Marginal bone loss around cement and screw-retained fixed implant prosthesis

Clinical Effects of Photofunctionalization on Implant Stability and Marginal Bone Loss: Systematic Review and Meta-Analysis

BACKGROUND

Several clinical trials have recently been conducted to elucidate the effectiveness of photofunctionalization. The aim of this review was to systematically analyze the clinical effects of photofunctionalization on implant stability and marginal bone loss (MBL).

METHODS

An electronic search in four databases and a manual search were conducted in September 2022. Randomized controlled trials (RCTs), clinical controlled trials (CCTs), and cohort and case-control studies evaluating the effects of photofunctionalization on implant stability or marginal bone loss (MBL) in humans were included. The methodological quality assessment using RoB 2.0 and the ROBINS-I tool was performed based on different study designs.

RESULTS

Seven studies were included for a qualitative analysis, and five of them were chosen for a meta-analysis. The meta-analysis revealed that photofunctionalization significantly improved the stability of the implant 2 months after implantation (p = 0.04; MD = 3.48; 95% CI = -0.23 to 6.73) and increased the osseointegration speed index (OSI) (p = 0.007; MD = 2.13; 95% CI = 0.57 to 3.68). However, no significant improvements of implant stability were observed 2 weeks (p = 0.62), 4 weeks (p = 0.31), nor 4 months (p = 0.24) after implantation. The evaluation presented no significant reductions in MBL.

CONCLUSIONS

Based on the positive effect of photofunctionalization on the rate of establishing implant stability, photofunctionalization may provide an effective and practical strategy to achieve faster osseointegration and reduce the overall healing time. Photofunctionalization appears to improve the implant stability. However, the clinical effect of photofunctionalization on MBL remains unclear due to the shortage of available studies.

Marginal Bone Loss around Implant-Retaining Overdentures versus Implant-Supported Fixed Prostheses 12-Month Follow-Up: A Retrospective Study

Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the mean MBL and radiographic bone-implant interface contact (r-BIIC) around IODs and implant-supported FPs. We also investigated osseointegration and MBL around non-submerged dental implants. We measured the changes between the MBL in the mesial and distal sites immediately after prosthetic delivery and after one year. The mean MBL and its changes in the IOD group were significantly higher. The mean percentage of r-BIIC was significantly higher in the FP group. MBL and its changes in males were significantly higher in the IOD group. The percentage of r-BIIC was significantly higher in the FP group. MBL in the lower site in the IOD group was significantly higher. Regarding MBL, the location of the implant was the only significant factor in the IOD group, while gender was the only significant predictor in the FP group. Regarding the r-BIIC percentage, gender was a significant factor in the FP group. We concluded that non-submerged dental implants restored with FPs and IODs maintained stable bone remodeling one year after prosthetic delivery.

Radiographic comparisons of crestal bone levels around implants placed with low-speed drilling and standard drilling protocols: Preliminary results

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.

Clinical and radiographic variables related to implants with simultaneous grafts among type 2 diabetic patients treated with different hypoglycemic medications: a retrospective study

Background

The influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents.

Methods

In this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal–Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons.

Results

After a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P < 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P < 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P < 0.05) and GLP-1 group (P < 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P > 0.05).

Conclusions

The radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone.

Clinical trial registration number ChiCTR2000034211 (retrospectively registered).

Clinical outcomes of single implant supported crowns versus 3-unit implant-supported fixed dental prostheses in Dubai Health Authority: a retrospective study

Background

This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs).

Methods

This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations.

Results

A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient’s age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001).

Conclusions

Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.

Influence of moderate cigarette-smoking on the peri-implant clinicoradiographic inflammatory parameters around cement- and screw-retained dental implants

The aim was to assess the influence of moderate cigarette-smoking on the clinical (bleeding on probing [BoP] and probing depth [PD]) and radiographic (crestal bone resorption [CBR]) around cement- and screw-retained dental implants at 5 years' follow-up. A questionnaire was used to collect information about age, gender, smoking history, duration of implants in function, jaw location of the implant, and daily toothbrushing and flossing. Peri-implant BoP, PD and CBR were measured in all groups. Group comparisons were performed using one-way analysis of variance and for multiple comparisons, the Bonferroni Post hoc adjustment test was performed. Level of significance was set at P<0.05. Forty-eight patients (25 smokers and 23 non-smokers) had cement-retained dental implants; and 48 (24 smokers and 24 non-smokers) had screw-retained dental implants. Among patients with cement and screw-retained dental implants, PD (P<0.05) and CBR (P<0.05) were significantly higher among smokers than non-smokers. The peri-implant sites that demonstrated BoP were statistically significantly higher among non-smokers (P<0.05) than smokers among patients with cement- and screw-retained dental implants. There was no statistically significant difference in peri-implant PD and CBR among smokers with cement- and screw-retained dental implants. Among non-smokers with cement and screw-retained dental implants, there was no statistically significant difference in BoP, PD and CBR. Cigarette-smoking is associated with an increased PD and CBR around cement- and screw-retained dental implants. Cigarette-smoking increases peri-implant soft tissue inflammation as well as loss of crestal bone and this relationship is independent of the type of implant retention protocol used.The author recommends that cement- and screw-retained dental implants are suitable for prosthesis restoration in non-smokers. Further studies on dual-smokers (individuals smoking cigarettes and other forms of tobacco products) are needed related to the clinicoradiographic inflammatory parameters around cement- and screw-retained dental implants.

Marginal bone loss around oral implants supporting fixed versus removable prostheses: a systematic review

Aim

The aim of this systematic review was to evaluate and compare the marginal bone loss (MBL) around implants of fixed (FISP) versus removable implant-supported prosthesis (RISP).

Material and methods

This review was conducted according to the PRISMA guidelines. A systematic search of the literature on Web of Science and Ovid (MEDLINE) was conducted in March 2019 to identify randomized controlled trials/quasi-randomized trials, prospective and retrospective studies written in German and English. Two reviewers screened the identified papers for eligibility and performed an independent data extraction. The Newcastle-Ottawa Scale was used to evaluate the level of evidence of the included studies.

Results

The search resulted in 2577 studies, of which 42 were selected for full-text evaluation. Finally, six studies were included in qualitative analyses, reporting results from 248 participants (81 FISP versus 167 RISP). Five of the included studies were prospective and one study was retrospective. MBL was highest in the first year after implant placement and ranged from 0.17 ± 0.07 mm to 2.1 ± 1.6 mm in FISP and from 0.22 ± 0.55 mm to 2.5 ± 2.7 mm in RISP. After 4 years, there was no statistically significant difference between the groups; MBL ranged from 0.36 ± 0.22 mm to 1.5 mm in FISP and 0.56 ± 0.45 mm to 1.4 mm in RISP. Of the six included studies, two each were rated as good quality, fair quality, and poor quality.

Conclusion

Fixed and removable implant-supported prostheses seem to have similar long-term outcomes regarding marginal bone loss. However, the evidence provided in this systematic review is limited due to the poor quality of two of the included studies. Future studies with study designs specified to the topic of this review are necessary to provide clear information about marginal bone level alterations in modern implant therapy.