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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 Biomedical Materials... Jul 2022Apart from osseointegration, the stability and long-term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft-tissue integration... (Review)
Review
Apart from osseointegration, the stability and long-term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft-tissue integration in the transcutaneous region. A firm connective tissue seal is needed to minimize soft-tissue dehiscence and epithelial downgrowth. It is well-known that the implant surface plays a key role in controlling the biological response of the surrounding keratinized tissue and several coating systems have been suggested to enhance the soft-tissue cell interactions. Although some promising results have been obtained in vitro, their clinical significance can be debated. Therefore, the purpose of this systematic review is to gain more insight into the effect of such coatings on the interface formed with keratinized soft-tissue in vivo. A comprehensive search was undertaken in March 2021. Relevant electronic databases were consulted to identify appropriate studies using a set of search strings. In total, 12 out of 4971 publications were included in this review. The reported coating systems were assigned to several subgroups according to their characteristics: metallic, ceramic and composite. Notwithstanding the differences in study characteristics (animal model, implantation period, reported outcomes), it was noticed that several coatings improve the soft-tissue integration as compared to pristine titanium. Porous titanium coatings having only limited pore sizes (<250 μm) do not support dermal fibroblast tissue attachment. Yet, larger pores (>700 μm) allow extensive vascularized soft-tissue infiltration, thereby supporting cell attachment. Nanostructured ceramic coatings are found to reduce the inflammatory response in favor of the formation of cell adhesive structures, that is, hemidesmosomes. Biomolecule coatings seem of particular interest to stimulate the soft-tissue behavior provided that a durable fixation to the implant surface can be ensured. In this respect, fibroblast growth factor-2 entrapped in a biomimetic apatite coating instigates a close to natural soft-tissue attachment with epidermal collagen fibers attaching almost perpendicular to the implant surface. However, several studies had limitations with respect to coating characterization and detailed soft-tissue analysis, small sample size and short implantation periods. To date, robust and long-term in vivo studies are still lacking. Further investigation is required before a clear consensus on the optimal coating system allowing enhancing the soft-tissue seal around percutaneous titanium implants can be reached.
Topics: Animals; Coated Materials, Biocompatible; Osseointegration; Porosity; Prostheses and Implants; Surface Properties; Titanium
PubMed: 35103386
DOI: 10.1002/jbm.b.35025 -
Journal of Dental Research, Dental... 2021It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The... (Review)
Review
It is critical to understand laser-microtextured implant collars' influence on peri-implant pocket depths and marginal bone levels, especially in crucial areas. The present review investigated the peri-implant marginal bone loss (MBL) and pocket depths and failure rates of dental implants with laser-microtextured collars. An electronic search was run in the PubMed and Embase databases until September 15, 2019. Randomized and prospective clinical studies comparing peri-implant MBL and pocket depths and failure rates between implants with laser-microtextured and machined collar surfaces were included. Five studies (two cohort studies and three RCTs) were included in the meta-analysis after the inclusion and exclusion criteria and qualitative assessments were applied. The risk ratio of osseointegrated implant failure and mean differences in peri-implant MBL and pocket depths were calculated using the Comprehensive Meta-Analysis (CMA) software. Implants with laser-microtextured collars exhibited significantly better marginal bone level scores ( < 0.001; MD: 0.54; 95% CI: 0.489‒0.592) and a significant reduction in peri-implant probing depths than implants with machined collars ( < 0.001; MD: 1.01; 95% CI: 0.90‒1.13). The assessed studies showed that 17 out of 516 implants failed (3.29%), comprising nine implants with machined (3.62%) and eight implants with laser-microtextured collars (2.98%). However, no significant differences were detected in the implant neck surface characterization ( = 0.695; RR: 1.205; 95% CI: 0.472‒3.076). This study suggests that laser-microtexturing of implant collar significantly affected the peri-implant MBL and probing depths. Although no significant differences were noted in implant failure rates between implants with laser-microtextured and machined collar surfaces, the peri-implant MBL and probing depths with laser-microtextured collars were significantly lower than the machined collars.
PubMed: 35070185
DOI: 10.34172/joddd.2021.048 -
International Journal of Dentistry 2022Many factors play a significant role in osseointegration and healing after dental implant insertion and restoration. Some factors are related to dental biomaterials,... (Review)
Review
BACKGROUND
Many factors play a significant role in osseointegration and healing after dental implant insertion and restoration. Some factors are related to dental biomaterials, such as the dental implant, prosthesis, and grafting materials. Other factors can be connected to operator skills and accumulated experience. Local and systemic patient-related factors are crucial in determining the success of the dental implant. Thorough examination and analysis of local factors using available examination tools are vital to prepare the implant candidate for such treatment. The patient's systemic condition directly affects the healing of the dental implant. One of the most overlooked systemic factors is the patients' vitamin level, which influences bone formation around the implant and subsequent osseointegration. The current review examined the available literature regarding the association between vitamin supplementation and dental implant osseointegration.
METHODS
Data of this review were derived from recent research available on PubMed, Google Scholar, and Scopus. Inclusion criteria were the relation between the vitamin serum and dental implant osseointegration or failure. The Systematic Reviews and Meta-Analyses (PRISMA) checklist was followed to perform the review. The study's outcome was the need for vitamin supplementation to prevent implant failure.
RESULTS
Five human studies (including case reports, case series, and retrospective studies) and six animal studies. All included studies discussed the relationship between vitamin , early dental implant failure, and bone implant contact. Three retrospective studies found no significant relationship between vitamin supplementation and EDIFs in humans. On the other hand, one retrospective study showed a significant relationship in humans. A case report and case series claimed that the implant was successfully placed after vitamin supplementation. A total of four animal studies showed a significant relationship between vitamin supplementation and osseointegration of the dental implant. Two animal studies showed no significant association.
CONCLUSION
To ensure optimal treatment outcomes, it is recommended to supplement the patient with vitamin if the serum level is not within the normal range. Further clinical studies and case reports are needed to confirm the association between serum vitamin levels and osseointegration.
PubMed: 35069741
DOI: 10.1155/2022/2845902 -
International Journal of Implant... Jan 2022To perform a systematic review and meta-analysis on the presence of inflammatory polymorphisms in patients with peri-implantitis (PI). PI is the main complication... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To perform a systematic review and meta-analysis on the presence of inflammatory polymorphisms in patients with peri-implantitis (PI). PI is the main complication associated to dental implant therapy. Although its main risk factors are history of periodontitis, poor plaque control and lack of regular maintenance, genetic susceptibility could also be a determinant factor for its appearance. Single nucleotide polymorphisms (SNP) are small mutations of the DNA that alter the osseointegration of implants. Inflammatory proteins participate in both destruction of the extracellular matrix and reabsorption of the alveolar bone.
METHODS
A bibliographical research was made in PubMed, Scopus and Web of Science (keywords: "single nucleotide polymorphism", "polymorphism", "periimplantitis", "SNP" and "implant failure").
RESULTS
There is a statistically significant association of peri-implant bone loss with the homozygotic model of IL-1β (- 511) (OR: 2.255; IC: 1.040-4.889).
CONCLUSIONS
Associations between inflammatory polymorphisms and PI must be taken with caution due to the heterogeneous methodological design, sample size and diagnostic criteria of the studies. Thus, more well-designed studies are needed that analyze the relationship between these and more SNP and PI.
Topics: Dental Implants; Humans; Mutation; Osseointegration; Peri-Implantitis; Periodontitis
PubMed: 35061134
DOI: 10.1186/s40729-022-00400-y -
Journal of International Society of... 2021The aim of this study was to systematically review the applications of teriparatide (TP) for alveolar bone regeneration in oral cavity. (Review)
Review
AIM
The aim of this study was to systematically review the applications of teriparatide (TP) for alveolar bone regeneration in oral cavity.
MATERIALS AND METHODS
An electronic search of the data was conducted in Medline (PubMed), Scopus, Web of Science, and Embase. The original research associated with the applications of TP for alveolar bone regeneration was evaluated. Cochrane's tool [for human randomized controlled trials (RCTs)] and SYRCLE's tool (for animal RCTs) were used to assess the risk of bias. About two human and four animal studies had low risk of bias.
RESULTS
The results from the 11 studies that were included in the review showed that TP enhanced alveolar bone formation in osteonecrosis of jaws, chronic periodontitis (CP), osseointegration of dental implants as well as orthodontic tooth movement.
CONCLUSION
The TP may be applied for alveolar bone regeneration in osteonecrosis of jaws and CP. However, further human clinical trials are required to verify its applications and adverse effects in various oral bone conditions.
PubMed: 35036372
DOI: 10.4103/jispcd.JISPCD_169_21 -
Journal of Stomatology, Oral and... Oct 2022This systematic review aimed to evaluate complications and survival rates of dental implants placed in patients suffering from autoimmune diseases.
PURPOSE
This systematic review aimed to evaluate complications and survival rates of dental implants placed in patients suffering from autoimmune diseases.
MATERIALS AND METHODS
A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines (PRISMA), using Google scholar and PubMed electronic databases with a stop date of September 2021. The eligibility criteria included all full text human studies in the English language literature reporting on patients with autoimmune diseases treated with dental implants.
RESULTS
Fifty-five studies reporting on nine distinct autoimmune diseases were analyzed: 17 on Sjögren's syndrome (SS), 11 on oral lichen planus (OLP), 8 on Type 1 diabetes, 6 on rheumatoid arthritis (RA), 4 on systemic scleroderma (SSc), 3 on Crohn's disease (CD), 3 on systemic lupus erythematosus (SLE), 2 on mucous membrane pemphigoid (MMB) and 1 on pemphigus vulgaris (PV). Despite the heterogeneity and methodological limitations of most of the studies, results showed that dental implant survival rates were comparable to those reported in the general population. However, patients with secondary SS or erosive OLP were more susceptible to developing peri-mucositis and increased marginal bone loss.
CONCLUSION
This review suggested that dental implants may be considered as a safe and viable therapeutic option in the management of edentulous patients suffering from autoimmune diseases. Nevertheless, scrupulous maintenance of oral hygiene and long-term follow-up emerge as being the common determinants for uneventful dental implant treatment.
Topics: Dental Implants; Humans; Lichen Planus, Oral; Sjogren's Syndrome
PubMed: 35033725
DOI: 10.1016/j.jormas.2022.01.005 -
Annals of Palliative Medicine Dec 2021With the continuous improvement of human living standards, more and more dental patients are requiring oral implant restoration treatment. However, there is still... (Meta-Analysis)
Meta-Analysis
BACKGROUND
With the continuous improvement of human living standards, more and more dental patients are requiring oral implant restoration treatment. However, there is still controversy regarding the influence of risk factors such as osteoporosis, radiotherapy, diabetes, and smoking on the failure of oral implants. This study aimed to explore the correlation between risk factors and failure of oral implant restoration treatment.
METHODS
The databases of China National Knowledge Infrastructure (CNKI), Baidu Academic, Weipu, Wanfang, PubMed, EBSCO, Medline, Web of knowledge, Ovid, and the Cochrane Library were searched. The search strategies included: subject terms related to research results such as survival, osseointegration, failure, removal, replacement, and loss; related to risk factors: osteoporosis, head and neck cancer, diabetes, and smoking; and oral implantology as a keyword.
RESULTS
Thirty-two articles were included in meta-analysis, there was a high heterogeneity between radiotherapy and dental implant failure (I2=71.6%, P=0.000), and there was an obvious correlation between radiotherapy and dental implant failure [relative risk (RR) =2.09, 95% confidential interval (CI): 1.68-2.61]. There was heterogeneity between diabetes and oral implant failure in the included articles (I2=59.6%, P=0.084). There was no remarkable correlation between osteoporosis and dental implant failure (RR =1.19, 95% CI: 0.81-1.74). There was a high heterogeneity between smoking and dental implant failure in the included articles (I2=33.8%, P=0.092), showing obvious correlation (RR =1.80, 95% CI: 1.53-2.11).
DISCUSSION
The results of meta-analysis confirmed that radiotherapy and smoking were greatly associated with oral implant failure.
Topics: Administration, Oral; Diabetes Mellitus; Humans; Osteoporosis; Risk Factors; Smoking
PubMed: 35016469
DOI: 10.21037/apm-21-3449 -
Materials (Basel, Switzerland) Nov 2021Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication... (Review)
Review
Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.
PubMed: 34885335
DOI: 10.3390/ma14237183 -
Clinical Oral Investigations Feb 2022By means of a systematic review and network meta-analysis, this study aims to answer the following questions: (a) does the placement of a biomaterial over an extraction... (Meta-Analysis)
Meta-Analysis Review
AIM
By means of a systematic review and network meta-analysis, this study aims to answer the following questions: (a) does the placement of a biomaterial over an extraction socket lead to better outcomes in terms of horizontal and vertical alveolar dimensional changes and percentage of new bone formation than healing without coverage? And (b) which biomaterial(s) provide(s) the better outcomes?
MATERIALS AND METHODS
Parallel and split-mouth randomized controlled trials treating ≥ 10 patients were included in this analysis. Studies were identified with MEDLINE (PubMed), Embase, Cochrane Central Register of Controlled Trials, and Scopus. Primary outcomes were preservation of horizontal and vertical alveolar dimension and new bone formation inside the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes. For NMA, prediction intervals were calculated to estimate clinical efficacy, and SUCRA was used to rank the materials based on their performance; multidimensional ranking was used to rank treatments based on dissimilarity. The manuscript represents the proceedings of a consensus conference of the Italian Society of Osseointegration (IAO).
RESULTS
Twelve trials were included in the qualitative and quantitative analysis: 312 sites were evaluated. Autologous soft tissue grafts were associated with better horizontal changes compared to resorbable membranes. A statistically significant difference in favor of resorbable membranes, when compared to no membrane, was found, with no statistically significant heterogeneity. For the comparison between crosslinked and non-crosslinked membranes, a statistically significant difference was found in favor of the latter and confirmed by histomorphometric NMA analysis. Given the relatively high heterogeneity detected in terms of treatment approaches, materials, and outcome assessment, the findings of the NMA must be interpreted cautiously.
CONCLUSIONS
Coverage of the healing site is associated with superior results compared to no coverage, but no specific sealing technique and/or biomaterial provides better results than others. RCTs with larger sample sizes are needed to better elucidate the trends emerged from the present analysis.
CLINICAL RELEVANCE
Autologous soft tissue grafts and membranes covering graft materials in post-extraction sites were proved to allow lower hard tissue shrinkage compared to the absence of coverage material with sealing effect. Histomorphometric analyses showed that non-crosslinked membranes provide improved hard tissue regeneration when compared to crosslinked ones.
Topics: Alveolar Ridge Augmentation; Biocompatible Materials; Dental Care; Humans; Network Meta-Analysis; Randomized Controlled Trials as Topic; Tooth Extraction; Tooth Socket; Treatment Outcome; Wound Healing
PubMed: 34825280
DOI: 10.1007/s00784-021-04262-3