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Cureus Oct 2023Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the... (Review)
Review
Osseodensification is a novel biomechanical bone preparation technique that has been established to replace conventional bone drilling and therefore will optimize the implant site. The purpose of this systematic review was to compare the implant stability obtained by osseodensification drilling to those associated with conventional drilling techniques. An electronic search was performed in the PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases searched through Elton B. Stephens Company (EBSCO) for potentially relevant publications in the English language from January 2013 to December 2022. Randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs), contrasting osseodensification drilling with conventional drilling, studies documenting implant stability quotient (ISQ), and studies reporting the immediate outcome and at least three months of follow-up after dental implant placement were included. Two independent investigators evaluated the quality of the reviewed studies to determine the risk of bias using the version 2 of Cochrane risk-of-bias (RoB) tool for RCTs (RoB 2) and RoB for NRSIs (ROBINS-I). Majority of the studies showed that bone density was significantly higher in the osseodensification group. The overall RoB for the NRSIs was reported to be low with respect to confounding, selection, classification, incomplete data, deviance from interventions, outcome evaluation, and selective reporting. The quality assessment of the RCT studies included in the review using the RoB 2 tool showed a high overall risk. The findings of the current review reveal that osseodensification drilling exhibited higher resonance frequency analysis (RFA) and ISQ values than conventional drilling protocols. Similarly, when osseodensification regions were contrasted with traditional drilling, bone density at the implant surface was augmented.
PubMed: 37954787
DOI: 10.7759/cureus.46841 -
BMC Oral Health Oct 2023Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be...
BACKGROUND
Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be biological or mechanical complications during the therapy, which lead to the loss of the implant. This systematic review aims to evaluate the current state of the art in the literature on techniques used for the removal of dental implants. Various aspects will be analyzed, such as the success of the technique, any complications, and the advantages and disadvantages of their use.
METHODS
Two reviewers conducted a literature analysis (PubMed, Embase, Web of Science) of the last 20 years (2003-2023). The main criterion analyzed was the success of the technique, while secondary outcomes such as complications and risks of the technique were also analyzed. 258 articles were identified in the various search databases. 42 eligible articles were subsequently identified after an article screening. Only 18 full texts were subsequently included in the review.
RESULTS
A total of 18 articles were selected and 1142 implants and 595 patients were included. The main techniques used were the Counter-Torque Ratchet Technique (CTRT), Piezoelectric bone surgery (PBS), trephine drills, carbide burs, Erbium, Chromium, Yttrium, Scandium, Gallium, Garnett (Er:Cr:YSGG) laser and carbon dioxide (CO) laser. Combined uses of techniques have been identified such as: PBS and trephine burs or carbide burs, trephine burs with the use of a 3d-printed guide, CTRT and trephine burs. The technique with the highest success rate, less morbidity for the patient, and less removal of bone appears to be the CTRT.
CONCLUSIONS
The use of conservative techniques, especially CTRT, in bone removal is useful to allow for immediate implant placement in the removal area. However, further studies with a high sample size are needed to be performed on all techniques, particularly new randomized controlled trials (RCTs) that allow for the analysis of the success of alternative techniques such as Laser and Piezosurgery, which appear to be very promising.
Topics: Humans; Dental Implants; Bone-Anchored Prosthesis; Dental Implantation, Endosseous; Yttrium; Lasers, Solid-State
PubMed: 37833674
DOI: 10.1186/s12903-023-03438-5 -
Materials (Basel, Switzerland) Sep 2023The current review aims to provide an overview of the most recent research in the last 10 years on the potentials of graphene in the dental surgery field, focusing on... (Review)
Review
The current review aims to provide an overview of the most recent research in the last 10 years on the potentials of graphene in the dental surgery field, focusing on the potential of graphene oxide (GO) applied to implant surfaces and prosthetic abutment surfaces, as well as to the membranes and scaffolds used in Guided Bone Regeneration (GBR) procedures. "Graphene oxide" and "dental surgery" and "dentistry" were the search terms utilized on the databases Scopus, Web of Science, and Pubmed, with the Boolean operator "AND" and "OR". Reviewers worked in pairs to select studies based on specific inclusion and exclusion criteria. They included animal studies, clinical studies, or case reports, and in vitro and in vivo studies. However, they excluded systematic reviews, narrative reviews, and meta-analyses. Results: Of these 293 studies, 19 publications were included in this review. The field of graphene-based engineered nanomaterials in dentistry is expanding. Aside from its superior mechanical properties, electrical conductivity, and thermal stability, graphene and its derivatives may be functionalized with a variety of bioactive compounds, allowing them to be introduced into and improved upon various scaffolds used in regenerative dentistry. This review presents state-of-the-art graphene-based dental surgery applications. Even if further studies and investigations are still needed, the GO coating could improve clinical results in the examined dental surgery fields. Better osseointegration, as well as increased antibacterial and cytocompatible qualities, can benefit GO-coated implant surgery. On bacterially contaminated implant abutment surfaces, the CO coating may provide the optimum prospects for soft tissue sealing to occur. GBR proves to be a safe and stable material, improving both bone regeneration when using GO-enhanced graft materials as well as biocompatibility and mechanical properties of GO-incorporated membranes.
PubMed: 37763569
DOI: 10.3390/ma16186293 -
The Japanese Dental Science Review Dec 2023The use of graphecs excellent mechanical properties. However, it is necessary to evaluate the biological effects of this material. This systematic review aimed to... (Review)
Review
The use of graphecs excellent mechanical properties. However, it is necessary to evaluate the biological effects of this material. This systematic review aimed to observe and understand through studies the current state of the art regarding osseointegration, antimicrobial capacity, and the cytotoxicity of graphene coating applied to the surface of dental implant materials. Searches in PubMed, Embase, Science Direct, Web of Science, and Google Scholar databases were conducted between June and July 2021 and updated in May 2022 using the keywords: graphene, graphene oxide, dental implants, zirconium, titanium, peek, aluminum, disilicate, methyl-methacrylate, cytotoxicity, osseointegration, and bone regeneration. The criteria included in vivo and in vitro studies that evaluated antimicrobial capacity and/or osseointegration and/or cytotoxicity of dental implant materials coated with graphene compounds. The risk of bias for in vitro studies was assessed by the JBI tool, and for in vivo studies, Syrcle's risk of bias tool for animal studies was used. The database search resulted in 176 articles. Of the 18 articles selected for full reading, 16 remained in this systematic review. The use of graphene compounds as coatings on the surface of implant materials is promising because it promotes osseointegration and has antimicrobial capacity. However, further studies are needed to ensure its cytotoxic potential.
PubMed: 37680613
DOI: 10.1016/j.jdsr.2023.08.005 -
Frontiers in Bioengineering and... 2023The amputee population according to the World-Health-Organization is about 40 million. However, there is a high abandon rate of socket prostheses for the lower limb... (Review)
Review
The amputee population according to the World-Health-Organization is about 40 million. However, there is a high abandon rate of socket prostheses for the lower limb (25%-57%). The direct connection between the external prosthesis and the patient's bone makes osseointegrated prostheses for transfemoral amputees advantageous (e.g., improvement of the motor control) compared to socket prostheses, which are currently the gold standard. However, similarly to other uncemented prostheses, the osseointegrated ones are at risk of aseptic loosening and adverse bone remodelling caused by stress-shielding. The preclinical assessment of these prostheses has already been evaluated using different methods which did not provide unanimous and comparable evidence. To compare data from different investigations, a clear and detailed overview of the methods used to assess the performance is necessary. In this review 17 studies investigating the primary stability, stress shielding and stress concentration of osseointegrated transfemoral prostheses are examined. Primary stability consists in the biomechanical stability upon implant insertion. Primary stability is assessed measuring extraction force (either with a pull-out or a push-out test) and micromotion at the interface between the implant and the host bone with LVDT ( test) or numerical models. Stress-shielding causes adaptive changes in the bone density around metal implants, and thus in the bone strength and stiffness. Stress-shielding is assessed with strain gauges or numerical models measuring the load transfer and the strain distribution on the surface of the femur, and between the implant and the bone respectively. Stress concentration can lead to the formation of cracks inside the bone, resulting in fractures. The stress concentration is assessed measuring the load transfer and the strain energy density at the interface between the implant and the bone, using numerical models. As a result, a global view and consensus about the methods are missing from all these tests. Indeed, different setup and loading scenario were used in the test, while different model parameters (e.g., bone properties) were used in the numerical models. Once the preclinical assessment method is established, it would be important to define thresholds and acceptance criteria for each of the possible failure scenarios investigated.
PubMed: 37662439
DOI: 10.3389/fbioe.2023.1237919 -
Revista Espanola de Cirugia Ortopedica... 2024The purpose of this study is to analyze the indications, complications, survivorship and clinical/functional outcome of metaphyseal sleeves as a treatment option in... (Review)
Review
BACKGROUND AND OBJECTIVES
The purpose of this study is to analyze the indications, complications, survivorship and clinical/functional outcome of metaphyseal sleeves as a treatment option in revision total knee arthroplasty.
MATERIAL AND METHOD
A systematic review was made following the PRISMA recommendations on the use of metaphyseal sleeves for revision total knee arthroplasty. We included prospective and retrospective studies published in the last 10 years looking at implant survivorship, clinical and functional outcome with a minimum follow-up of 2 years.
RESULTS
The included studies showed good both functional and clinical outcomes. The overall reoperation rate was 16.2%, with an overall survival rate of 92.2% and aseptic survivorship of 98.2%.
CONCLUSIONS
Metaphyseal sleeves are a good treatment option for this surgery, especially in AORI II or III type bone defects, achieving good intraoperative and primary stability of the implant, with good and rapid osseointegration.
PubMed: 37573941
DOI: 10.1016/j.recot.2023.08.014 -
International Journal of Nanomedicine 2023Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone... (Review)
Review
Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE's) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40-105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.
Topics: Animals; Osseointegration; Osteogenesis; Titanium; Prostheses and Implants; Printing, Three-Dimensional; Surface Properties; Porosity
PubMed: 37525692
DOI: 10.2147/IJN.S409033 -
Journal of Prosthodontic Research Apr 2024Purpose This study aimed to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on promoting osseointegration around dental implants.Study selection A... (Meta-Analysis)
Meta-Analysis
Purpose This study aimed to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) on promoting osseointegration around dental implants.Study selection A comprehensive search was performed on two databases, including MEDLINE (PubMed) and Web of Science to identify relevant studies published before June 1, 2022. Randomized controlled trials that met the inclusion criteria were selected for the study. The year of publication, study design, animal species, number of animals, number of implants, implant position, implant size, intervention, follow-up time, bone volume ratio (BV/TV), bone-implant contact ratio (BIC), and implant removal torque value (RTV) measurements, including mean and SD, were extracted.Results Ten randomized trials were included in this meta-analysis. The results showed that LIPUS significantly promoted osteogenesis around dental implants. Furthermore, in animal models of pre-existing diseases such as osteoporosis and diabetes, LIPUS had the same effect. The included data were divided into subgroups to explore the effects of different follow-up time, acoustic intensities, and frequencies. Results showed that higher acoustic intensities and frequencies significantly improve the osteogenic effects of LIPUS. There was some degree of heterogeneity owing to bias in the included studies. More high-quality randomized controlled trials are necessary in the future.Conclusions LIPUS can promote bone healing around dental implants and is an attractive option for edentulous patients, especially those with pre-existing diseases. Further clinical trials on the use of LIPUS in implant dentistry are warranted. Furthermore, future studies must pay more attention to acoustic intensity and frequency.
Topics: Animals; Humans; Osteogenesis; Dental Implants; Osseointegration; Ultrasonic Waves
PubMed: 37518333
DOI: 10.2186/jpr.JPR_D_23_00068 -
Biomedizinische Technik. Biomedical... Feb 2024To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ). (Review)
Review
OBJECTIVES
To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ).
CONTENT
Methods to evaluate the stability of dental implants.
SUMMARY
A search was performed in the PubMed, Scopus, and Web of Science databases for articles on the proposed subject up to January 29, 2023, using search terms that combined "resonance frequency analysis" and "Periotest" with "correlation" or "relationship"; and combinations of "implant stability quotient" and "Periotest" with "correlation" or "relationship." The inclusion criteria were clinical studies in English involving human subjects who received dental implants and evaluating the correlation between PTV and ISQ. A total of 46 articles were screened, of which 10 were selected for full-text analysis, and eight articles were included in this review. Based on three articles, 75 % of the results of this systematic review showed a negative correlation between PTV and ISQ, regardless of the type of stability assessed. Based on the remaining five articles, 100 % (regardless of the patient's gender) and 66.66 % of the results showed a negative correlation for primary and secondary stability, respectively. There is a negative correlation between PTV and ISQ for both primary and secondary dental implant stability.
OUTLOOK
This review can serve as a reference for the development of methodologies for future clinical studies on this topic.
Topics: Humans; Osseointegration; Dental Implants; Dental Implantation, Endosseous; Dental Prosthesis Retention
PubMed: 37489593
DOI: 10.1515/bmt-2023-0194 -
Heliyon Jun 2023The objective of the systematic review is to find an answer to a question: "Do surface treatments on titanium implants produced by additive manufacturing improve...
The objective of the systematic review is to find an answer to a question: "Do surface treatments on titanium implants produced by additive manufacturing improve osseointegration, compared to untreated surfaces?". This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022321351). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on March 22nd, 2022. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: articles in animals that addressed the influence of surface treatments on osseointegration in implants produced by additive manufacturing. Articles were excluded that (1) did not use titanium surface, 2) that did not evaluate surface treatments, 3) that did not described osseointegration, 4) Studies with only in vitro analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports and personal opinions.). 1003 articles were found and, after applying the eligibility criteria, 17 were used for the construction of this review. All included studies found positive osseointegration results from performing surface treatments on titanium. The risk of bias was analyzed using the SYRCLE assessment tool. Surface treatments are proposed to promote changes in the microstructure and composition of the implant surface to favor the adhesion of bone cells responsible for osseointegration. It is observed that despite the benefits generated by the additive manufacturing process in the microstructure of the implant surface, surface treatments are still indispensable, as they can promote more suitable characteristics for bone-implant integration. It can be concluded that the surface treatments evaluated in this systematic review, performed on implants produced by additive manufacturing, optimize osseointegration, as it allows the creation of a micro-nano-textured structure that makes the surface more hydrophilic and allows better contact bone-implant.
PubMed: 37484223
DOI: 10.1016/j.heliyon.2023.e17105