Treatment of an early failing implant by guided bone regeneration using resorbable collagen membrane and bioactive glass

A short note on bioglass in Periodontics

Bone augmentation grafts may act as space-maintaining devices to allow coronal migration of periodontal progenitor cells. The ideal bone replacement graft should be able to trigger osteogenesis, cementogenesis and formation of a functional periodontal ligament. It has been theorized that bioactive glass, which is a ceramic has bioactive properties that guide and promote osteogenesis allowing rapid formation of bone. Bioactive glass consists of sodium and calcium salts, phosphates and silicon dioxide for dental applications. When this material comes into contact with tissue fluids, the surface of the particles becomes coated with hydroxy carbonate apatite, incorporates organic ground proteins such as chondroitin sulfate and glycosaminoglycans and attracts osteoblasts that rapidly form bone.

Application of bioactive glasses in various dental fields

Bioactive glasses are a group of bioceramic materials that have extensive clinical applications. Their properties such as high biocompatibility, antimicrobial features, and bioactivity in the internal environment of the body have made them useful biomaterials in various fields of medicine and dentistry. There is a great variation in the main composition of these glasses and some of them whose medical usage has been approved by the US Food and Drug Administration (FDA) are called Bioglass. Bioactive glasses have appropriate biocompatibility with the body and they are similar to bone hydroxyapatite in terms of calcium and phosphate contents. Bioactive glasses are applied in different branches of dentistry like periodontics, orthodontics, endodontics, oral and maxillofacial surgery, esthetic and restorative dentistry. Also, some dental and oral care products have bioactive glasses in their compositions. Bioactive glasses have been used as dental implants in the human body in order to repair and replace damaged bones. Other applications of bioactive glasses in dentistry include their usage in periodontal disease, root canal treatments, maxillofacial surgeries, dental restorations, air abrasions, dental adhesives, enamel remineralization, and dentin hypersensitivity. Since the use of bioactive glasses in dentistry is widespread, there is a need to find methods and extensive resources to supply the required bioactive glasses. Various techniques have been identified for the production of bioactive glasses, and marine sponges have recently been considered as a rich source of it. Marine sponges are widely available and many species have been identified around the world, including the Persian Gulf. Marine sponges, as the simplest group of animals, produce different bioactive compounds that are used in a wide range of medical sciences. Numerous studies have shown the anti-tumor, anti-viral, anti-inflammatory, and antibiotic effects of these compounds. Furthermore, some species of marine sponges due to the mineral contents of their structural skeletons, which are made of biosilica, have been used for extracting bioactive glasses.

Utilization of Carbon Nanotubes in Manufacturing of 3D Cartilage and Bone Scaffolds

Cartilage and bone injuries are prevalent ailments, affecting the quality of life of injured patients. Current methods of treatment are often imperfect and pose the risk of complications in the long term. Therefore, tissue engineering is a rapidly developing branch of science, which aims at discovering effective ways of replacing or repairing damaged tissues with the use of scaffolds. However, both cartilage and bone owe their exceptional mechanical properties to their complex ultrastructure, which is very difficult to reproduce artificially. To address this issue, nanotechnology was employed. One of the most promising nanomaterials in this respect is carbon nanotubes, due to their exceptional physico-chemical properties, which are similar to collagens-the main component of the extracellular matrix of these tissues. This review covers the important aspects of 3D scaffold development and sums up the existing research tackling the challenges of scaffold design. Moreover, carbon nanotubes-reinforced bone and cartilage scaffolds manufactured using the 3D bioprinting technique will be discussed as a novel tool that could facilitate the achievement of more biomimetic structures.

Bioactive Glass Applications in Dentistry

At present, researchers in the field of biomaterials are focusing on the oral hard and soft tissue engineering with bioactive ingredients by activating body immune cells or different proteins of the body. By doing this natural ground substance, tissue component and long-lasting tissues grow. One of the current biomaterials is known as bioactive glass (BAG). The bioactive properties make BAG applicable to several clinical applications involving the regeneration of hard tissues in medicine and dentistry. In dentistry, its uses include dental restorative materials, mineralizing agents, as a coating material for dental implants, pulp capping, root canal treatment, and air-abrasion, and in medicine it has its applications from orthopedics to soft-tissue restoration. This review aims to provide an overview of promising and current uses of bioactive glasses in dentistry.

Decontamination of Dental Implant Surfaces by the Er:YAG Laser Beam: A Comparative in Vitro Study of Various Protocols

Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers, is still controversial. Previous studies have revealed a reduction in osteoblast adhesion to carbon-contaminated implant surfaces. This in-vitro study aimed to evaluate the decontamination of failed implants by assessing the carbon proportion, after irradiation by low-energy erbium yttrium-aluminum-garnet laser (Er:YAG) (Fotona; 2940 nm, Ljubljana, Slovenia) for a single and for multiple passages, until getting a surface, free of organic matters; to find the appropriate procedure for dental-implant surface-decontamination. Ninety implants were used. Thirty sterile implants were kept as a negative control. Thirty failed implants were irradiated by the Er:YAG laser, for a single passage, and the other thirty, for multiple passages. The parameters used in our experiments were an irradiation energy of 50 mJ, frequency of 30 Hz, and an energy density of 3.76 J/cm². A sapphire tip, with a length of 8 mm, was used with concomitant water spray irrigation, under air 6 and water spray 4. Super short pulse mode (SSP) was of 50 μs; irradiation speed being 2 mm/s. We used energy-dispersive X-ray spectroscopy (EDX) to evaluate the carbon proportion on the surfaces of the sterile implants, the contaminated, and the lased implants, with one (LX1) and with three passages (LX3). Statistical analysis was performed by ANOVA. Results showed mean difference between the three groups (contaminated, LX1, and LX3) with p < 0.0001, as between LX1 and Group A (p < 0.0001), while the difference between LX3 and the control group was not statistically significant. The decontamination of the implant surfaces with a low-energy Er:YAG laser with three passages, appeared to be an encouraging approach.

Radiographic analysis of dental implant extensions using bone grafts on dogs

BACKGROUND

Despite the wide use of dental implants they can bring inconveniences, as the moment one reaches osseointegration, these can no longer be extended. Therefore, if a problem occurs regarding its positioning, the options open are substitution or burial of the implant. With implant substitution, there exists the risk of local bone loss and/or future loss of the new implant.

PURPOSE

This study proposes a new device (implant extender) for extending the dental implant. The feasibility of this technique is verified through installing dental implant extensions onto the humerus bone of dogs with autogenous bone grafts.

MATERIALS AND METHODS

Implants of 3.3 mm in diameter by 6 mm in length and implant extensions with a 3.3 mm diameter and 2.2 mm length were installed onto humerus of 4 healthy dogs, using an autogenous bone graft in a block made from ilium. The biomechanical percussion tests were performed on the implant extensions and then the implant-extension sets were removed for radiographic analysis.

RESULTS

In the biomechanical percussion, none of the extensions present clinical mobility. As for the x-rays, these were analyzed by 20 professionals, who concluded that there was a 100% success rate with bone formation around the implants, 74.1% for bone neoformation of the implant extensions, and 80.1% referring to the adaptation of the implant extension.

DISCUSSION AND CONCLUSION

Bone formation occurred in every installed dental implant. In most cases, there occurred bone neoformation of the extensions and adaptation of the extension/implant set, according to the x-ray analysis performed by the evaluators. An absence of clinical mobility in the extensions was also observed. Although the results were promising, these techniques still need to be researched in humans, as an alternative for reducing elongated prosthetic crowns or poorly installed implants, as well as the modification of the type of implants among other applications.

Bioactive-glass in periodontal surgery and implant dentistry

Bioactive-glass (B-G) is a material known for its favorable biological response when in contact with surrounding fibro-osseous tissues, due not only to an osteoconductive property, but also to an osteostimulatory capacity, and superior biocompatibility for use in human body. The objectives of this paper are to review recent studies on B-G in periodontal and implant therapy, describing its basic properties and mechanism of activity as well as discoursing about state of art and future perspective of utilization. From a demonstrated clinical benefit as bone graft for the elimination of osseous defects due to periodontal disease (intrabony/furcation defects) and surgeries (alveolar ridge preservation, maxillary sinus augmentation), to a potential use for manufacturing bioactive dental implants, possibly allowing wider case selection criteria together with improved integration rates even in the more challenging osteoporotic and medically compromised patients, this biomaterial represents an important field of study with high academic, clinical and industrial importance.

Peptide functionalisation of nanocomposite polymer for bone tissue engineering using plasma surface polymerisation

Biofunctionalisation of POSS-PCU for bone tissue engineering by plasma surface treatment.

Fractal analysis of ibuprofen effect on experimental dog peri-implantitis

INTRODUCTION

The aim of this study was to assess the correlation between the fractal analysis of gingival changes and systemic nitro-oxidative stress in a short-term low-dose ibuprofen (IBU) treatment at experimental peri-implantitis (PI).

MATERIALS AND METHODS

Six adult male mixed-breed dogs with PI were randomly treated for 2 weeks, 3 with IBU (5 mg/kg b.w.) and 3 with placebo. Clinical and radiological evaluation were performed. Gingival biopsies were assessed by light microscopy, transmission electron microscopy, and fractal analysis. Blood was collected to assay nitric oxide (NOx), total oxidative status (TOS), total antioxidant response (TAR), and oxidative stress index (OSI).

RESULTS

Specific gingival ultrastructural alterations, bone loss, and systemic nitro-oxidative stress were evident in PI-placebo animals. IBU caused significant clinical, microscopic, fractal dimensions (P < 0.01), NOx, TOS, and OSI improvements. IBU caused no important bone and TAR changes.

CONCLUSION

This study confirms that fractal analysis was a good method to assess the complex morphological changes and correlations with the nitro-oxidative stress in PI. Short-term low-dose IBU treatment consistently improved gingival status and reduced systemic nitro-oxidative stress.

Guided Bone Regeneration Using Glass-Reinforced Hydroxyapatite and Collagen Membrane in the Treatment of Peri-Implantitis

Implant therapy has provided the clinician a wide variety of treatment options with respect to the replacement of missing natural teeth. With more number of dentists practicing implant dentistry, one is likely to be presented with peri-implantitis and implant related failures in day to day practice. Peri-impant mucositis can be reversed by elimination of the biofilm but peri-implantitis which results in bone loss and subsequent exfoliation of the implant if left unattended have to be treated using a regenerative approach in addition to conventional non surgical therapy. The present case demonstrates the guided bone regeneration procedure using a glass-reinforced HA and collagen membrane in the treatment of an intrabony defect around the implant. Nine months post operative radiograph revealed complete resolution of the defect. This novel composite alloplast shows promise in treating such lesions.Keywords: Peri-implantitis, Guided bone regeneration, Alloplast, Dental implant, Bone graft, Collagen membrane, Implant decontamination.