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Journal of Dentistry (Shiraz, Iran) Sep 2022Bone morphogenetic protein (BMP), a potential osteoinductive agent, was systematically reviewed for merits and demerits when used as a bone additive that was intervened...
STATEMENT OF THE PROBLEM
Bone morphogenetic protein (BMP), a potential osteoinductive agent, was systematically reviewed for merits and demerits when used as a bone additive that was intervened during the surgical phase of dental implant placement; and suitable drug carriers that could withstand the functional load and deliver BMP at its lowest concentration.
PURPOSE
To identify the carriers and concentration of BMP acceptable during surgical phase of implant placement and evaluate its efficacy in bone gain and osseointegration.
MATERIALS AND METHOD
The study design was systematic review. Literature search as per PICO format was carried out within a time range from 2000 to July 2021. The review fol-lowed PRISMA guidelines and registered with the PROSPERO (CRD42020171667). The focus question included the population with an intra-oral implant placed in both animal and human models that were intervened with BMP-2 as an external additive biomaterial during the surgical phase. 2631 articles selected from the initial search were systematically filtered and yielded 16 articles that were qualitatively analysed.
RESULTS
The inter-rater reliability and level of agreement were 93.71%, κ(Kappa)>0.81 re-spectively. Results revealed the collagen carrier was commonly used for BMP delivery but lacked the property to withstand functional load and sustained release. BMP concentration varied in the range of 0.215μg to 0.8mg and the study revealed significantly indifferent out-come with low dose compared to the highest dose. BMP supplement showed better osseointe-gration in comparison with non-supplemented sites during the early period (within 6 months).
CONCLUSION
BMP at lower concentrations and with appropriate carriers, collagen sponge, hydroxyapatite/tricalcium phosphate (HA/TCP) with a bio ceramic bulking agent, and poly (D, L-lactide-co-glycolic acid) (PLGA) reinforced with gelatin/HA/TCP accelerated bone growth during the initial stages of healing. Further long-term clinical trials for dental implant, analysing the sustained release of BMP with biodegradable and load-bearing carriers should be considered.
PubMed: 36588970
DOI: 10.30476/DENTJODS.2021.90931.1536 -
Supportive Care in Cancer : Official... Oct 2023To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To investigate the survival rate in implants placement in irradiated and non-irradiated bone in patients undergoing head and neck cancer (HNC) treatment. We focused on the consequences of the main complications, such as osteoradionecrosis and peri-implantitis.
METHODS
An electronic search conducted by PRISMA protocol was performed. Full texts were carefully assessed, and data were assimilated into a tabular form for discussion and consensus among the expert panel. The quality assessment and the risk of bias are verified by Joanna Briggs Institute checklist (JBI) and The Newcastle-Ottawa Scale (NOS), and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) assessment tool.
RESULTS
A total of 452 records were identified in the based on our PICOs strategy and after screening, 19 articles were included in the descriptive analysis of the review. Totaling 473 implants placed in irradiated and non-irradiated bone, and 31.6% of the patients were over 60 years of age. 57.9%) performed implant placement in a period of 12 months or more after the ending of radiotherapy. Only 5 studies had a follow-up period longer than 5 years after implant placement, of which three were used for the meta-analysis. In the meta-analysis of 5-year survival rate, analysis of implants in irradiated bone was assessed; a random effect model was used and a weighted proportion (PP) of 93.13% (95% CI: 87.20-99.06; p < 0.001), and in the 5-year survival rate, analysis of implants in non-irradiated bone was analysed; a fixed effect model was used and a weighted proportion (PP) of 98.52% survival (95% CI: 97.56-99.48, p < 0.001).
CONCLUSIONS
Survival rates of implants placed in irradiated bone are clinically satisfactory after a follow-up of 5 years, with a fewer percentage than in implants placed in non-irradiated bone after metanalyses performed.
Topics: Humans; Middle Aged; Aged; Bone-Anchored Prosthesis; Head and Neck Neoplasms
PubMed: 37851170
DOI: 10.1007/s00520-023-08088-5 -
The Journal of Prosthetic Dentistry Sep 2022Strontium has been validated for potent bone-seeking and antiosteoporotic properties and elicits a potentially beneficial impact on implant osseointegration in patients... (Review)
Review
STATEMENT OF PROBLEM
Strontium has been validated for potent bone-seeking and antiosteoporotic properties and elicits a potentially beneficial impact on implant osseointegration in patients with osteoporosis. However, the efficacy of strontium supplementation on improving new bone formation and implant osseointegration in the presence of osteoporotic bone is still unclear.
PURPOSE
The purpose of this systematic review was to comprehensively assess the efficacy of strontium supplementation, encompassing oral intake and local delivery of strontium, on implant osseointegration in patients with osteoporosis.
MATERIAL AND METHODS
Searches on electronic databases (MEDLINE or PubMed, Web of Science, EBSCO, Embase, and Clinicaltrials.gov) and manual searches were conducted to identify relevant preclinical animal trials up to June 2020. The primary outcomes were the percentage of bone-implant contact and bone area; the secondary outcomes were quantitative parameters of biomechanical tests and microcomputed tomography (μCT).
RESULTS
Fourteen preclinical trials (1 rabbit, 1 sheep, and 12 rat), with a total of 404 ovariectomized animals and 798 implants, were eligible for analysis. The results revealed a significant 17.1% increase in bone-implant contact and 13.5% increase in bone area, favoring strontium supplementation despite considerable heterogeneity. Subgroup analyses of both bone-implant contact and bone area exhibited similar outcomes with low to moderate heterogeneity. Results of biomechanical and μCT tests showed that strontium-enriched implantation tended to optimize the mechanical strength and microarchitecture of newly formed bone despite moderate to generally high heterogeneity.
CONCLUSIONS
Based on the available preclinical evidence, strontium supplementation, including local and systemic delivery, showed promising results for enhancing implant osseointegration in the presence of osteoporosis during 4 to 12 weeks of healing. Future well-designed standardized studies are necessary to validate the efficacy and safety of strontium supplementation and to establish a standard methodology for incorporating Sr into implant surfaces in a clinical setting.
Topics: Animals; Dental Implants; Dietary Supplements; Osseointegration; Osteoporosis; Rabbits; Rats; Sheep; Strontium; Titanium; X-Ray Microtomography
PubMed: 33589234
DOI: 10.1016/j.prosdent.2020.12.031 -
Journal of Clinical Medicine Aug 2020Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review... (Review)
Review
BACKGROUND
Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review and meta-analysis is to assess the effect of the two methods and possible differences.
MATERIALS AND METHODS
The systematic research of pre-clinical animal studies was conducted up to May 2020 in the databases PubMed/Medline, Scopus and the Cochrane Lybrary. A meta-analysis was performed by using the DerSimonian-Laird estimator in random-effects models.
RESULTS
Through the digital search, 518 articles were identified; after duplicate removal and screening process 10 papers were included. Four studies evaluating UV treatment in rabbits were included in the meta-analysis. The qualitative evaluation of the included studies showed that both UV photofunctionalization and non-thermal plasma argon functionalization of titanium implant surfaces might be effective in vivo to improve the osseointegration. The meta-analysis on four studies evaluating UV treatment in rabbits showed that bone to implant contact values (expressed as standardized mean differences and raw mean differences) were significantly increased in the bio-activated groups when follow-up times were relatively homogeneous, although a high heterogeneity ( > 75%) was found in all models.
CONCLUSIONS
The present systematic review and meta-analysis on pre-clinical studies demonstrated that chair-side treatment of implants with UV or non-thermal plasma appear to be effective for improving osseointegration. This systematic review supports further clinical trials on this topic.
PubMed: 32878146
DOI: 10.3390/jcm9092817 -
Journal of Oral & Maxillofacial Research 2022The purpose of this systematic review and meta-analysis is to examine the success rate of osseointegrated dental implants placed secondarily in fibula free flaps using... (Review)
Review
OBJECTIVES
The purpose of this systematic review and meta-analysis is to examine the success rate of osseointegrated dental implants placed secondarily in fibula free flaps using the Albrektsson and colleagues criteria.
MATERIAL AND METHODS
A computerized database search was performed using PubMed, Embase, Web of Science and Cochrane CENTRAL. Specific ascertainment criteria were applied for the inclusion of the eligible studies. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all the included studies.
RESULTS
The meta-analysis was carried using ten studies that met the inclusion criteria. The present review pooled data obtained from 242 patients (167 males and 75 females), with the age range of 13 to 79 years. A total of 848 dental implants were placed in the free fibula flaps. All dental implants were placed in a delayed fashion, ranging from 14 to 192 months. The estimated proportion of successful implants placed in fibula flaps used to reconstruct the maxillomandibular complex was 0.94 or 94% (95% CI [confidence interval] = 0.91 to 0.96]) with an insignificant heterogeneity of 37%, P = 0.12. Using a random effect model the annual implant failure rate was 0.02 with a 95% CI = 0.01 to 0.03.
CONCLUSIONS
The results of this systematic review and meta-analysis strongly indicate that using objective criteria, delayed implant placement in free fibula flaps is highly successful.
PubMed: 35574211
DOI: 10.5037/jomr.2022.13103 -
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 -
Journal of Taibah University Medical... Oct 2017Bisphosphonates (BPs) are a class of drugs that are used to treat osteoporosis. It has been suggested that BP coatings on dental implants have a positive effect on new... (Review)
Review
OBJECTIVES
Bisphosphonates (BPs) are a class of drugs that are used to treat osteoporosis. It has been suggested that BP coatings on dental implants have a positive effect on new bone formation. The purpose of this review is to analyse the currently available data concerning the clinical and experimental efficacy of BP-releasing titanium implants such that their potential in clinical oral implant dentistry may be ascertained.
METHODS
Based on a literature review, a focused research question was constructed: what is the effect of a BP-releasing coating on the osseointegration of titanium dental implant? The databases of PubMED/MEDLINE; ISI Web of Knowledge; Embase and Google Scholar were searched electronically using the keywords 'dental implant'; 'bisphosphonate' and 'titanium.' The quality; general characteristics and outcomes of each study were summarized and analysed systematically.
RESULTS
A total of eleven articles fulfilled the criteria to be included in this review. Eight studies were experimental; two studies were clinical; and one study was experimental and clinical. In nine studies (82%), BP-coated implants resulted in higher osseointegration, as indicated by higher resonance frequency values, removal torque, bone-implant contact and new bone formation. In two studies (18%), there was no difference between the osseointegration of BP-coated implants and controls.
CONCLUSIONS
Bisphosphonates-loaded implants may have a positive effect on osseointegration. However, more well-designed clinical studies are required to demonstrate their osseoconductive effects.
PubMed: 31435266
DOI: 10.1016/j.jtumed.2017.05.007 -
The Journal of Oral Implantology Aug 2013Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone disorders. The aim of this study was to... (Review)
Review
Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone disorders. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP drugs with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw. Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations, and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to address this topic more accurately in the future.
Topics: Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Dental Implantation, Endosseous; Diphosphonates; Humans; Osseointegration; Risk Assessment
PubMed: 23964780
DOI: 10.1563/AAID-JOI-D-11-00234 -
Journal of Oral Rehabilitation Nov 2016Recent research data have suggested that the beneficial action of statins in bone tissue could improve osseointegration around titanium implants by increasing the bone... (Review)
Review
Recent research data have suggested that the beneficial action of statins in bone tissue could improve osseointegration around titanium implants by increasing the bone implant contact (BIC), the expression of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF). The aim of this systematic review was to evaluate the influence of statins on osseointegration of titanium implants in animal studies. Two reviewers searched independently four databases (MEDLINE, SCOPUS, WEB OF SCIENCE and the Cochrane Library), until March 15, 2016. The Cochrane Collaboration's Tool for Assessing Risk of Bias was used to assess the quality of the included studies. Papers that reported outcome data considering bone implant contact (BIC), mechanical tests or other histological evaluation were eligible for inclusion. 312 references were eletronically retrieved, 21 full-text papers were screened and 17 studies were included. Thirteen trials presented histomorphometry data on bone implant contact measures. All of them showed a significant improved BIC when using statins. Despite data from included studies point to beneficial effects, standardized studies and with less risk of bias, are needed to clarify the role of statins on osseointegration.
Topics: Animals; Biomechanical Phenomena; Dental Implants; Dose-Response Relationship, Drug; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Models, Animal; Osseointegration
PubMed: 27611923
DOI: 10.1111/joor.12438 -
Journal of Indian Prosthodontic Society 2020Peri implant diseases lead to pathological changes in the peri implant tissues and loss of osseointegration. The purpose of this analysis is to evaluate the effect of... (Review)
Review
AIM
Peri implant diseases lead to pathological changes in the peri implant tissues and loss of osseointegration. The purpose of this analysis is to evaluate the effect of various lasers and photodynamic therapy (PDT) on peri implant diseases compared to conventional procedures.
SETTING AND DESIGN
This meta analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines.
MATERIALS AND METHODS
A systematic search of the electronic databases such as PubMed, ICTRP, CT.gov, Embase, and Cochrane Library was done additional to manual search of peer review article on peri-implant diseases. Eleven randomized control clinical trials were included in which laser therapy and PDT were used as an interventional procedure.
RESULTS AND STATISTICAL ANALYSIS USED
Review Manager 5.03 (RevMan, Nordic Cochrane Center, Copenhagen, Denmark), and random effects model were used to assess mean difference (MD). Bivariate differential mean statistic was used in intergroup estimate with 95% confidence interval (CI). I2 test statistics was applied for heterogenity and < 0.05 was considered significant statistically. The literature search yielded a total of 113 articles among which 11 articles were included for quantitative analysis. The selected outcome PD reported MD -0.01 with 95% CI (-0.13, 0.16), = 0.84, and CAL reported MD -0.09 with 95% CI (-0.32, 0.14), = 0.45, respectively.
CONCLUSION
Laser treatment as an adjunctive therapy or monotherapy in peri implantitis does not show any superior effects than conventional measures as per evidence. However, cases with peri implant mucositis have shown far more promising results with laser therapy compared to peri implantitis.
PubMed: 33487962
DOI: 10.4103/jips.jips_144_20