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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 -
PloS One 2022Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding...
BACKGROUND
Implant periapical lesion (IPL), as a peri-implant disease originating from implant apex, maintains coronal osseointegration in the early stage. With the understanding to IPL increasingly deepened, IPL classification based on different elements was proposed although there still lacks an overall classification system. This study, aiming to systematically integrate the available data published in the literature on IPL associated with histopathology, proposed a comprehensive classification framework and treatment decision tree for IPL.
METHODS AND FINDINGS
English articles on the topic of "implant periapical lesion", "retrograde peri-implantitis" and "apical peri-implantitis" were searched on PubMed, Embase and Web of Science from 1992 to 2021, and citation retrieval was performed for critical articles. Definite histopathology and radiology of IPL are indispensable criteria for including the article in the literature. The protocol was registered in PROSPERO (CRD42022378001). A total of 509 papers identified, 28 studies were included in this review. In only one retrospective study, 37 of 39 IPL were reported to be at the inflammatory or abscess stage. 27 cases (37 implants) were reported, including acute non-suppurative (1/37, developed to chronic granuloma), chronic granuloma (5/37), acute suppurated (2/37), chronic suppurated-fistulized (6/37), implant periapical cyst (21/37), poor bone healing (2/37), foreign body reaction (1/37). Antibiotics alone did not appear to be effective, and the consequence of surgical debridement required cautious interpretation because of the heterogeneity of lesion course and operation. Implant apicoectomy and marsupialization were predictable approaches in some cases.
CONCLUSIONS
The diversiform nature of IPL in the case reports confirms the need for such histopathological classification, which may enhance the comparison and management of different category.
Topics: Humans; Peri-Implantitis; Retrospective Studies; Radicular Cyst; Suppuration; Granuloma; Decision Trees; Dental Implants
PubMed: 36548276
DOI: 10.1371/journal.pone.0277387 -
Journal of Clinical Medicine Nov 2022Several clinical trials have recently been conducted to elucidate the effectiveness of photofunctionalization. The aim of this review was to systematically analyze the... (Review)
Review
BACKGROUND
Several clinical trials have recently been conducted to elucidate the effectiveness of photofunctionalization. The aim of this review was to systematically analyze the clinical effects of photofunctionalization on implant stability and marginal bone loss (MBL).
METHODS
An electronic search in four databases and a manual search were conducted in September 2022. Randomized controlled trials (RCTs), clinical controlled trials (CCTs), and cohort and case-control studies evaluating the effects of photofunctionalization on implant stability or marginal bone loss (MBL) in humans were included. The methodological quality assessment using RoB 2.0 and the ROBINS-I tool was performed based on different study designs.
RESULTS
Seven studies were included for a qualitative analysis, and five of them were chosen for a meta-analysis. The meta-analysis revealed that photofunctionalization significantly improved the stability of the implant 2 months after implantation ( = 0.04; MD = 3.48; 95% CI = -0.23 to 6.73) and increased the osseointegration speed index (OSI) ( = 0.007; MD = 2.13; 95% CI = 0.57 to 3.68). However, no significant improvements of implant stability were observed 2 weeks ( = 0.62), 4 weeks ( = 0.31), nor 4 months ( = 0.24) after implantation. The evaluation presented no significant reductions in MBL.
CONCLUSIONS
Based on the positive effect of photofunctionalization on the rate of establishing implant stability, photofunctionalization may provide an effective and practical strategy to achieve faster osseointegration and reduce the overall healing time. Photofunctionalization appears to improve the implant stability. However, the clinical effect of photofunctionalization on MBL remains unclear due to the shortage of available studies.
PubMed: 36498616
DOI: 10.3390/jcm11237042 -
Journal of Periodontal & Implant Science Dec 2022Rodent models have emerged as an alternative to established larger animal models for peri-implantitis research. However, the construct validity of rodent models is...
PURPOSE
Rodent models have emerged as an alternative to established larger animal models for peri-implantitis research. However, the construct validity of rodent models is controversial due to a lack of consensus regarding their histological, morphological, and biochemical characteristics. This systematic review sought to validate rodent models by characterizing their morphological changes, particularly marginal bone loss (MBL), a hallmark of peri-implantitis.
METHODS
This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed electronically using MEDLINE (PubMed), and Embase, identifying pre-clinical studies reporting MBL after experimental peri-implantitis induction in rodents. Each study's risk of bias was assessed using the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool. A meta-analysis was performed for the difference in MBL, comparing healthy implants to those with experimental peri-implantitis.
RESULTS
Of the 1,014 unique records retrieved, 23 studies that met the eligibility criteria were included. Peri-implantitis was induced using 4 methods: ligatures, lipopolysaccharide, microbial infection, and titanium particles. Studies presented high to unclear risks of bias. During the osseointegration phase, 11.6% and 6.4%-11.3% of implants inserted in mice and rats, respectively, had failed to osseointegrate. Twelve studies were included in the meta-analysis of the linear MBL measured using micro-computed tomography. Following experimental peri-implantitis, the MBL was estimated to be 0.25 mm (95% confidence interval [CI], 0.14-0.36 mm) in mice and 0.26 mm (95% CI, 0.19-0.34 mm) in rats. The resulting peri-implant MBL was circumferential, consisting of supra- and infrabony components.
CONCLUSIONS
Experimental peri-implantitis in rodent models results in circumferential MBL, with morphology consistent with the clinical presentation of peri-implantitis. While rodent models are promising, there is still a need to further characterize their healing potentials, standardize experiment protocols, and improve the reporting of results and methodology.
TRIAL REGISTRATION
PROSPERO Identifier: CRD42020209776.
PubMed: 36468467
DOI: 10.5051/jpis.2200900045 -
Journal of Taibah University Medical... Feb 2023Dental implants are prosthetic devices that are surgically placed in direct contact with the jawbone to support intra-oral functions and esthetics. Diabetes mellitus may... (Review)
Review
Dental implants are prosthetic devices that are surgically placed in direct contact with the jawbone to support intra-oral functions and esthetics. Diabetes mellitus may contribute to peri-implant bone loss. During the last few years, there have been attempts to reduce this bone loss and improve the survival rate of implants. Metformin, an anti-diabetic drug known for its osteogenic properties, is thought to prevent peri-implant bone loss in diabetic patients. Although several studies have been conducted to study metformin's effect on diabetic and non-diabetic study models, no systematic review has analyzed and summarized these studies critically. Therefore, the objectives of this systematic review were to summarize the outcomes of these studies and critically appraise them. Seven studies were included in this systematic review. Four studies used only animal models, two used both animal and cell culture models, and one used only cell culture studies. The general characteristics and outcomes of the included studies were summarized, and Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines were used to assess the quality of the animal studies. In vitro studies indicate that metformin may induce stem cells to undergo osteoblastic differentiation to produce a higher amount of bone and may also improve osseointegration. Nevertheless, several studies had potential sources of bias. Therefore, it is recommended that emphasis be placed on increasing the quality of future animal studies and human trials to determine the effects of metformin on the osseointegration of dental implants. Future studies are needed with adequate follow-up to evaluate the efficacy of metformin in improving the osseointegration of dental implants.
PubMed: 36398019
DOI: 10.1016/j.jtumed.2022.07.003 -
Journal of Clinical Medicine Oct 2022Spinal fusion (SF) comprises surgical procedures for several pathologies that affect different spinal levels, and different cages are employed in SF surgery. Few... (Review)
Review
Spinal fusion (SF) comprises surgical procedures for several pathologies that affect different spinal levels, and different cages are employed in SF surgery. Few clinical studies highlight the role of cages in complications beyond the outcomes. The aim of this systematic review is to collect the last 10 years' worth of clinical studies that include cages in SF surgery, focusing on complications. Three databases are employed, and 21 clinical studies are included. The most-performed SF procedure was anterior cervical discectomy and fusion (ACDF), followed by lumbar SF. The polyetheretherketone (PEEK) cage was the most-used, and it was usually associated with autograft or calcium phosphate ceramics (hydroxyapatite (HA) and tricalcium phosphate (βTCP)). For lumbar SF procedures, the highest percentages of subsidence and pseudoarthrosis were observed with PEEK filled with bone morphogenetic protein 2 (BMP2) and βTCP. For ACDF procedures, PEEK filled with autograft showed the highest percentages of subsidence and pseudoarthrosis. Most studies highlighted the role of surgical techniques in patient complications. There are many interacting events that contextually affect the rate of clinical success or failure. Therefore, in future clinical studies, attention should focus on cages to improve knowledge of chemical, biological and topographical characteristics to improve bone growth and to counteract complications such as cage loosening or breaking and infections.
PubMed: 36362508
DOI: 10.3390/jcm11216279 -
Materials (Basel, Switzerland) Oct 2022Immunomodulatory biomaterials have the potential to stimulate an immune response able to promote constructive and functional tissue remodeling responses as opposed to... (Review)
Review
UNLABELLED
Immunomodulatory biomaterials have the potential to stimulate an immune response able to promote constructive and functional tissue remodeling responses as opposed to persistent inflammation and scar tissue formation. As such, the controlled activation of macrophages and modulation of their phenotype through implant surface modification has emerged as a key therapeutic strategy.
METHODS
Online databases were searched for in vitro studies between January 1991 and June 2020 which examined the effect of titanium implant surface topography on the adherent macrophage phenotype at either the gene or protein level.
RESULTS
Thirty-nine studies were subsequently included for review. Although there was significant heterogeneity between studies, treatment of titanium surfaces increased the surface roughness or hydrophilicity, and hence increased macrophage attachment but decreased cell spreading. Physical coating of the titanium surface also tended to promote the formation of cell clusters. Titanium and titanium-zirconium alloy with a micro- or nano-scale rough topography combined with a hydrophilic surface chemistry were the most effective surfaces for inducing an anti-inflammatory phenotype in adherent macrophages, as indicated by significant changes in cytokine gene expression and or cytokine secretion profiles.
CONCLUSIONS
The published data support the hypothesis that incorporation of specific topographical and physiochemical surface modifications to titanium can modulate the phenotypic response of adherent macrophages.
PubMed: 36295379
DOI: 10.3390/ma15207314 -
Frontiers in Bioengineering and... 2022Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically...
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms "titanium dental implants", "surface properties", "bioactive surface modifications", "biomolecules", "BMP", "antibacterial agent", "peptide", "collagen", "grown factor", "osseointegration", "bone apposition", "osteogenic", "osteogenesis", "new bone formation", "bone to implant contact", "bone regeneration" and " studies", until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
PubMed: 36225604
DOI: 10.3389/fbioe.2022.986112 -
Nutrients Aug 2022Phenolic compounds are natural phytochemicals that have recently reported numerous health benefits. Resveratrol, curcumin, and quercetin have recently received the most...
Phenolic compounds are natural phytochemicals that have recently reported numerous health benefits. Resveratrol, curcumin, and quercetin have recently received the most attention among these molecules due to their documented antioxidant effects. The review aims to investigate the effects of these molecules on bone metabolism and their role in several diseases such as osteopenia and osteoporosis, bone tumours, and periodontitis. The PubMed/Medline, Web of Science, Google Scholar, Scopus, Cochrane Library, and Embase electronic databases were searched for papers in line with the study topic. According to an English language restriction, the screening period was from January 2012 to 3 July 2022, with the following Boolean keywords: ("resveratrol" AND "bone"); ("curcumin" AND "bone"); ("quercetin" AND "bone"). A total of 36 papers were identified as relevant to the purpose of our investigation. The studies reported the positive effects of the investigated phenolic compounds on bone metabolism and their potential application as adjuvant treatments for osteoporosis, bone tumours, and periodontitis. Furthermore, their use on the titanium surfaces of orthopaedic prostheses could represent a possible application to improve the osteogenic processes and osseointegration. According to the study findings, resveratrol, curcumin, and quercetin are reported to have a wide variety of beneficial effects as supplement therapies. The investigated phenolic compounds seem to positively mediate bone metabolism and osteoclast-related pathologies.
Topics: Curcumin; Dietary Supplements; Humans; Osteoporosis; Periodontitis; Quercetin; Resveratrol
PubMed: 36079777
DOI: 10.3390/nu14173519 -
Journal of Oral Biology and... 2022This systematic review was executed to determine the influence of proton pump inhibitors on biomechanical efficiency of dental implants. (Review)
Review
PURPOSE
This systematic review was executed to determine the influence of proton pump inhibitors on biomechanical efficiency of dental implants.
MATERIALS AND METHODS
The comprehensive online literature search was conducted on digital database of Pubmed, Cochrane database and EBSCO host, Web of Science and Scopus from 2010 to 2021(Dec).The studies included in our research comprised of randomized controlled trials and animal studies. Literature review, Letter to the editor, short communication and studies not related to the dental implants were excluded. A total of 6 studies were finalized and included in the systemic review.
RESULT
The proton pump inhibitors have a negative influence on the bone metabolism and adversely affect the Osseointegration of the dental implants. Further they reduce the biomechanical efficiency of dental implant which ultimately results in their failure.
CONCLUSION
Proton pump inhibitors are a risk factor for dental implant survival. This conclusion has been drawn from the limited research available. Hence well designed prospective randomized controlled trials should be carried out on a large population including the users and non-users, to more thoroughly elucidate the effect of proton pump inhibitor on osseointegration process of dental implants.
PubMed: 36052118
DOI: 10.1016/j.jobcr.2022.08.016