-
Periodontology 2000 Jun 2023Incorrect implant positioning can lead to functional and aesthetic compromise. Implant positioning errors can occur in three dimensions: mesiodistal, corono-apical, and... (Review)
Review
Incorrect implant positioning can lead to functional and aesthetic compromise. Implant positioning errors can occur in three dimensions: mesiodistal, corono-apical, and orofacial. Treatment solutions to manage adverse outcomes through positioning errors require an understanding of the underlying conditions and of those factors that may have led to the error being committed in the first place. These types of complications usually occur because of human factors. If errors do occur with adverse aesthetic outcomes, they are difficult and sometimes impossible to correct. Connective tissue grafts to reverse recession defects are only feasible in defined situations. The option to remove and replace the implant may be the only recourse, provided the removal process does not further compromise the site. Error in judgment by the clinician.
Topics: Humans; Treatment Outcome; Esthetics, Dental; Dental Implantation, Endosseous; Immediate Dental Implant Loading; Maxilla; Dental Implants, Single-Tooth
PubMed: 36683018
DOI: 10.1111/prd.12474 -
Molecules (Basel, Switzerland) Apr 2022Nacre is a biomaterial that has shown osteoinductive and osteoconductive properties in vitro and in vivo. These properties make nacre a material of interest for inducing...
Nacre is a biomaterial that has shown osteoinductive and osteoconductive properties in vitro and in vivo. These properties make nacre a material of interest for inducing bone regeneration. However, information is very limited regarding the introduction of nacre to dental implant surgery for promoting osteogenesis. This study investigated the potential of nacre powder for peri-implant bone regeneration in a porcine model. Ninety-six dental implants were placed into the tibia of twelve male domestic pigs. The dental implants were coated with nacre powder from the giant oyster before implantation. Implantations without nacre powder were used as control groups. Euthanization took place at 2, 4 and 6 weeks after implantation, after which we measured bone-to-implant contact (BIC) and bone volume density (BVD) of the implanted bone samples using micro-computed tomography (micro-CT), and examined the histology of the surrounding bone using histological sections stained with Stevenel's blue and Alizarin red S. The micro-CT analyses showed that the BIC of dental implantations with nacre powder were significantly higher than those without nacre powder, by 7.60%. BVD of implantations with nacre powder were significantly higher than those without nacre powder, by 12.48% to 13.66% in cortical bone, and by 3.37% to 6.11% in spongy bone. Histological study revealed more peri-implant bone regeneration toward the surface of the dental implants after implantation with nacre powder. This was consistent with the micro-CT results. This study demonstrates the feasibility of using nacre to promote peri-implant bone regeneration in dental implantation.
Topics: Animals; Dental Implants; Male; Nacre; Osseointegration; Powders; Surface Properties; Swine; Titanium; X-Ray Microtomography
PubMed: 35566000
DOI: 10.3390/molecules27092653 -
Periodontology 2000 Oct 2022Historically, there has been broad consensus that osseointegration represents a homeostasis between a titanium dental implant and the surrounding bone, and that the... (Review)
Review
Historically, there has been broad consensus that osseointegration represents a homeostasis between a titanium dental implant and the surrounding bone, and that the crestal bone loss characteristic of peri-implantitis is a plaque-induced inflammatory process. However, this notion has been challenged over the past decade by proponents of a theory that considers osseointegration an inflammatory process characterized by a foreign body reaction and peri-implant bone loss as an exacerbation of this inflammatory response. A key difference in these two schools of thought is the perception of the relative importance of dental plaque in the pathogenesis of crestal bone loss around implants, with obvious implications for treatment. This review investigates the evidence for a persistent foreign body reaction at osseointegrated dental implants and its possible role in crestal bone loss characteristic of peri-implantitis. Further, the role of implant-related material release within the surrounding tissue, particularly titanium particles and corrosion by-products, in the establishment and progression in peri-implantitis is explored. While it is acknowledged that these issues require further investigation, the available evidence suggests that osseointegration is a state of homeostasis between the titanium implant and surrounding tissues, with little evidence that a persistent foreign body reaction is responsible for peri-implant bone loss after osseointegration is established. Further, there is a lack of evidence for a unidirectional causative role of corrosion by-products and titanium particles as possible non-plaque related factors in the etiology of peri-implantitis.
Topics: Alveolar Bone Loss; Dental Implants; Foreign Bodies; Foreign-Body Reaction; Humans; Osseointegration; Peri-Implantitis; Titanium
PubMed: 35916872
DOI: 10.1111/prd.12456 -
BioMed Research International 2021
Topics: Computer-Aided Design; Dental Implants; Dentistry; Guidelines as Topic; Humans; Inventions; Prostheses and Implants
PubMed: 35155668
DOI: 10.1155/2021/9852932 -
PloS One 2022The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal bone remodeling.
METHODS
A systematic review including PubMed and EMBASE databases through June 2021 was conducted. Two independent examiners screened titles/abstracts and selected full-text articles. Studies evaluating titanium dental implant osseointegration in native alveolar bone were included. A quality assessment of reporting was performed. Random-effects meta-analyses and meta-regressions were produced for bone-implant contact (BIC), first BIC, and crestal bone level.
RESULTS
125 out of 249 full-text articles were reviewed, 55 original studies were included. Quality of reporting was generally low, omissions included animal characteristics, examiner masking/calibration, and sample size calculation. The typical minipig model protocol included surgical extraction of the mandibular premolars and first molar, 12±4 wks post-extraction healing, placement of three narrow regular length dental implants per jaw quadrant, submerged implant healing and 8 wks of osseointegration. Approximately 90% of studies reported undecalcified incandescent light microscopy histometrics. Overall, mean BIC was 59.88% (95%CI: 57.43-62.33). BIC increased significantly over time (p<0.001): 40.93 (95%CI: 34.95-46.90) at 2 wks, 58.37% (95%CI: 54.38-62.36) at 4 wks, and 66.33% (95%CI: 63.45-69.21) beyond 4 wks. Variability among studies was mainly explained by differences in observation interval post-extraction and post-implant placement, and implant surface. Heterogeneity was high for all studies (I2 > 90%, p<0.001).
CONCLUSIONS
The minipig intraoral dental implant model appears to effectively demonstrate osseointegration and alveolar bone remodeling similar to that observed in humans and canine models.
Topics: Dental Implants
PubMed: 35226690
DOI: 10.1371/journal.pone.0264475 -
Dental Materials : Official Publication... Sep 2023Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This... (Review)
Review
OBJECTIVES
Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This region promotes a challenging environment for the successfulness of dental components due to the transitional characteristics between soft and hard tissues, the presence of bacteria, and mechanical forces. This review explored the most current approaches to modify trans-mucosal components in terms of macro-design and surface properties.
METHODS
This critical review article revised intensely the literature until July 2023 to demonstrate, discuss, and summarize the current knowledge about marketable and innovative trans-mucosal components for dental implants.
RESULTS
A large number of dental implant brands have promoted the development of several implant-abutment designs in the clinical market. The progress of abutment designs shows an optimistic reduction of bacteria colonization underlying the implant-abutment gap, although, not completely inhibited. Fundamental and preclinical studies have demonstrated promising outcomes for altered-surface properties targeting antibacterial properties and soft tissue sealing. Nanotopographies, biomimetic coatings, and antibiotic-release properties have been shown to be able to modulate, align, orient soft tissue cells, and induce a reduction in biofilm formation, suggesting superior abilities compared to the current trans-mucosal platforms available on the market.
SIGNIFICANCE
Future clinical implant-abutments show the possibility to reduce peri-implant diseases and fortify soft tissue interaction with the implant-substrate, defending the implant system from bacteria invasion. However, the absence of technologies translated to commercial stages reveals the need for findings to "bridge the gap" between scientific evidences published and applied science in the industry.
Topics: Humans; Dental Implants; Peri-Implantitis; Tooth; Dental Abutments; Dental Implant-Abutment Design
PubMed: 37537095
DOI: 10.1016/j.dental.2023.07.009 -
Clinical Oral Investigations Apr 2021To immunohistochemically characterize and correlate macrophage M1/M2 polarization status with disease severity at peri-implantitis sites.
OBJECTIVES
To immunohistochemically characterize and correlate macrophage M1/M2 polarization status with disease severity at peri-implantitis sites.
MATERIALS AND METHODS
A total of twenty patients (n = 20 implants) diagnosed with peri-implantitis (i.e., bleeding on probing with or without suppuration, probing depths ≥ 6 mm, and radiographic marginal bone loss ≥ 3 mm) were included. The severity of peri-implantitis was classified according to established criteria (i.e., slight, moderate, and advanced). Granulation tissue biopsies were obtained during surgical therapy and prepared for immunohistological assessment and macrophage polarization characterization. Macrophages, M1, and M2 phenotypes were identified through immunohistochemical markers (i.e., CD68, CD80, and CD206) and quantified through histomorphometrical analyses.
RESULTS
Macrophages exhibiting a positive CD68 expression occupied a mean proportion of 14.36% (95% CI 11.4-17.2) of the inflammatory connective tissue (ICT) area. Positive M1 (CD80) and M2 (CD206) macrophages occupied a mean value of 7.07% (95% CI 5.9-9.4) and 5.22% (95% CI 3.8-6.6) of the ICT, respectively. The mean M1/M2 ratio was 1.56 (95% CI 1-12-1.9). Advanced peri-implantitis cases expressed a significantly higher M1 (%) when compared with M2 (%) expression. There was a significant correlation between CD68 (%) and M1 (%) expression and probing depth (PD) values.
CONCLUSION
The present immunohistochemical analysis suggests that macrophages constitute a considerable proportion of the inflammatory cellular composition at peri-implantitis sites, revealing a significant higher expression for M1 inflammatory phenotype at advanced peri-implantitis sites, which could possibly play a critical role in disease progression.
CLINICAL RELEVANCE
Macrophages have critical functions to establish homeostasis and disease. Bacteria might induce oral dysbiosis unbalancing the host's immunological response and triggering inflammation around dental implants. M1/M2 status could possibly reveal peri-implantitis' underlying pathogenesis.
Topics: Connective Tissue; Dental Implants; Humans; Macrophages; Peri-Implantitis; Tooth
PubMed: 32886246
DOI: 10.1007/s00784-020-03556-2 -
British Dental Journal May 2024Peri-implant diseases are frequent complications that occur around osseointegrated endosseous implants and are the result of an imbalance between the bacterial challenge... (Review)
Review
Peri-implant diseases are frequent complications that occur around osseointegrated endosseous implants and are the result of an imbalance between the bacterial challenge and host response. Peri-implant diseases may affect the peri-implant mucosa only (peri-implant mucositis) or also involve the supporting bone (peri-implantitis). Early detection of peri-implant diseases and timely treatment is important for the success of dental implant treatment. Peri-implant probing is essential to assess the peri-implant health status and should be done at each recall visit. Dental practitioners should be familiar with the clinical and radiological features of both conditions in order to make an accurate diagnosis and determine the appropriate treatment required. This article aims to provide clinicians with an understanding of the key differences between peri-implant health, peri-implant mucositis and peri-implantitis.
Topics: Humans; Peri-Implantitis; Dental Implants; Stomatitis; Mucositis
PubMed: 38789756
DOI: 10.1038/s41415-024-7402-z -
Australian Dental Journal Mar 2021This study investigated the possible correlations between patient-performed implant hygiene and peri-implant success and disease, as well as patient-reported outcomes,...
BACKGROUND
This study investigated the possible correlations between patient-performed implant hygiene and peri-implant success and disease, as well as patient-reported outcomes, in a community-based cohort.
METHODS
Fifty-one patients (78 implants) from two private general practices were surveyed on their dental implant treatment history, oral hygiene instructions (OHI) received, home hygiene habits and current implant concerns. Their dentition, plaque/calculus scores and clinical implant parameters were examined. Correlations between hygiene habits, risk factors, implant success and peri-implant disease rates were assessed.
RESULTS
Implants had a patient-reported mean time in function of 6.7 years. Floss (74.4%), interdental brushes (IDB) (44.9%) and mouthwash (39.7%) were commonly used, while 7.7% of implants were only cleaned by brushing. Over half (56.4%) of implants fulfilled the success criteria, 61.5% had peri-implant health, 24.4% had mucositis and 7.7% had peri-implantitis. Only brushing (P < 0.001) and detectable plaque/calculus (P < 0.001) were significantly associated with more peri-implant disease. Local prosthetic factors affecting cleaning accessibility significantly reduced implant success (P < 0.001). Patients reported mixed recall of implant OHI, 7.7% of implants were aesthetically unsatisfactory and 9.0% had peri-implant symptoms.
CONCLUSIONS
Lack of interproximal cleaning and the presence of plaque/calculus were significantly associated with peri-implant disease in a community-based general practice setting, and patients reported mixed recall of OHI.
Topics: Dental Implants; Humans; Oral Hygiene; Patient Reported Outcome Measures; Peri-Implantitis; Periodontal Index
PubMed: 33174206
DOI: 10.1111/adj.12806 -
Clinical and Experimental Dental... Jun 2023To compare the accuracy of five different tooth-implant impression techniques. (Review)
Review
PURPOSE
To compare the accuracy of five different tooth-implant impression techniques.
MATERIALS AND METHODS
In this in vitro, experimental study, an acrylic model containing one bone-level Straumann dental implant at the site of maxillary first molar and an adjacent second premolar prepared for a porcelain fused to metal restoration was used. Impressions were made from the model using five different one-step tooth-implant impression techniques including scanning with an intraoral scanner, occlusal matrix, wax relief, closed-tray, and open-tray techniques. Each technique was repeated 15 times. The impressions were poured with dental stone, and the obtained casts were scanned by a laboratory scanner. The scan file of each technique was compared with the scan file of the original acrylic model by Geomagic Design X software. Data were analyzed by one-way analysis of variance, and Tamhane's post-hoc test (α = 0.05).
RESULTS
For dental implant, intraoral scanning had the highest accuracy (0.1004 mm ) followed by open-tray (0.1914 mm ), occlusal matrix (0.2101 mm ), closed-tray (0.2422 mm ), and wax relief (0.2585 mm ) techniques (p < 0.05). For the prepared tooth, wax relief (0.0988 mm ) had the highest accuracy followed by occlusal matrix (0.1211 mm ), open-tray (0.1663 mm ), closed-tray (0.1737 mm ), and intraoral scanning (0.4903 mm ) technique (p < 0.05). For both dental implant and prepared tooth, occlusal matrix (0.2431 mm ) had the highest accuracy followed by open-tray (0.2574 mm ), wax relief (0.2693 mm ), closed-tray (0.2862 mm ), and intraoral scanning (0.3192 mm ) technique (p > 0.05).
CONCLUSION
The compared simultaneous tooth-implant impression techniques had comparable accuracy with no significant difference.
Topics: Humans; Dental Implants; Dental Impression Technique; Dental Impression Materials; Dimensional Measurement Accuracy; Models, Dental
PubMed: 37042090
DOI: 10.1002/cre2.737