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Jafarpour D, El-Amier N, Feine J, Bedos C, Abi-Nader S, Esfandiari S, Shuster T, Zimmermann E, de Souza R. 3D printing vs traditional workflow for the fabrication of mandibular implant overdentures: study protocol for a mixed-methods cross-over RCT. Trials 2024; 25:267. [PMID: 38627819 PMCID: PMC11022432 DOI: 10.1186/s13063-024-08097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Complete tooth loss is a significant global oral health issue, particularly impacting older individuals with lower socioeconomic status. Computer-assisted technologies enhance oral healthcare access by the elderly. Despite promising in vitro reports on digital denture materials, evidence from randomized clinical trials (RCTs) is lacking to verify their performance. This cross-over RCT will investigate whether 3D-printed implant-retained mandibular overdentures (IMO) are more satisfactory for edentulous seniors than those made through traditional methods. METHODS/DESIGN We will recruit 26 completely edentulous participants (any sex/gender) based on the following eligibility criteria: age ≥ 60 years, no tooth extraction in the past 12 months, two implants in the lower jaw, and need for new dentures in both jaws. Each participant will receive two denture pairs, either manufactured by 3D printing or traditionally, to be worn in a random order. A timeline of 3 months with each denture pair will be considered for outcome assessment (total: 6 months). Patient satisfaction with dentures will be measured by the McGill Denture Satisfaction Questionnaire. We will evaluate other patient-reported outcomes (including oral health-related quality of life) as well as clinician-assessed quality and cost. At the end of the trial, participants will choose which denture pair they wish to keep and interviewed about their experiences with the 3D-printed IMO. The quantitative and qualitative data will be incorporated through an explanatory mixed-methods strategy. A final quantitative assessment will happen after 12 months with the preferred IMO to assess the long-term performance and maintenance needs. DISCUSSION This mixed-methods RCT will explore patient experiences with 3D-printed IMOs, aiming to assess the potential for altering clinical practice and dental public health policies. Our results will inform policies by showing whether 3D printing offers comparable outcomes at lower costs, facilitating greater access to oral care for the elderly. TRIAL REGISTRATION ClinicalTrials.gov, NCT06155630, Registered on 04 December 2023. https://classic. CLINICALTRIALS gov/ct2/show/NCT06155630.
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Affiliation(s)
- Dana Jafarpour
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Nesma El-Amier
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
- Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Jocelyne Feine
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Christophe Bedos
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Samer Abi-Nader
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Shahrokh Esfandiari
- Faculty of Dental Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Tibor Shuster
- Department of Family Medicine, McGill University, Montreal, Canada
| | - Elizabeth Zimmermann
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada
| | - Raphael de Souza
- Faculty of Dental Medicine and Oral Health Sciences, Strathcona Anatomy and Dentistry Building, McGill University, 3640 University Street, Room #M/65A, Montréal, QC, H3A 2B2, Canada.
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Mauland EK, Bull VH, Melbye EL, Verket A. Patient-reported outcomes following dental implant rehabilitation according to reason for missing teeth: A survey from a Norwegian population 8 years following treatment. J Clin Periodontol 2024; 51:135-144. [PMID: 37915235 DOI: 10.1111/jcpe.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
AIM The aim of this study was to assess patient-reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR). MATERIALS AND METHODS The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi-square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs. RESULTS Of the respondents (n = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis (n = 784) reported greater oral function improvement and better pre-treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons (n = 515). Age, level of education, self-funded cost, pre-treatment information, history of complications and the reason for missing teeth were found to predict PROs. CONCLUSIONS In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self-report of complications and lack of pre-treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function.
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Affiliation(s)
- Erik Klepsland Mauland
- Department of Periodontology, University of Oslo, Oslo, Norway
- Oral Health Centre of Expertise, Rogaland, Norway
| | | | | | - Anders Verket
- Department of Periodontology, University of Oslo, Oslo, Norway
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Zumstein K, Waller T, Hämmerle CHF, Jung RE, Benic G, Mühlemann S. Clinical performance of monolithic zirconia crowns on titanium-zirconium reduced-diameter implants in the molar area: Interim data at three years of a randomized controlled trial. Clin Oral Implants Res 2023; 34:1354-1362. [PMID: 37668109 DOI: 10.1111/clr.14179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
AIM The aim of the present study was (i) to evaluate the clinical performance of reduced-diameter implants placed in the molar area and (ii) to test whether monolithic zirconia implant-supported crowns lead to similar clinical outcomes compared to porcelain-fused-to-metal crowns. MATERIALS AND METHODS A total of 76 patients needing a single implant crown in the posterior region were recruited. All patients received a titanium-zirconium reduced-diameter implant (Straumann Roxolid, Tissue Level, Standard Plus, diameter 3.3 mm, regular neck) randomly allocated to receive either a (1) monolithic zirconia crown (test) or (2) porcelain-fused-to-metal crown (control). Implant survival, prosthetic outcomes, and patient-reported outcomes were assessed at crown delivery and after 3 years of follow-up. Marginal bone levels (MBL) as well as clinical parameters including probing depth (PD), bleeding on probing (BOP), and plaque levels (PCR) were also recorded. RESULTS A total of 59 patients were available at the 3-year follow-up; 32 patients with a monolithic zirconia crown (TEST) and 27 patients with a porcelain-fused-to-metal crown (CONTROL). 14 implants (11 implant fractures/3 aseptic losses) were lost leading to an estimated implant survival rate of 80% ± 5.1% (95% CI 70.8%-90.8%). Prosthetic complications were limited to the control group and involved minor chippings. CONCLUSIONS This type of reduced-diameter implant to support single implant molar crowns in the molar area cannot be recommended. Monolithic zirconia crowns appear to be a viable option in the posterior region showing similar prosthetic outcomes to porcelain-fused-to-metal crowns.
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Affiliation(s)
- K Zumstein
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T Waller
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - C H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - R E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - G Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - S Mühlemann
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Stavropoulos A, Bellon B, Pipenger B, Andersen OZ. Two- and three-piece implants to boost data generation in preclinical in vivo research-A short technical report. Clin Exp Dent Res 2023; 9:1004-1008. [PMID: 37905711 PMCID: PMC10728500 DOI: 10.1002/cre2.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
The purpose of this technical report is to present two novel experimental implant designs to boost data generation in preclinical in vivo research. Specifically, the report describes the rationale and the components of (1) a two-piece experimental implant suitable for a small animal platform (e.g., the rabbit femur/tibial epiphysis model), consisting of a threaded apical- and a coronal cylindrical piece, which is intended for collecting two types of biomechanical data, and (2) a three-piece experimental implant suitable for a large animal platform (e.g., the mini-pig mandible model), consisting of an apical "wound chamber", which allows the collection of histological/histomorphometrical data, and a middle threaded and coronal cylindrical piece, which also allow the collection of two types of biomechanical data. The increased volume of information generated from a single experiment in a small animal platform, using the proposed two-piece implant design, may assist in a more qualified decision-making process, on whether it is relevant to proceed to further assessment using a large animal platform. Furthermore, the increased volume of information generated in a single animal experiment either in a small or large animal platform, using the proposed two- and three-piece implants, respectively, likely decreases the number of animals otherwise needed for collecting the same information with standard one-piece implants and, thus, contributes to the reduction/refinement elements of the 3R principle.
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Affiliation(s)
- Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyMalmö UniversityMalmöSweden
- Division of Conservative Dentistry and Periodontology, University Clinic of DentistryMedical University of ViennaViennaAustria
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - Benjamin Bellon
- Department of Periodontology, Faculty of DentistryUniversity of ZurichZurichSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
| | - Benjamin Pipenger
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
| | - Ole Z. Andersen
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
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Al-Nawas B, Aghaloo T, Aparicio C, Bedrossian E, Brecht L, Brennand-Roper M, Chow J, Davó R, Fan S, Jung R, Kämmerer PW, Kumar VV, Lin WS, Malevez C, Morton D, Pijpe J, Polido WD, Raghoebar GM, Stumpel LJ, Tuminelli FJ, Verdino JB, Vissink A, Wu Y, Zarrine S. ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes. Int J Implant Dent 2023; 9:28. [PMID: 37698775 PMCID: PMC10497463 DOI: 10.1186/s40729-023-00489-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES The aim of the ITI Consensus Workshop on zygomatic implants was to provide Consensus Statements and Clinical Recommendations for the use of zygomatic implants. MATERIALS AND METHODS Three systematic reviews and one narrative review were written to address focused questions on (1) the indications for the use of zygomatic implants; (2) the survival rates and complications associated with surgery in zygomatic implant placement; (3) long-term survival rates of zygomatic implants and (4) the biomechanical principles involved when zygoma implants are placed under functional loads. Based on the reviews, three working groups then developed Consensus Statements and Clinical Recommendations. These were discussed in a plenary and finalized in Delphi rounds. RESULTS A total of 21 Consensus Statements were developed from the systematic reviews. Additionally, the group developed 17 Clinical Recommendations based on the Consensus Statements and the combined expertise of the participants. CONCLUSIONS Zygomatic implants are mainly indicated in cases with maxillary bone atrophy or deficiency. Long-term mean zygomatic implant survival was 96.2% [95% CI 93.8; 97.7] over a mean follow-up of 75.4 months (6.3 years) with a follow-up range of 36-141.6 months (3-11.8 years). Immediate loading showed a statistically significant increase in survival over delayed loading. Sinusitis presented with a total prevalence of 14.2% [95% CI 8.8; 22.0] over a mean 65.4 months follow-up, representing the most common complication which may lead to zygomatic implant loss. The international experts suggested clinical recommendations regarding planning, surgery, restoration, outcomes, and the patient's perspective.
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Affiliation(s)
- Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany.
| | - Tara Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Carlos Aparicio
- Indiana University School of Dentistry, Indianapolis, USA
- Hepler Bone Clinic, ZAGA Center Barcelona, Barcelona, Spain
| | - Edmond Bedrossian
- Department of Oral and Maxillofacial Surgery University of the Pacific, Dugoni School of Dentistry, San Francisco, CA, USA
| | - Lawrence Brecht
- Department of Dental Medicine and Oral and Maxillofacial Surgery, Northwell Health, New Hyde Park, New York, USA
- Division of Prosthodontics and Restorative Dentistry, NYC College of Dentistry, New York, USA
| | | | - James Chow
- Brånemark Osseointegration Center, Hong Kong SAR, China
| | - Rubén Davó
- Medimar International Hospital, Department of Implantology and Maxillofacial Surgery, Vithas Davó Instituto Dental, Alicante, Spain
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany
- Second Dental Center, School of Medicine, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Vinay V Kumar
- Oral Rehabilitation Center, Bangalore, India
- Department of Surgical Sciences, Odontology and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Chantal Malevez
- Department of Oral and Maxillofacial Surgery, Clinique Saint-Jean, Brussels, Belgium
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Justin Pijpe
- Department of Oral and Maxillofacial Surgery, Special Care and Orthodontics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Waldemar D Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, USA
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Frank J Tuminelli
- Department of Veterans Affairs, New York Harbor Healthcare System, New York, USA
| | | | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Yiqun Wu
- Second Dental Center, School of Medicine, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
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Derksen W, Joda T, Chantler J, Fehmer V, Gallucci GO, Gierthmuehlen PC, Ioannidis A, Karasan D, Lanis A, Pala K, Pjetursson BE, Roccuzzo M, Sailer I, Strauss FJ, Sun TC, Wolfart S, Zitzmann NU. Group 2 ITI Consensus Report: Technological developments in implant prosthetics. Clin Oral Implants Res 2023; 34 Suppl 26:104-111. [PMID: 37750528 DOI: 10.1111/clr.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES Group-2 reviewed the scientific evidence in the field of «Technology». Focused research questions were: (1) additive versus subtractive manufacturing of implant restorations; (2) survival, complications, and esthetics comparing prefabricated versus customized abutments; and (3) survival of posterior implant-supported multi-unit fixed dental prostheses. MATERIALS AND METHODS Literature was systematically screened, and 67 publications could be critically reviewed following PRISMA guidelines, resulting in three systematic reviews. Consensus statements were presented to the plenary where after modification, those were accepted. RESULTS Additively fabricated implant restorations of zirconia and polymers were investigated for marginal/internal adaptation and mechanical properties without clear results in favor of one technology or material. Titanium base abutments for screw-retained implant single crowns compared to customized abutments did not show significant differences concerning 1-year survival. PFM, veneered and monolithic zirconia implant-supported multi-unit posterior fixed dental prostheses demonstrated similar high 3-year survival rates, whereas veneered restorations exhibited the highest annual ceramic fracture and chipping rates. CONCLUSIONS For interim tooth-colored implant single crowns both additive and subtractive manufacturing are viable techniques. The clinical performance of additively produced restorations remains to be investigated. Implant single crowns on titanium base abutments show similar clinical performance compared to other type of abutments; however, long-term clinical data from RCTs are needed. The abutment selection should be considered already during the planning phase. Digital planning facilitates 3D visualization of the prosthetic design including abutment selection. In the posterior area, monolithic zirconia is recommended as the material of choice for multi-unit implant restorations to reduce technical complications.
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Affiliation(s)
- W Derksen
- Private Practice, Arnhem, The Netherlands
- Section of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - T Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - J Chantler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - V Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - G O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - P C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - A Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - D Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - A Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - K Pala
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - B E Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland
| | - M Roccuzzo
- Private Practice, Torino, Italy
- Division of Maxillo-Facial Surgery, University of Torino, Torino, Italy
| | - I Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - F J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - T C Sun
- Department of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - S Wolfart
- Department of Prosthodontics and Biomaterials, RWTH Aachen University, Aachen, Germany
| | - N U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
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Ginesin O, Mayer Y, Gabay E, Rotenberg D, Machtei EE, Coyac BR, Bar-On Y, Zigdon-Giladi H. Revealing leukocyte populations in human peri-implantitis and periodontitis using flow cytometry. Clin Oral Investig 2023; 27:5499-5508. [PMID: 37490117 DOI: 10.1007/s00784-023-05168-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To identify, quantify, and characterize leukocyte populations in PI and periodontitis using flow cytometry. METHODS Fresh biopsies from human PI and periodontitis lesions were processed to a single-cell suspension. The immune cell types were identified using flow cytometry. RESULTS Twenty-one biopsies were obtained and analyzed corresponding to fourteen PI and seven periodontitis samples. Participants' average age was 63.95 ± 14.77 years without a significant difference between PI and periodontitis patients, the female/male ratio was 8/12, and mean PD was 8.5 ± 2.17. High similarity was found between periodontitis and PI in the main immune cell types. Out of the leukocytes, the PMN proportion was 40% in PI and 33% in periodontitis. T-cells 22% in PI and 18% in periodontitis. Similar proportions of B-cells 10% and macrophages 6% were found in PI and periodontitis. Dendritic and NK cells were found in low proportions (~ 1%) in PI and periodontitis. T-cell sub-analysis showed that CD4-positive were more prevalent than CD8-positive in both diseases (CD4/CD8 ratio of 1.2). CONCLUSION With the use of flow cytometry analysis, the leukocyte populations in human peri-implantitis and periodontitis were classified. In PI and periodontitis, we identified similar proportions of specific (CD4/CD8) and innate (dendritic and NK) immune cells. These results corroborate previous histological studies. CLINICAL RELEVANCE Flow cytometry analysis can be used to identify and quantify immune cells in PI and periodontitis, including sub-classification of T cells (CD4/8) as well as detection of cells that require multiple markers for identification (such as dendritic cells).
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Affiliation(s)
- Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel.
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel.
| | - Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Eran Gabay
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Daniel Rotenberg
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Eli Eliahu Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Benjamin R Coyac
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel
| | - Yotam Bar-On
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| | - Hadar Zigdon-Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
- Laboratory for Bone Repair, CRIR Institute, Rambam Health Care Campus, Haifa, Israel
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8
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Duong LT, Petit S, Kerner S, Clerc MM, Arnoult C, Nowwarote N, Osathanon T, Fournier BPJ, Isaac J, Ferré FC. Role of periosteum during healing of alveolar critical size bone defects in the mandible: a pilot study. Clin Oral Investig 2023; 27:4541-4552. [PMID: 37261496 DOI: 10.1007/s00784-023-05079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Minipigs present advantages for studying oral bone regeneration; however, standardized critical size defects (CSD) for alveolar bone have not been validated yet. The objectives of this study are to develop a CSD in the mandibular alveolar bone in Aachen minipigs and to further investigate the specific role of periosteum. MATERIALS AND METHODS Three female Aachen minipigs aged 17, 24, and 84 months were used. For each minipig, a split-mouth design was performed: an osteotomy (2 cm height × 2.5 cm length) was performed; the periosteum was preserved on the left side and removed on the right side. Macroscopic, cone beam computed tomography (CBCT), microcomputed tomography (µCT), and histological analyses were performed to evaluate the bone defects and bone healing. RESULTS In both groups, spontaneous healing was insufficient to restore initial bone volume. The macroscopic pictures and the CBCT results showed a larger bone defect without periosteum. µCT results revealed that BMD, BV/TV, and Tb.Th were significantly lower without periosteum. The histological analyses showed (i) an increased osteoid apposition in the crestal area when periosteum was removed and (ii) an ossification process in the mandibular canal area in response to the surgical that seemed to increase when periosteum was removed. CONCLUSIONS A robust model of CSD model was developed in the alveolar bone of minipigs that mimics human mandibular bone defects. This model allows to further investigate the bone healing process and potential factors impacting healing such as periosteum. CLINICAL RELEVANCE This model may be relevant for testing different bone reconstruction strategies for preclinical investigations.
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Affiliation(s)
- Lucas T Duong
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Surgery, Dental Faculty, Université Paris Cité, Paris, France
- Oral Surgery Department, Charles Foix Hospital, AP-HP, Ivry-Sur-Seine, France
- Department of Head and Neck Surgical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Stéphane Petit
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France
| | - Stéphane Kerner
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France
- Department of Periodontology, Dental Faculty, Université Paris Cité, Paris, France
- Department of Periodontics, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - Mélodie M Clerc
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Periodontology, Dental Faculty, Université Paris Cité, Paris, France
| | | | - Nunthawan Nowwarote
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France
| | - Thanaphum Osathanon
- Dental Stem Cell Biology Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Regenerative Dentistry and Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Rd. Pathumwan, Bangkok, 10330, Thailand
| | - Benjamin P J Fournier
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France
- Reference Center for Oral and Dental Rare Diseases, ORARES, Odontology Department, Rothschild Hospital, APHP, Paris, France
| | - Juliane Isaac
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France
| | - François C Ferré
- Centre de Recherche Des Cordeliers, UMRS 1138, Molecular Oral Pathophysiology, Université Paris Cité, INSERM, Sorbonne Université, Paris, France.
- Department of Oral Surgery, Dental Faculty, Université Paris Cité, Paris, France.
- Department of Oral Biology, Dental Faculty, Université Paris Cité, Paris, France.
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9
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Abstract
Successful periodontal repair and regeneration requires the coordinated responses from soft and hard tissues as well as the soft tissue-to-bone interfaces. Inspired by the hierarchical structure of native periodontal tissues, tissue engineering technology provides unique opportunities to coordinate multiple cell types into scaffolds that mimic the natural periodontal structure in vitro. In this study, we designed and fabricated highly ordered multicompartmental scaffolds by melt electrowriting, an advanced 3-dimensional (3D) printing technique. This strategy attempted to mimic the characteristic periodontal microenvironment through multicompartmental constructs comprising 3 tissue-specific regions: 1) a bone compartment with dense mesh structure, 2) a ligament compartment mimicking the highly aligned periodontal ligaments (PDLs), and 3) a transition region that bridges the bone and ligament, a critical feature that differentiates this system from mono- or bicompartmental alternatives. The multicompartmental constructs successfully achieved coordinated proliferation and differentiation of multiple cell types in vitro within short time, including both ligamentous- and bone-derived cells. Long-term 3D coculture of primary human osteoblasts and PDL fibroblasts led to a mineral gradient from calcified to uncalcified regions with PDL-like insertions within the transition region, an effect that is challenging to achieve with mono- or bicompartmental platforms. This process effectively recapitulates the key feature of interfacial tissues in periodontium. Collectively, this tissue-engineered approach offers a fundament for engineering periodontal tissue constructs with characteristic 3D microenvironments similar to native tissues. This multicompartmental 3D printing approach is also highly compatible with the design of next-generation scaffolds, with both highly adjustable compartmentalization properties and patient-specific shapes, for multitissue engineering in complex periodontal defects.
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Affiliation(s)
- Y. Yao
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J.E. Raymond
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - F. Kauffmann
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Department of Oral and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Freiburg, Germany
| | - S. Maekawa
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Current address: Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - J.V. Sugai
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J. Lahann
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - W.V. Giannobile
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Current address: Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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