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Acta Biomaterialia Jun 2024A wide variety of microorganisms have been closely linked to metal corrosion in the form of adherent surface biofilms. Biofilms allow the development and maintenance of... (Review)
Review
A wide variety of microorganisms have been closely linked to metal corrosion in the form of adherent surface biofilms. Biofilms allow the development and maintenance of locally corrosive environments and/or permit direct corrosion including pitting corrosion. The presence of numerous genetically distinct microorganisms in the oral environment poses a threat to the integrity and durability of the surface of metallic prostheses and implants used in routine dentistry. However, the association between oral microorganisms and specific corrosion mechanisms is not clear. It is of practical importance to understand how microbial corrosion occurs and the associated risks to metallic materials in the oral environment. This knowledge is also important for researchers and clinicians who are increasingly concerned about the biological activity of the released corrosion products. Accordingly, the main goal was to comprehensively review the current literature regarding oral microbiologically influenced corrosion (MIC) including characteristics of biofilms and of the oral environment, MIC mechanisms, corrosion behavior in the presence of oral microorganisms and potentially mitigating technologies. Findings included that oral MIC has been ascribed mostly to aggressive metabolites secreted during microbial metabolism (metabolite-mediated MIC). However, from a thermodynamic point of view, extracellular electron transfer mechanisms (EET-MIC) through pili or electron transfer compounds cannot be ruled out. Various MIC mitigating methods have been demonstrated to be effective in short term, but long term evaluations are necessary before clinical applications can be considered. Currently most in-vitro studies fail to simulate the complexity of intraoral physiological conditions which may either reduce or exacerbate corrosion risk, which must be addressed in future studies. STATEMENT OF SIGNIFICANCE: A thorough analysis on literature regarding oral MIC (microbiologically influenced corrosion) of biomedical metallic materials has been carried out, including characteristics of oral environment, MIC mechanisms, corrosion behaviors in the presence of typical oral microorganisms and potential mitigating methods (materials design and surface design). There is currently a lack of mechanistic understanding of oral MIC which is very important not only to corrosion researchers but also to dentists and clinicians. This paper discusses the significance of biofilms from a biocorrosion perspective and summarizes several aspects of MIC mechanisms which could be caused by oral microorganisms. Oral MIC has been closely associated with not only the materials research but also the dental/clinical research fields in this work.
PubMed: 38942189
DOI: 10.1016/j.actbio.2024.06.032 -
Tissue Engineering and Regenerative... Jun 2024Classical guided bone regeneration (GBR) treatments can achieve favorable clinical results for ridge defects. However, extensive bone augmentation in the non-esthetic...
BACKGROUND
Classical guided bone regeneration (GBR) treatments can achieve favorable clinical results for ridge defects. However, extensive bone augmentation in the non-esthetic area in the posterior region for minor ridge defects is unnecessary. Therefore, this study used a collagen and Platelet-rich fibrin (PRF) mixture for bone augmentation on minor posterior ridge defects and evaluated the effects.
METHODS
22 Seibert Class I ridge defects were treated with BC and covered with a PRF membrane (simplified guided bone regeneration, simplified GBR) and other 22 were treated with Bio-Oss and covered with Bio-Gide (classical GBR). Cone-beam computed tomography imaging was conducted 6 months post-surgery to compare the ridge's horizontal width (HW) and buccal ridge's horizontal width to assess the osteogenic effect. In addition, the buccal ridge contour morphology was studied and classified.
RESULTS
The buccal ridge contour of simplified GBR was Type A in 14 cases, Type B in 7 cases, and Type C in 1 case and it of classical GBR was Type A in 11 cases, Type B in 8 cases, and Type C in 3 cases. The mean HW significantly increased by 1.50 mm of simplified GBR treatment, while it increased by 1.83 mm in classical GBR treatment.
CONCLUSION
The combined use of BC and PRF had a significant effect on bone augmentation and this treatment exhibited promising clinical results for correcting posterior Seibert Class I ridge defects. The morphological classification of the reconstructive effect in this study can be utilized in future clinical work.
PubMed: 38943036
DOI: 10.1007/s13770-024-00654-0 -
The International Journal of Oral &... Jun 2024To investigate residual debris within internal features of new "as received" dental implants.
PURPOSE
To investigate residual debris within internal features of new "as received" dental implants.
MATERIALS AND METHODS
A total of 15 new dental implants representing various dental implant brands were obtained in sealed containers from the manufacturers. Batch numbers and implant types were documented. In a controlled setting, implants were carefully unpacked, and their internal aspects were visually examined. Further analysis involved light microscopy imaging to document and photograph any foreign material. The internal aspect of the implants were sampled with both an endodontic paper cone and a fine bristle brush swab. These were inserted into the implant, rotated three times, then removed and examined under a microscope at 30x magnification. Post sampling some of the brushes/swabs were washed with alcohol to remove debris that could be further examined under magnification.
RESULTS
Inspection of the implants without magnification revealed no visible foreign materials. However, under light microscopy (x10 and x30), all 15 implants exhibited small black particles at various internal sites, including connections, threads, and deep within screw channels. Swabs evaluated at magnification detected what appeared to be metal particles in all 15 implants, ranging from distinct metal shards to smaller particles.
CONCLUSION
This study suggests that implant manufacturers have not effectively removed all machining debris from within implant bodies, potentially producing prosthetic and clinical complications.
PubMed: 38941171
DOI: 10.11607/jomi.11002 -
The International Journal of Oral &... Jun 2024Several anatomical and histological limitations can complicate implant placement, angulated implant positioning appeared to compensate these limitations. However several...
OBJECTIVES
Several anatomical and histological limitations can complicate implant placement, angulated implant positioning appeared to compensate these limitations. However several studies suggested a higher rate of marginal bone loss and implant failure regarding tilted implants in comparison with conventional implant. Therefore this umbrella review aims to summarize and analyze all the evidence available concerning marginal bone loss and implant failure between tilted and axial implants.
METHODS
An electronic literature search was conducted, without any language restrictions and only systematic reviews with meta-analysis or meta-analysis studies were included. The outcomes assessed in this review were implant failure and marginal bone loss in mm. Relative risks (RRs) and the differences of the mean (MD) were calculated with 95% confidence intervals (CIs) regarding implant failure and marginal bone loss respectively.
RESULTS
in total 8 studies were included, based on the short-term results, a non-significant mean difference (MD=0.00; 95% Cl; -0.01-0.02; p-value = 0.75) was recorded between tilted and axial implants supporting full-arch dentures, meanwhile a significant mean difference was recorded on a 3 years and long term follow-up reached (MD= 0.08 95% Cl = 0.05-0.11; p value<0.00001)) and (MD= 0.18; 95% Cl= 0.15-0.20; p value< 0.00001) respectively, and an insignificant difference was observed between tilted and axial implants regarding implant failure (RR=1.02; 95% Cl=0.85-1.23; p value= 0.81) Conclusion: this review based on high and moderated quality studies with low risk of bias demonstrated no significant outcome was observed between tilted implants supporting full-arch or fixed partial denture and axial implants regarding implant failure.
PubMed: 38941170
DOI: 10.11607/jomi.10885 -
The International Journal of Oral &... Jun 2024The aim of this study is to examine the stresses on the peri-implant bone under occlusal forces of 30% Carbon fiber reinforced PEEK (Cfr-PEEK) and 60% Cfr-PEEK materials...
PURPOSE
The aim of this study is to examine the stresses on the peri-implant bone under occlusal forces of 30% Carbon fiber reinforced PEEK (Cfr-PEEK) and 60% Cfr-PEEK materials that can be used as an alternative to titanium dental implants by finite element analysis.
MATERIALS AND METHODS
Single-tooth implants of 30% Cfr-PEEK, 60% Cfr-PEEK and titanium were modeled in each of the maxillary anterior, maxilla posterior, mandibular posterior regions. As a result of the applied vertical and oblique forces; Von Misses stress, maximum principal stress and minimum principal stress values and stress distributions in the implant, cortical bone and spongious bone in each of the models were examined.
RESULTS
30% Cfr-PEEK implants stress in the surrounding bone was higher than titanium and 60% Cfr-PEEK implants. The 60% Cfr-PEEK material displayed lower stress distribution on both cortical and spongious peri-implant bone in all models.
CONCLUSION
Titanium and 60% Cfr- PEEK implants exhibited biomechanically similar behavior and these implants conducted stresses to bone more homogeneous than the 30% Cfr-PEEK implants. Overall, oblique forces had more destructive effect than vertical forces and denser bone structure showed better stress distribution against incoming forces. For the routine use of Cfr-PEEK material as dental implant material; animal and long-term clinical studies are needed.
PubMed: 38941169
DOI: 10.11607/jomi.10954 -
The International Journal of Oral &... Jun 2024To evaluate multiple risk factors of peri-implant bone loss.
OBJECTIVE
To evaluate multiple risk factors of peri-implant bone loss.
MATERIALS AND METHODS
A case-control study was conducted on patients who had received dental implants treatment from January 2018 to December 2021. Implants with bone loss were included in the case group, and implants with no bone loss were included in the control group. Risk factors including history of periodontitis, abutment connection type, implant surface, diameter, location, three-dimensional position, opposing dentition, adjacent teeth, prosthetic type, retention type and custom abutment were evaluated. A multivariate logistic regression model was used to evaluate these risk factors, providing corresponding odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS
A total of 776 implants in 479 patients were included in the analysis. The number of implants in the case group and the control group were 84 and 692, respectively. Cement-retained prostheses (OR=2.439, 95%CI=1.241-4.795) and nonplatform switch design (OR=2.055, 95%CI=1.167-3.619) were identified as weak risk factors. Horizontal deviation (OR=4.177, 95%CI=2.265-7.703) was a moderate risk factor. Vertical deviation (OR=10.107, 95%CI=5.280-19.347) and implants located in the mandibular molar region (OR=10.427, 95%CI=1.176-92.461) were considered high risk factors.
CONCLUSION
Implants in the molar region, cement retained, non-platform switch design, and poor three-dimensional implant positioning are identified as significant risk factors for peri-implant bone loss.
PubMed: 38941164
DOI: 10.11607/jomi.10939 -
The International Journal of Oral &... Jun 2024There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The...
PURPOSE
There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes.
MATERIALS AND METHODS
The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement.
RESULTS
In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups.
CONCLUSIONS
Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.
PubMed: 38941163
DOI: 10.11607/jomi.11037 -
Clinical Oral Investigations Jun 2024The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of...
OBJECTIVES
The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels.
MATERIALS AND METHODS
77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test.
RESULTS
PrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn't show a significant difference (p > 0.05).
CONCLUSIONS
PPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups.
CLINICAL RELEVANCE
The PPh should be considered when planning implant surgery.
Topics: Humans; Matrix Metalloproteinase 8; Female; Prospective Studies; Peri-Implantitis; Male; Middle Aged; Phenotype; Gingival Crevicular Fluid; Leukocyte L1 Antigen Complex; Dental Implants; Enzyme-Linked Immunosorbent Assay; Biomarkers; Stomatitis; Periodontal Index; Adult; Aged
PubMed: 38940878
DOI: 10.1007/s00784-024-05798-w -
Clinical Implant Dentistry and Related... Jun 2024The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
AIM
The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
METHODS
This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.
RESULTS
As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.
CONCLUSIONS
The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.
PubMed: 38940681
DOI: 10.1111/cid.13357 -
Clinical Oral Implants Research Jun 2024The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants....
OBJECTIVES
The aim of this study was to evaluate esthetic parameters in the anterior maxillary region by comparing single-piece zirconia versus titanium narrow-diameter implants. Additionally, clinical, radiological and patient-reported outcome measures (PROMs) were analyzed.
MATERIALS AND METHODS
Thirty implants (tissue level implant) were placed in 30 patients in the maxillary esthetic sector. Depending on randomization, a zirconia (test) or titanium implant (control) was placed. Esthetic, clinical, and radiological parameters, including the implant crown esthetic index (ICAI), pink esthetic score (PES), probing pocket depth, bleeding on probing, plaque index, and marginal bone levels, were evaluated at 12, 36 and 60 months after loading.
RESULTS
Sixty months after crown placement, no significant differences were found between groups. The ICAI values were 5.25 ± 4.21 and 4.50 ± 2.98 for the test and control groups, respectively. The corresponding PES values were 7.44 ± 1.93 and 7.43 ± 1.74 for the test and control groups, respectively. There were no significant intergroup differences for the rest of the parameters evaluated.
CONCLUSION
It can be suggested that monotype zirconia implants may serve as a potential alternative to titanium implants in selected clinical scenarios. While the results demonstrated comparable esthetic, clinical, and radiological aspects for zirconia implants as compared to titanium implants after a 5-year follow-up period, further research with larger sample sizes and longer-term follow-up is recommended.
PubMed: 38940623
DOI: 10.1111/clr.14319