). CONCLUSIONS A guided healing procedure with preformed caps seemed to give better outcomes regarding marginal bone loss and papilla index than those of conventional abutments.
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Affiliation(s)
- Giovanni Battista Menchini Fabris
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy.
| | - Paolo Toti
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Ugo Covani
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Giovanni Crespi
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Signorini Luca
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Crespi
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
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Helmy MA, El-Shaheed NH, El Waseef FA, Ahmed WS, Hegazy SA. Effect of Ridge Splitting of Mandibular Knife Edge Ridges with Two-implant Retained Overdenture with Locator Attachments on Peri-implant Bone Level and Posterior Ridge Resorption: A One-year Preliminary Study. J Contemp Dent Pract 2023; 24:834-839. [PMID: 38238269 DOI: 10.5005/jp-journals-10024-3592] [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: 01/23/2024]
Abstract
AIM This study was conducted to evaluate peri-implant bone height changes and posterior ridge resorption by using two-implant retained polyetheretherketone (PEEK) overdentures with locator attachments following expansion of mandibular knife edge ridges by ridge splitting. MATERIALS AND METHODS Eighteen patients were selected for ridge splitting followed by expansion, implant placement, and bone graft application. Six months later, the fabrication of PEEK overdentures retained by locator attachments was accomplished. Friedman test, Wilcoxon signed-rank test, and Spearman correlation were used to evaluate the changes over time. RESULTS Peri-implant bone height loss increased significantly with the advance of time between 6 and 12 months following denture insertion. Posterior area index changes were significant over time when measured at the time of denture insertion and twelve months following denture insertion. CONCLUSION The effect of using PEEK as overdenture base material retained with two locator attachments allowed sharing the load between the peri-implant bone anteriorly and residual ridge posteriorly in cases with ridge splitting technique. CLINICAL SIGNIFICANCE Using PEEK as an overdenture base material is a successful means of bone preservation. How to cite this article: Helmy MA, El-Shaheed NH, El Waseef FA, et al. Effect of Ridge Splitting of Mandibular Knife Edge Ridges with Two-implant Retained Overdenture with Locator Attachments on Peri-implant Bone Level and Posterior Ridge Resorption: A One-year Preliminary Study. J Contemp Dent Pract 2023;24(11):834-839.
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Affiliation(s)
- Marwa A Helmy
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Dakahlia, Egypt, Phone: +20 1008871218, e-mail:
| | - Noha H El-Shaheed
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Dakahlia, Egypt
| | - Fatma A El Waseef
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Dakahlia, Egypt
| | - Wael S Ahmed
- Department of Oral Surgery, Faculty of Dentistry, Mansoura University, Dakahlia, Egypt
| | - Salah A Hegazy
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Dakahlia, Egypt
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Singh S, Dhawan P, Kaur H. Correlation of Serum Vitamin D with Crestal Bone Level in Dental Implant Patients Using CBCT: A Clinical Retrospective Study. J Contemp Dent Pract 2023; 24:415-418. [PMID: 37622616 DOI: 10.5005/jp-journals-10024-3537] [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: 08/26/2023]
Abstract
AIM The purpose of this study is to correlate the role of serum vitamin D levels associated with crestal bone in dental implant patients using cone-beam computed tomography (CBCT). MATERIALS AND METHODS This retrospective study enrolled patients among whom implants were placed after a detailed planning using CBCT and the delayed loading protocol was followed. After 3 months and 6 months of loading, CBCT evaluations were carried out, serum vitamin D levels were also tested at the end of 6 months of loading. A total of 30 patients were recruited with 15 patients in each group based on normal and deficient levels of vitamin D to correlate with crestal bone levels using CBCT. RESULTS Clinically acceptable crestal bone loss (CBL) was visible with all the implants at different time intervals. Statistical analysis was done for intergroup and intragroup comparisons which showed significant p-value (< 0.05) for CBL at the time of loading, at 3 months, and at 6 months follow-up for both normal and deficient serum values. In the deficient group, the mean value at baseline was 9.69 mm ± 1.10 and the CBL at 6 months follow-up was 8.80 mm ± 1.10 whereas for the normal group at baseline, the mean was 9.08 mm ± 1.21 and at 6 months follow-up was 8.12 mm ± 1.25 which showed meaningful difference. CONCLUSION There is a positive correlation seen between CBL on CBCT and vitamin D serum levels. The success of the implant is significantly affected by vitamin D as it regulates the bone physiology and has systemic effects on accelerating bone formation around titanium implants. CLINICAL SIGNIFICANCE Vitamin D is essential in maintaining the balance of bone minerals and assists to preserve the crestal bone level making the implant treatment more predictable and successful.
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Affiliation(s)
- Shubhaani Singh
- Department of Prosthodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Pankaj Dhawan
- Department of Prosthodontics, Manav Rachna Dental College, Faridabad, Haryana, India
| | - Harsimran Kaur
- Department of Prosthodontics, Manav Rachna Dental College, Faridabad, Haryana, India, Phone: +91 7838408622, e-mail:
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López-Valverde N, López-Valverde A, Blanco-Rueda JA. Efficacy of adjuvant metronidazole therapy on peri-implantitis: a systematic review and meta-analysis of randomized clinical studies. Front Cell Infect Microbiol 2023; 13:1149055. [PMID: 37287463 PMCID: PMC10242105 DOI: 10.3389/fcimb.2023.1149055] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023] Open
Abstract
Peri-implant diseases are pathological conditions that affect the survival of dental implants. Etiological studies are limited, accepting a prevalence of 20% at the implant level and 24% at the patient level. The benefits of adjuvant metronidazole are controversial. A systematic review and meta-analysis of RCTs according to PRISMA and PICOS was performed with an electronic search over the last 10 years in MEDLINE (PubMed), WOS, Embase, and Cochrane Library. The risk of bias was measured using the Cochrane Risk of Bias tool and the methodological quality using the Jadad scale. Meta-analysis was performed with RevMan version 5.4.1, based on mean difference and standard deviation, with 95% confidence intervals; the random-effects model was selected, and the threshold for statistical significance was defined as p < 0.05. A total of 38 studies were collected and five were selected. Finally, one of the studies was eliminated because of unanalyzable results. All studies reached a high methodological quality. A total of 289 patients were studied with follow-up periods from 2 weeks to 1 year. Statistical significance was only found, with respect to the use of adjunctive metronidazole, in the pooled analysis of the studies (p = 0.02) and in the analysis of the radiographic values reported on peri-implant marginal bone levels, in the studies with a 3-month follow-up (p = 0.03). Discrepancies in the use of systemic metronidazole require long-term randomized clinical trials (RCTs) to determine the role of antibiotics in the treatment of peri-implantitis.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - José Antonio Blanco-Rueda
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
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Giro G, Taira J, Andriani F, Watinaga S, Bastos MF, Shibli JA. Evaluation of IL-4, MIP-1α, and MMP-9 gene expression levels in peri-implant tissues in peri-implantitis. Braz Dent J 2023; 34:129-135. [PMID: 37466520 PMCID: PMC10355265 DOI: 10.1590/0103-6440202305382] [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: 01/11/2023] [Accepted: 03/20/2023] [Indexed: 07/20/2023] Open
Abstract
This case-control study evaluated the gene expression levels of interleukin (IL)-4, macrophage inflammatory protein type 1 alpha (MIP-1α), and metalloproteinase (MMP)-9, factors involved in the formation of giant cells in healthy peri-implant tissue and peri-implantitis. Thirty-five subjects (15 healthy and 20 with peri-implantitis), who met the inclusion and exclusion criteria, were included in this study. The peri-implant tissue biopsies were subjected to total RNA extraction, DNAse treatment, and cDNA synthesis. Subsequently, the reaction of real-time PCR was performed to evaluate the gene expression levels of IL-4, MIP-1α, and MMP-9 concerning the reference gene. IL-4 gene expression showed higher (18-fold) values in the Peri-Implantitis Group of Patients when compared with the Healthy (Control) Group (p<0.0001). Although MIP- 1α and MMP-9 gene expression levels were higher in diseased implants, they showed no significant differences (p=0.06 and p=0.2337), respectively. Within the limitations of this study, the results showed that in tissues affected by peri-implantitis, only levels of Il-4 were increased when compared with tissues in the control group.
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Affiliation(s)
- Gabriela Giro
- Guarulhos University, Department of Periodontology and Oral
Implantology, Dental Research Division. Praça Tereza Cristina, 289, 07023-030,
Guarulhos, SP, Brazil
| | - Jorge Taira
- Guarulhos University, Department of Periodontology and Oral
Implantology, Dental Research Division. Praça Tereza Cristina, 289, 07023-030,
Guarulhos, SP, Brazil
| | - Fernando Andriani
- Guarulhos University, Department of Periodontology and Oral
Implantology, Dental Research Division. Praça Tereza Cristina, 289, 07023-030,
Guarulhos, SP, Brazil
| | - Sidney Watinaga
- Guarulhos University, Department of Periodontology and Oral
Implantology, Dental Research Division. Praça Tereza Cristina, 289, 07023-030,
Guarulhos, SP, Brazil
| | | | - Jamil Awad Shibli
- Guarulhos University, Department of Periodontology and Oral
Implantology, Dental Research Division. Praça Tereza Cristina, 289, 07023-030,
Guarulhos, SP, Brazil
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Fuda S, Martins BGDS, Castro FCD, Heboyan A, Gehrke SA, Fernandes JCH, Mello-Moura ACV, Fernandes GVO. Marginal Bone Level and Clinical Parameter Analysis Comparing External Hexagon and Morse Taper Implants: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:diagnostics13091587. [PMID: 37174979 PMCID: PMC10178059 DOI: 10.3390/diagnostics13091587] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
The goal of this systematic review was to verify the marginal bone loss (MBL) and other clinical parameters comparing external hexagon (EH) and Morse taper (MT) implants when they were evaluated within the same study. The focused question was, "For patients (P) treated with external connection (I) or Morse taper (C) dental implants, were there differences in the marginal bone crest maintenance after at least three months in occlusal function (O)"? As for the inclusion criteria that were considered, they included clinical studies in English that compared the MBL in implants with EH and MT, with follow-up of at least three months, that were published between 2011 and 2022; as for the exclusion criteria, they included publications investigating only one type of connection that analyzed other variables and did not report results for the MBL, reports based on questionnaires, interviews, and case reports/series, systematic reviews, or studies involving patients with a significant health problem (ASA Physical Status 3 and above). The PubMed/MEDLINE, Embase, and Web of Science databases were screened, and all of the data obtained were registered in a spreadsheet (Excel®). The Jadad scale was used to assess the quality of the studies. A total of 110 articles were initially identified; 11 were considered for full-text reading. Then, six articles (four RCTs and two prospective studies) met the eligibility criteria and were included in this study. A total of 185 patients (mean age of 59.71) were observed, and the follow-up ranged from 3 months to 36 months. A total of 541 implants were registered (267 EH and 274 MT). The survival rate ranged between 96% and 100% (the average was 97.82%). The MBL was compared among all periods studied; therefore, the common assessment period was the 12-month follow-up, presenting greater MBL for EH than for MT (p < 0.001). A mean MBL of 0.60 mm (95% CI 0.43-0.78) was found after the same period. BoP was reported in 5 studies and plaque index was reported in 4 (2 with more than 30%). Deep PD was observed in three studies. High heterogeneity was observed (I2 = 85.06%). Thus, within the limitation of this review, it was possible to conclude that there is higher bone loss in EH than in MT implants when evaluating and comparing this variable within the same study. However, the results must be carefully interpreted because of this review's limited number of clinical studies, the short assessment period, and the high heterogeneity found.
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Affiliation(s)
- Samuele Fuda
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | | | | | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan 0025, Armenia
| | - Sergio Alexandre Gehrke
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Instituto de Bioingenieria, Universidad Miguel Hernández, 03202 Elche, Spain
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
| | | | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
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Jain S, Mattoo K, Khalid I, Baig FA, Kota MZ, Ishfaq M, Ibrahim M, Hassan S. A Study of 42 Partially Edentulous Patients with Single-Crown Restorations and Implants to Compare Bone Loss Between Crestal and Subcrestal Endosseous Implant Placement. Med Sci Monit 2023; 29:e939225. [PMID: 36772790 PMCID: PMC9930363 DOI: 10.12659/msm.939225] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The purpose of the study was to evaluate the influence of dental implant placement at different bone levels upon the resultant postoperative peri-implant bone loss. MATERIAL AND METHODS Forty-two partially edentulous patients seeking implant-supported single-crown restorations were screened followed by segregation into 2 groups (GP), GP E (equicrestal) and GP S (subcrestal) (n=21 each). Sixty endosseous implants (30 each) (Adin Tourage-S, Israel), size 3.5/8 and 4/10 mm for mandibles, were placed using a 2-stage surgical procedure. At 4 to 6 months, straight abutments were attached followed by restoration (Vita Zahnfabrik, Germany). Crestal bone levels (mesial/distal) of implant fixtures were assessed at 5 time intervals (after surgery, and at 3, 6, 9, and 12 months) using digital radiography. Means and standard deviations were calculated, following which the differences were statistically analyzed using ANOVA at P value of <0.05. RESULTS The mean annual bone loss for GP S (1.96 mm) was higher than GP E (1.10 mm). At all studied time intervals, the bone loss for implants in GP S was higher than in GP E (P<0.05). Between time intervals, lowest bone loss was observed on the distal side in GP E (0.11 mm/6-9 month) and the highest bone loss was observed on the distal side of GP S (0.6 mm/9-12 month). Differences in the means between the 2 groups on mesial and distal sides were statistically significant at all time intervals (P<0.05). CONCLUSIONS Subcrestal implant placement was associated with more bone loss than when implants are placed at the crestal level.
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Affiliation(s)
- Shailesh Jain
- Department of Prosthodontics and Crown/Bridge, School of Dental Sciences, Sharda University, Greater Noida, India
| | - Khurshid Mattoo
- Prosthetic Dental Sciences, College of dentistry, Jazan University, Jazan, Saudi Arabia
| | - Imran Khalid
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Fawaz A.H. Baig
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Zahir Kota
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Muhammad Ishfaq
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Ibrahim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Sahba Hassan
- Department of Prosthodontics and Crown/Bridge, School of Dental Sciences, Sharda University, Greater Noida, India
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De Stefano M, Lanza A, Faia E, Ruggiero A. A distinct ultrashort dental implant design for the reduction of the bone stress/strain field: a comparative numerical investigation. BIOMEDICAL ENGINEERING ADVANCES 2023. [DOI: 10.1016/j.bea.2023.100077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Albrektsson T, Tengvall P, Amengual L, Coli P, Kotsakis GA, Cochran D. Osteoimmune regulation underlies oral implant osseointegration and its perturbation. Front Immunol 2023; 13:1056914. [PMID: 36761175 PMCID: PMC9902598 DOI: 10.3389/fimmu.2022.1056914] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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Affiliation(s)
- T. Albrektsson
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden
| | - P. Tengvall
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden,*Correspondence: P. Tengvall,
| | - L. Amengual
- Dental Implantology Unit, Hospital Leonardo Guzmán, Antofagasta, Chile
| | - P. Coli
- Edinburgh Dental Specialists, Edinburgh, United Kingdom,Department of Prosthetic Dentistry and Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden,Department of Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - G. A. Kotsakis
- Department of Periodontology, University of Texas, San Antonio, TX, United States
| | - D. Cochran
- Department of Periodontology, University of Texas, San Antonio, TX, United States
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Exploring the Importance of Corticalization Occurring in Alveolar Bone Surrounding a Dental Implant. J Clin Med 2022; 11:jcm11237189. [PMID: 36498764 PMCID: PMC9738071 DOI: 10.3390/jcm11237189] [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: 10/22/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Several measures describing the transformation of trabecular bone to cortical bone on the basis of analysis of intraoral radiographs are known (including bone index or corticalization index, CI). At the same time, it has been noted that after functional loading of dental implants such transformations occur in the bone directly adjacent to the fixture. Intuitively, it seems that this is a process conducive to the long-term maintenance of dental implants and certainly necessary when immediate loading is applied. The authors examined the relationship of implant design features to marginal bone loss (MBL) and the intensity of corticalization over a 10-year period of functional loading. This study is a general description of the phenomenon of peri-implant bone corticalization and an attempt to interpret this phenomenon to achieve success of implant treatment in the long term. Corticalization significantly increased over the first 5-year functional loading (CI from 200 ± 146 initially to 282 ± 182, p < 0.001) and maintained a high level (CI = 261 ± 168) in the 10-year study relative to the reference bone (149 ± 178). MBL significantly increased throughout the follow-up period—5 years: 0.83 ± 1.26 mm (p < 0.001), 10 years: 1.48 ± 2.01 mm (p < 0.001). MBL and radiographic bone structure (CI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. In the scope of the study, it can be concluded that the phenomenon of peri-implant jawbone corticalization seems an unfavorable condition for the future fate of bone-anchored implants, but it requires further research to fully explain the significance of this phenomenon.
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AlAhmari F, Preethanath RS, Divakar DD, Ali D. Association of Peri-Implant Health Status With COVID-19. Int Dent J 2022; 73:443-448. [PMID: 36642571 PMCID: PMC9712070 DOI: 10.1016/j.identj.2022.11.019] [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: 09/24/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The aim of this research was to evaluate peri-implant health status in patients infected with COVID-19 and control patients (individuals without COVID-19). METHODS This observational investigation was performed in adults with (test group) and without (control group) COVID-19 infection having at least 1 functional dental implant. Self-reported education status and daily frequency of toothbrushing and flossing was determined. A questionnaire was administered to record demographic data, brushing/flossing frequency, and education status. Periodontal examination comprised full-mouth assessment of clinical attachment loss (CAL), plaque index (PI), probing depth (PD), and gingival index (GI). Peri-implant PD, modified PI, and modified gingival index were recorded. Loss of marginal and crestal bone around teeth and implants was also measured. Significance level was established for P < .05. RESULTS Seventy-three (41 males) and 71 (44 males) individuals were included in the test and control groups, respectively. Average ages of patients and controls were 44.6 ± 5.2 and 40.1 ± 3.1 years, respectively. University-level education was attained by 52 (75.3%) and 50 (70.4%) individuals in the test and control groups, respectively. Seventy (95.9%) and 68 (95.7%) patients and controls were brushing twice a day. Once-daily interproximal flossing was reported by 44 (60.3%) and 48 (67.6%) individuals in test and control groups. All participants had healthy periodontal and peri-implant tissues. CONCLUSIONS The study indicated that there are no short-term adverse effects on the peri-implant tissues due to acute COVID-19 infection, and further well-controlled longitudinal studies are needed to evaluate the long-term effect of the infection on these tissues.
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Affiliation(s)
- Fatemah AlAhmari
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Reghunathan S Preethanath
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University, Ministry of Health, Lusaka, Zambia
| | - Dena Ali
- Department of General Dental Practice, Faculty of Dentistry, Kuwait University, Safat, Kuwait
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Mao C, Yu W, Jin M, Wang Y, Shang X, Lin L, Zeng X, Wang L, Lu E. Mechanobiologically optimized Ti-35Nb-2Ta-3Zr improves load transduction and enhances bone remodeling in tilted dental implant therapy. Bioact Mater 2022; 16:15-26. [PMID: 35386333 PMCID: PMC8958422 DOI: 10.1016/j.bioactmat.2022.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 12/13/2022] Open
Abstract
The tilted implant with immediate function is increasingly used in clinical dental therapy for edentulous and partially edentulous patients with excessive bone resorption and the anatomic limitations in the alveolar ridge. However, peri-implant cervical bone loss can be caused by the stress shielding effect. Herein, inspired by the concept of “materiobiology”, the mechanical characteristics of materials were considered along with bone biology for tilted implant design. In this study, a novel Ti–35Nb–2Ta–3Zr alloy (TNTZ) implant with low elastic modulus, high strength and favorable biocompatibility was developed. Then the human alveolar bone environment was mimicked in goat and finite element (FE) models to investigate the mechanical property and the related peri-implant bone remodeling of TNTZ compared to commonly used Ti–6Al–4V (TC4) in tilted implantation under loading condition. Next, a layer-by-layer quantitative correlation of the FE and X-ray Microscopy (XRM) analysis suggested that the TNTZ implant present better mechanobiological characteristics including improved load transduction and increased bone area in the tilted implantation model compared to TC4 implant, especially in the upper 1/3 region of peri-implant bone that is “lower stress”. Finally, combining the static and dynamic parameters of bone, it was further verified that TNTZ enhanced bone remodeling in “lower stress” upper 1/3 region. This study demonstrates that TNTZ is a mechanobiological optimized tilted implant material that enhances load transduction and bone remodeling. The mechanical properties and deformation mechanisms of Ti–35Nb–2Ta–3Zr alloys were studied. The cell biocompatibility, a layer-by-layer correlation of the finite element and X-ray Microscopy analysis were evaluated. Ti–35Nb–2Ta–3Zr implant improves load transduction and enhances bone remodeling in tilted implantation models. Mechanobiologically optimized Ti–35Nb–2Ta–3Zr alloy meets the clinical application requirements of tilted implant therapy.
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Affiliation(s)
- Chuanyuan Mao
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Weijun Yu
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Min Jin
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yingchen Wang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Materials Genome Initiative Centre, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xiaoqing Shang
- National Engineering Research Center of Light Alloy Net Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Lu Lin
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Xiaoqin Zeng
- National Engineering Research Center of Light Alloy Net Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- Corresponding author.
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Materials Genome Initiative Centre, Shanghai Jiao Tong University, Shanghai, 200240, China
- Corresponding author.
| | - Eryi Lu
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
- Corresponding author.
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Afshari Z, Yaghini J, Naseri R. LEVELS OF SMOKING AND PERI‑IMPLANT MARGINAL BONE LOSS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101721. [PMID: 36162899 DOI: 10.1016/j.jebdp.2022.101721] [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: 07/06/2021] [Revised: 02/09/2022] [Accepted: 03/13/2022] [Indexed: 10/18/2022]
Abstract
AIM This systematic review and meta-analysis sought to determine if there was a significantly enhanced risk of peri‑implant marginal bone loss (MBL) due to the increased number of cigarettes smoked per day. MATERIALS AND METHODS Six databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, and ProQuest, were searched until February, 2021. The search terms "dental implant, oral implant, smoking, smoker, non-smoker, marginal bone loss and crestal bone loss" were used in combination to seek the articles providing data for MBL related to the smoking habit. Articles were excluded if the quantity of cigarettes smoked per day was not reported. Random-effects meta-analyses were used to pool the estimates of mean difference (MD) with 95% confidence intervals (CI). RESULTS Eight studies were included for qualitative and 5 for quantitative synthesis. The meta-analyses revealed higher levels of MBL in patients who smoked <10 or >10 cigarettes/day than in non-smokers (<10: (MD -0.33, 95% CI -0.69-0.03 and >10: MD -0.58, 95% CI -0.96- -0.19). There was a significant risk of MBL between patients who smoked >10 and <10 cigarettes/day (MD -0.23, 95% CI -0.47-0.01). CONCLUSION It seems the risk of MBL is steadily increasing as daily smoking increases.
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Affiliation(s)
- Zohreh Afshari
- Dental Implants Research Center, Department of Periodontics, Dental research institute, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaber Yaghini
- Dental Implants Research Center, Department of Periodontics, Dental research institute, School of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roohollah Naseri
- Dental Research Center, Department of Periodontics, Dental Research Institute, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran.
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Di Fiore A, Montagner M, Sivolella S, Stellini E, Yilmaz B, Brunello G. Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J Clin Med 2022; 11:jcm11164812. [PMID: 36013048 PMCID: PMC9409652 DOI: 10.3390/jcm11164812] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | | | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Department of Oral Surgery, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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18
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López-Valverde N, Aragoneses J, López-Valverde A, Rodríguez C, Macedo de Sousa B, Aragoneses JM. Role of chitosan in titanium coatings. trends and new generations of coatings. Front Bioeng Biotechnol 2022; 10:907589. [PMID: 35935477 PMCID: PMC9354072 DOI: 10.3389/fbioe.2022.907589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/04/2022] [Indexed: 01/03/2023] Open
Abstract
Survival studies of dental implants currently reach high figures. However, considering that the recipients are middle-aged individuals with associated pathologies, research is focused on achieving bioactive surfaces that ensure osseointegration. Chitosan is a biocompatible, degradable polysaccharide with antimicrobial and anti-inflammatory properties, capable of inducing increased growth and fixation of osteoblasts around chitosan-coated titanium. Certain chemical modifications to its structure have been shown to enhance its antibacterial activity and osteoinductive properties and it is generally believed that chitosan-coated dental implants may have enhanced osseointegration capabilities and are likely to become a commercial option in the future. Our review provided an overview of the current concepts and theories of osseointegration and current titanium dental implant surfaces and coatings, with a special focus on the in vivo investigation of chitosan-coated implants and a current perspective on the future of titanium dental implant coatings.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- *Correspondence: Antonio López-Valverde,
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
| | - Bruno Macedo de Sousa
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Polo I‐Edifício Central Rua Larga, Coimbra, Portugal
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Satpathy M, Duan Y, Betts L, Priddy M, Griggs JA. Effect of Bone Remodeling on Dental Implant Fatigue Limit Predicted Using 3D Finite Element Analysis. JOURNAL OF DENTISTRY AND ORAL EPIDEMIOLOGY 2022; 2:10.54289/jdoe2200102. [PMID: 36851985 PMCID: PMC9968486 DOI: 10.54289/jdoe2200102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND To evaluate the effect of bone remodelling around a reduced-diameter dental implant on its fatigue limit using finite element analysis (FEA). METHODS A dental implant assembly, which included a reduced-diameter dental implant (Biomet-3i external hex), an abutment (GingiHue®) and a connector screw (Gold-Tite Square screw), was scanned using micro-computed tomography (Skyscan 1172). Its dimensions were measured using Mimics (Materialise) and an optical microscope (Keyence). The digital replicas of the physical specimens were constructed using SOLIDWORKS (Dassault Systems). A cylindrical bone specimen holder with two layers (cortical and cancellous bone) was designed in SOLIDWORKS. Two assemblies were created: (a) Model 1: Having non-remodelled bone; (b) Model 2: Cancellous bone remodelled at the regions adjacent to the implant screw threads. FEA was performed in ABAQUS (SIMULIA). In Model 1, the Young's modulus of cortical and cancellous bone were 20 GPa and 14 GPa, respectively. For Model 2, the region of the cancellous bone adjacent to the implant screw threads was assigned a Young's modulus of 20 GPa. fe-safe (SIMULIA) was used to estimate the fatigue limit. RESULTS The maximum von Mises stress under 100 N load was 439.9 MPa for both models 1 and 2 and was located at the connector screw. The fatigue limit was 116.4 N for both models 1 and 2. CONCLUSIONS The results suggest that implant fatigue resistance tested according to ISO 14801 may be accurately predicted without bothering to simulate the non-homogeneous stiffness that occurs at the bone-implant interface in the clinical case.
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Affiliation(s)
- Megha Satpathy
- Department of Biomedical Materials Science, University of Mississippi Medical Centre, Jackson, MS, USA
| | - Yuanyuan Duan
- Department of Biomedical Materials Science, University of Mississippi Medical Centre, Jackson, MS, USA
| | - Logan Betts
- Department of Mechanical Engineering, Mississippi State University, Starkville, MS, USA
| | - Matthew Priddy
- Department of Mechanical Engineering, Mississippi State University, Starkville, MS, USA
| | - Jason A Griggs
- Department of Biomedical Materials Science, University of Mississippi Medical Centre, Jackson, MS, USA
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20
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Tabassum A. Radiographic comparisons of crestal bone levels around implants placed with low-speed drilling and standard drilling protocols: Preliminary results. Saudi Dent J 2021; 33:965-971. [PMID: 34938039 PMCID: PMC8665170 DOI: 10.1016/j.sdentj.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 07/04/2021] [Accepted: 08/01/2021] [Indexed: 12/02/2022] Open
Abstract
Background The present study aimed to investigate the mean crestal bone loss (CBL) by placing implants using two different drilling-protocols, i.e., standard drilling with saline irrigation and low-speed drilling without saline irrigation. Material and Methods The patients were enrolled in the present study from a university teaching institute. Patients who fulfilled the inclusion criteria were randomly placed in two study groups: 1) control group: Standard drilling with saline irrigation and 2) test group: low-speed drilling without saline irrigation. The radiographic mean crestal bone loss (CBL) was evaluated at 3 months of follow-up before implant loading. Data analysis was performed using SPSS 20.0 (IBM product, Chicago, USA) and a p-value ≤ 0.05 was considered statistically significant. Results Sixteen patients (10 males and 6 females) participated in the study. Thirty Camlog®-screw-line implants were placed (15 implants per study group). After 3 months of follow-up, the means CBL of implants placed with standard drilling and low-speed drilling protocols were 1.01 ± 0.49 mm and 0.74 ± 0.62 mm, respectively. No statistically significant difference could be recorded between two groups (p = 0.206). Conclusions Dental implants placed with low-speed drilling without saline irrigation exhibited a similar CBL to implants installed with the standard drilling protocol. However, further randomised clinical trials are recommended to obtain stronger evidence and a better understanding of the effect of the low-speed drilling protocol without saline irrigation on mean CBL and long-term implant survival.
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Affiliation(s)
- Afsheen Tabassum
- Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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21
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Zaki J, Yusuf N, El‐Khadem A, Scholten RJPM, Jenniskens K. Efficacy of bone-substitute materials use in immediate dental implant placement: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:506-519. [PMID: 34118175 PMCID: PMC8453723 DOI: 10.1111/cid.13014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/25/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the efficacy of using a bone substitute material (BSM) in the fixture-socket gap in patients undergoing tooth extraction and immediate implant placement. MATERIALS AND METHODS MEDLINE, EMBASE, and CENTRAL databases were searched for randomized controlled trials (RCTs). RCTs were screened for eligibility, and data were extracted by two authors independently. Risk of bias (ROB) was assessed using Cochrane's ROB tool 2.0. Primary outcomes were implant failure, overall complications, and soft-tissue esthetics. Secondary outcomes were vertical buccal bone resorption, vertical interproximal bone resorption, horizontal buccal bone resorption, and mid-buccal mucosal recession. Meta-analysis was performed using random-effects model with generic inverse variance weighing. GRADE was used to grade the certainty of the evidence. RESULTS After screening 19 544 potentially eligible references, 20 RCTs were included in this review, with a total of 848 patients (916 sites). Most included RCTs were deemed of some concerns (53%) or at low (38%) risk of bias, except for overall complications (high ROB). Implant failure did not differ significantly RR = 0.92 (confidence intervals [CI] 0.34 to 2.46) between using a BSM compared with not using a BSM (NoBSM). BSM use resulted in less horizontal buccal bone resorption (MD = -0.52 mm [95% CI -0.74 to -0.30]), a higher esthetic score (MD = 1.49 [95% CI 0.46 to 2.53]), but also more complications (RR = 3.50 [95% CI 1.11 to 11.1] compared with NoBSM. Too few trials compared types of BSMs against each other to allow for pooled analyses. The certainty of the evidence was considered moderate for all outcomes except implant failure (low), overall complications (very low), and vertical interproximal bone resorption (very low). CONCLUSION BSM use during immediate implant placement reduces horizontal buccal bone resorption and improves the periimplant soft-tissue esthetics. Although BSM use increases the risk of predominantly minor complications.
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Affiliation(s)
- John Zaki
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Maidan Dental ClinicKuwait
| | - Nermin Yusuf
- Department of Periodontology, Faculty of DentistryCairo UniversityGizaEgypt
| | - Ahmed El‐Khadem
- The Centre for Evidence‐Based Dentistry, Faculty of DentistryCairo UniversityGizaEgypt
- Department of Pediatric Dentistry, Faculty of DentistryCairo UniversityGizaEgypt
| | - Rob J. P. M. Scholten
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Kevin Jenniskens
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
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22
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Abstract
Implant supported dental prostheses are increasingly used in dental practice. The aim of this narrative review is to present the influence of transmucosal surface of prosthetic abutment and implant on peri-implant tissue. The article describes causes of bone loss around the dental implant. Moreover, properties of different materials are compared and discussed. The advantages, disadvantages, and biomechanical concept of different implant-abutment connections are presented. The location of connections in relation to the bone level and the influence of microgap between the abutment and implant are described. Additionally, the implant abutments for cemented and screwed prosthetic restorations are compared. The influence of implant and abutment surface at the transmucosal level on peri-implant soft tissue is discussed. Finally, the biological aspect of abutment-implant connection is analyzed.
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Choi B, Lee YC, Oh KC, Lee JH. Effects of photofunctionalization on early osseointegration of titanium dental implants in the maxillary posterior region: a randomized double-blinded clinical trial. Int J Implant Dent 2021; 7:37. [PMID: 33969450 PMCID: PMC8107060 DOI: 10.1186/s40729-021-00318-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the effects of ultraviolet (UV) photofunctionalization on the stability of implants during the early phase in the posterior region of the maxilla. The study was a randomized double-blinded clinical trial. Half of the participants received conventional commercial implants while the other half received UV-irradiated implants. The surgical sites were classified into three bone quality groups (II, III, IV) based on the grayscale value measured on cone-beam computed tomography. The values obtained from resonance frequency analysis were recorded immediately after implant placement and at 4 weeks and at 4 months postoperatively. The marginal bone level of the implants was evaluated using periapical radiographs at 4 weeks, 4 months, and 1 year postoperatively. Results Fifty-seven implants placed in 34 participants were analyzed in this study. In group III, significant differences were observed in terms of the differences of resonance frequency analysis values at 4 weeks (p = 0.004) and 4 months (p = 0.017) postoperatively. In group II, the UV-treated group showed significantly lesser bone loss at 4 weeks post-operatively (p = 0.037). Conclusions Within the limitation of the present study, we concluded that UV surface treatment on implants may increase the initial stability in the region of the maxilla with poor bone quality.
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Affiliation(s)
- Bada Choi
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Ye Chan Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Kyung Chul Oh
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Jae Hoon Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, 03722, Korea.
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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.
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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
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Coli P, Jemt T. Are marginal bone level changes around dental implants due to infection? Clin Implant Dent Relat Res 2021; 23:170-177. [PMID: 33463079 DOI: 10.1111/cid.12971] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant. Reduction of marginal bone levels in association with bleeding on probing have been claimed to be a sign of pathology and an indication of treatment needs. PURPOSE To assess the available evidence that peri-implant bone loss is caused by infection. MATERIALS AND METHODS This article is a narrative review on the interpretation of marginal bone level changes around dental implants as a consequence of infection. RESULTS AND CONCLUSIONS There is evidence that plaque accumulation induces an inflammatory reaction in the peri-implant soft tissues and that resumption of plaque control measures results in the reduction of the inflammation. Since plaque is always present in the oral cavity, a cause-effect relationship between plaque accumulation and peri-implantitis, defined as inflammation of the peri-implant soft tissues associated with marginal bone loss has been difficult to validate and has not been proven so far. There is no evidence of the mechanisms involved in the tissue reactions resulting in the conversion from a state of an inevitable inflammation contained in the soft tissues to a state of inflammation involving the loss of peri-implant marginal bone. There is today no consensus whether implants should be expected to be surrounded by tissues which are completely free from inflammation, or that an "immune-driven", chronic, subclinical inflammation should be expected at the foreign body implant. The infectious origin theory appears to be mainly supported by ligature-induced experimental peri-implantitis investigations in animal models that suffer of several methodological problems, and therefore, provide misleading information with regards to human clinical applications in large, routine populations.
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Affiliation(s)
- Pierluigi Coli
- Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
| | - Torsten Jemt
- Brånemark Clinic, Public Dental Health Care Service, Gothenburg, Västra Götaland, Sweden
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Nimbalkar S, Dhatrak P, Gherde C, Joshi S. A review article on factors affecting bone loss in dental implants. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.matpr.2020.07.428] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Immunological Aspects of Dental Implant Rejection. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7279509. [PMID: 33376734 PMCID: PMC7744195 DOI: 10.1155/2020/7279509] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/29/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
Nowadays, dental implants are a prominent therapeutic approach among dentists for replacing missing teeth. Failure in dental implants is a severe challenge recently. The factors which lead to dental implant failure are known. These factors can be categorized into different groups. In this article, we discussed the immunological aspects of implant failure as one of these groups. Cytokines and immune cells have extensive and various functions in peri-implantitis. The equilibrium between pro and anti-inflammatory cytokines and cells, which involve in this orchestra, has a crucial role in implant prognosis. In conclusion, immune cells, especially macrophages and dendritic cells, almost increased in the patients with implant failure. Also, proinflammatory cytokines were proposed as diagnostic factors according to their higher levels in dental implant rejection.
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The Effects of Smoking Cigarettes on Immediate Dental Implant Stability—A Prospective Case Series Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Smoking tobacco significantly affects the biology of periodontal tissues and contributes to the increased risk of peri-implant diseases. The aim of the study was to investigate whether smoking cigarettes affects the primary and secondary stability of maxillary dental implants, inserted into fresh sockets immediately after extraction. Methods: The study was conducted on 164 patients between the ages of 27–71 years old. 67 individuals smoked more than 20 cigarettes daily and 97 were non-smokers. 190 immediate implants were inserted in the maxilla. Immediate implantations were performed with simultaneous augmentation of the socket with xenogenic bone grafting material. In the posterior region, implants were inserted into the palatal alveolus. The stability of the implants was measured using Insertion Torque Value (ITV) and two types of devices: Periotest (PT) and Osstell (ISQ). Marginal bone loss was evaluated on cone beam computed tomography scans. Results: In an aesthetic area, the PT values at 6 months post-implantation were higher for smokers than non-smokers (p < 0.05), respectively. The ISQ values were significantly lower in smokers compared to non-smokers at 6 months post-implantation (p = 0.0226), respectively. In the posterior region PT values were higher in smokers both on the day of implantation (p = 0.0179), 6 months after surgery (p = 0.0003) as well as 24 months after surgery (p < 0.0001), as compared to non-smokers, respectively. Smokers revealed lower ISQ values than non-smokers (p = 0.0047) on the day of implantation, as well as 6 months after implantation (p = 0.0002), respectively. There were no significant differences in marginal bone loss after 18 months of loading between smokers and non-smokers in the aesthetic, as well as posterior regions (p > 0.05). ITV measurements were lower in smokers than non-smokers in the aesthetic (16.3 vs. 17.5 Ncm) and posterior area (16.8 vs. 17.9 Ncm). Conclusions: This study indicate that smoking cigarettes has a negative effect on the stability of immediate implants in the maxilla. Primary stability of immediate implants may be lower in the posterior area of the maxilla in smokers when compared to non-smokers, which may eliminate smokers from immediate implants in this region. Secondary stability of immediate implants may be lower in both the aesthetic and posterior areas in smokers compared to non-smokers, which may encourage the postponement of final crowns delivery at 6 months post op and the extension of the occlusaly temporary crowns use in some smoker cases.
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López-Valverde N, Flores-Fraile J, López-Valverde A. The Unknown Process Osseointegration. BIOLOGY 2020; 9:biology9070168. [PMID: 32708689 PMCID: PMC7407983 DOI: 10.3390/biology9070168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 12/18/2022]
Abstract
Although it was already described more than fifty years ago, there is yet no in-depth knowledge regarding the process of osseointegration as far as its mechanism of action is concerned. It could be one of the body’s ways of reacting to a foreign body, where the individual’s immune response capacity is involved. It is known that the nervous system has an impact on bone health and that the role of the autonomic nervous system in bone remodeling is an attractive field for current research. In the future, immuno/neuromodulatory techniques will open new and exciting lines of research.
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Peixoto RF, Tonin BSH, Martinelli J, Macedo AP, de Mattos MDGC. In vitro digital image correlation analysis of the strain transferred by screw-retained fixed partial dentures supported by short and conventional implants. J Mech Behav Biomed Mater 2019; 103:103556. [PMID: 31785542 DOI: 10.1016/j.jmbbm.2019.103556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE This study used digital image correlation (DIC) to evaluate the strain transferred by splinted and non-splinted screw-retained fixed partial dentures (FPDs) supported by short and conventional implants. MATERIAL AND METHODS Four polyurethane models were fabricated to simulate half of the mandibular arch with acrylic resin replicas of the first premolar. Short (5 mm) and/or conventional (11 mm) implants replaced the second premolar and the first and second molars. Groups were: G1, two conventional (second premolar and first molar) and one short (second molar) implant; G2, one conventional (second premolar) and two short (first and second molar) implants; G3, three short implants; and G4, three conventional implants. Splinted (S) and non-splinted (NS) FPDs were screwed to the implant abutments. Occlusal load and a single point load on the second premolar, both of 250 N, were applied. Strain in the horizontal direction (Ɛxx) was calculated and compared using the DIC software. RESULTS Splinted crowns presented the highest strain magnitudes of all tested groups (p < 0.05). The strain was concentrated near the short implants and presented a higher magnitude compared to conventional implants, especially in G2S (-560.13 μS), G3S (-372.97 μS), and G4S (-356.67 μS). CONCLUSIONS Splinted crowns presented a higher strain concentration around the implants, particularly near the implant replacing the first molar. A combination of short and conventional implants seems to be a viable alternative for the rehabilitation of the posterior edentulous mandible with reduced bone height.
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Affiliation(s)
- Raniel Fernandes Peixoto
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
| | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janisse Martinelli
- School of Dentistry, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
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Manea A, Baciut G, Baciut M, Pop D, Comsa DS, Buiga O, Trombitas V, Colosi H, Mitre I, Bordea R, Manole M, Lenghel M, Bran S, Onisor F. New Dental Implant with 3D Shock Absorbers and Tooth-Like Mobility-Prototype Development, Finite Element Analysis (FEA), and Mechanical Testing. MATERIALS 2019; 12:ma12203444. [PMID: 31640243 PMCID: PMC6829458 DOI: 10.3390/ma12203444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/08/2019] [Accepted: 10/18/2019] [Indexed: 11/26/2022]
Abstract
Background: Once inserted and osseointegrated, dental implants become ankylosed, which makes them immobile with respect to the alveolar bone. The present paper describes the development of a new and original implant design which replicates the 3D physiological mobility of natural teeth. The first phase of the test followed the resistance of the implant to mechanical stress as well as the behavior of the surrounding bone. Modifications to the design were made after the first set of results. In the second stage, mechanical tests in conjunction with finite element analysis were performed to test the improved implant design. Methods: In order to test the new concept, 6 titanium alloy (Ti6Al4V) implants were produced (milling). The implants were fitted into the dynamic testing device. The initial mobility was measured for each implant as well as their mobility after several test cycles. In the second stage, 10 implants with the modified design were produced. The testing protocol included mechanical testing and finite element analysis. Results: The initial testing protocol was applied almost entirely successfully. Premature fracturing of some implants and fitting blocks occurred and the testing protocol was readjusted. The issues in the initial test helped design the final testing protocol and the new implants with improved mechanical performance. Conclusion: The new prototype proved the efficiency of the concept. The initial tests pointed out the need for design improvement and the following tests validated the concept.
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Affiliation(s)
- Avram Manea
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Grigore Baciut
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Mihaela Baciut
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Dumitru Pop
- Department of Mechanical Systems Engineering, Faculty of Machine Building, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania.
| | - Dan Sorin Comsa
- Department of Manufacturing Engineering, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania.
| | - Ovidiu Buiga
- Department of Mechanical Systems Engineering, Faculty of Machine Building, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania.
| | - Veronica Trombitas
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Horatiu Colosi
- Department of Medical Education, Faculty of Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Ileana Mitre
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Marius Manole
- Department of Prosthetics and Dental Materials, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Manuela Lenghel
- Department of Surgical specialties, Faculty of Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Simion Bran
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
| | - Florin Onisor
- Department of Cranio-Maxillofacial Surgery and Radiology, Faculty of Dental Medicine, University of Medicine and Pharmacy 'Iuliu Hatieganu', 400012 Cluj-Napoca, Romania.
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Marotti J, Neuhaus S, Habor D, Bohner L, Heger S, Radermacher K, Wolfart S. High-Frequency Ultrasound for Assessment of Peri-Implant Bone Thickness. J Clin Med 2019; 8:jcm8101539. [PMID: 31557872 PMCID: PMC6832403 DOI: 10.3390/jcm8101539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 01/20/2023] Open
Abstract
Purpose: The aim of this study was to evaluate the accuracy of high-frequency ultrasound (HFUS) for measurement of bone thickness surrounding dental implants. Methods: Eight porcine bone samples containing dental implants were scanned by a HFUS scanner and compared using cone-beam computed tomography (CBCT) and an optical scanner. Bone thickness was measured in the buccolingual region of dental implants in 10 points distributed between the platform and apical portion of the implant. Results: The mean measurement error for the ultrasound method was 0.11 mm, whereas CBCT showed a measurement error of 0.20 mm. For both devices, the maximal measurement error was 0.28 mm. Conclusion: Within the simulated limited conditions of this study, high-frequency ultrasound, with optical scanning used as a reference, presented higher accuracy in comparison to CBCT, and seems to be a promising tool for measuring peri-implant bone.
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Affiliation(s)
- Juliana Marotti
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Sarah Neuhaus
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Daniel Habor
- Department of Medical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany.
| | - Lauren Bohner
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Stefan Heger
- Institute for Biomedical Engineering, Mannheim University, John-Deere-Strasse 85, 68163 Mannheim, Germany.
| | - Klaus Radermacher
- Department of Medical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany.
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
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Are Oral Implants the Same As Teeth? J Clin Med 2019; 8:jcm8091501. [PMID: 31546951 PMCID: PMC6781071 DOI: 10.3390/jcm8091501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 02/08/2023] Open
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Chaubey AK, Mishra SK, Chowdhary R. Positive Material Identification testing of dental implant to correlate their compositions with allergic conditions. J Oral Biol Craniofac Res 2019; 9:294-298. [PMID: 31289719 DOI: 10.1016/j.jobcr.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022] Open
Abstract
Background Rapid increase of products containing titanium leads to the increases in percutaneous and permucosal exposure of populations to the titanium. Purpose Evaluate the various material compositions in five commercially available dental implant systems and correlate the obtained material contents with allergic conditions seen with implants. Material and methods A total of 25 implant, with 5 samples each in 5 groups of commercially available dental implants (MKIII, Myriad, Nobel Replace, MIS and Alpha Dent) were used in the study. Positive Material Identification (PMI) testing was done to analyse the amount of different metals (percentage by mass) present in the dental implants. Results Highest titanium content, 99.47% by mass was found in sample 2 (Myriad) and least, 89.04% by mass in sample 5(Alpha dent). Nickel was found only in sample 5 (Alpha dent) in 0.079% by mass and zinc in sample 4 (MIS) in0.084% by mass, chromium was found in sample 1 (MK III) in 0.263% by mass and in sample 2 in0.273% by mass. Conclusions Implant composition should be made mandatory to be disclosed on the implant packet and before implant placement patch test for the allergen present in the particular implant can be done for the patient's health benefit and long term clinical success of dental implants.
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Affiliation(s)
- Avadhesh Kumar Chaubey
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, 560074, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Peoples College of Dental Sciences & Research Centre, Bhopal, 462037, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, 560074, India
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