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Indian Journal of Dental Research :... 2018As implant site preparation and bone are critical precursors to primary healing, thermal and mechanical damage to the bone must be minimized during the preparation of... (Review)
Review
BACKGROUND
As implant site preparation and bone are critical precursors to primary healing, thermal and mechanical damage to the bone must be minimized during the preparation of the implant site. Moreover, excessively traumatic surgery can adversely affect the maturation of bone tissue at the bone/implant interface and consequently diminish the predictability of osseointegration. So, this study was carried out to evaluate the various biological and mechanical factors responsible for heat generation during osteotomy site preparation to reduce the same for successful osseointegration of dental implants.
STUDY DESIGN
A broad search of the dental literature in PubMed added by manual search was performed for articles published between 1992 and December 2015. Various bio-mechanical factors related to dental implant osteotomy preparation such as dental implant drill designs/material/wear, drilling methods, type of irrigation, and bone quality were reviewed. Titles and abstracts were screened and articles which fulfilled the inclusion criteria were selected for a full-text reading.
RESULTS
The initial database search yielded 123 titles, of which 59 titles were discarded after reading the titles and abstracts, 30 articles were again excluded based on inclusion and exclusion criteria, and finally 34 articles were selected for data extraction. Many biological and mechanical factors responsible for heat generation were found.
CONCLUSION
Literatures of this review study have indicated that there are various bio-mechanical reasons, which affect the temperature rise during osteotomy and suggest that the amount of heat generation is a multifactorial in nature and it should be minimized for better primary healing of the implant site.
Topics: Biomechanical Phenomena; Dental Implantation, Endosseous; Hot Temperature; Humans; Osteotomy
PubMed: 29442092
DOI: 10.4103/ijdr.IJDR_729_16 -
Clinical Oral Investigations Jan 2017The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded... (Review)
Review
OBJECTIVES
The aim was to compile the current knowledge about the efficacy of different soft tissue correction methods around osseointegrated, already uncovered and/or loaded (OU/L) implants with insufficient soft tissue conditions. Procedures to increase peri-implant keratinized mucosa (KM) width and/or soft tissue volume were considered.
MATERIALS AND METHODS
Screening of two databases: MEDLINE (PubMed) and EMBASE (OVID), and manual search of articles were performed. Human studies reporting on soft tissue augmentation/correction methods around OU/L implants up to June 30, 2016, were considered. Quality assessment of selected full-text articles to weight risk of bias was performed using the Cochrane collaboration's tool.
RESULTS
Overall, four randomized controlled trials (risk of bias = high/low) and five prospective studies (risk of bias = high) were included. Depending on the surgical techniques and graft materials, the enlargement of keratinized tissue (KT) ranged between 1.15 ± 0.81 and 2.57 ± 0.50 mm. The apically positioned partial thickness flap (APPTF), in combination with a free gingival graft (FGG), a subepithelial connective tissue graft (SCTG), or a xenogeneic graft material (XCM) were most effective. A coronally advanced flap (CAF) combined with SCTG in three, combined with allogenic graft materials (AMDA) in one, and a split thickness flap (STF) combined with SCTG in another study showed mean soft tissue recession coverage rates from 28 to 96.3 %. STF combined with XCM failed to improve peri-implant soft tissue coverage.
CONCLUSIONS
The three APPTF-techniques combined with FGG, SCTG, or XCM achieved comparable enlargements of peri-implant KT. Further, both STF and CAF, both in combination with SCTG, are equivalent regarding recession coverage rates. STF + XCM and CAF + AMDA did not reach significant coverage.
CLINICAL RELEVANCE
In case of soft tissue deficiency around OU/L dental implants, the selection of both an appropriate surgical technique and a suitable soft tissue graft material is of utmost clinical relevance.
Topics: Connective Tissue; Dental Implants; Gingivoplasty; Humans; Jaw, Edentulous, Partially; Periodontium; Surgical Flaps; Vestibuloplasty
PubMed: 27873018
DOI: 10.1007/s00784-016-2007-9 -
Journal of Clinical Periodontology Feb 2017To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration. (Review)
Review
AIM
To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration.
MATERIALS AND METHODS
An electronic and hand search was conducted in three databases (MEDLINE, EMBASE and Cochrane). Only randomized clinical trials, written in English where L-PRF was applied in bone regeneration and implant procedures, were selected. No follow-up restrictions were applied.
RESULTS
A total of 14 articles were included and processed. Three subgroups were created depending on the application: sinus floor elevation (SFE), alveolar ridge preservation and implant therapy. In SFE, for a lateral window as well as for the trans-alveolar technique, histologically faster bone healing was reported when L-PRF was added to most common xenografts. L-PRF alone improved the preservation of the alveolar width, resulting in less buccal bone resorption compared to natural healing. In implant therapy, better implant stability over time and less marginal bone loss were observed when L-PRF was applied. Meta-analyses could not be performed due to the heterogeneity of the data.
CONCLUSIONS
Despite the lack of strong evidence found in this systematic review, L-PRF might have a positive effect on bone regeneration and osseointegration.
Topics: Alveolar Bone Loss; Biological Therapy; Bone Regeneration; Humans; Leukocytes; Osseointegration; Platelet-Rich Fibrin; Randomized Controlled Trials as Topic; Sinus Floor Augmentation
PubMed: 27891638
DOI: 10.1111/jcpe.12658 -
Journal of Clinical Medicine Jun 2020Animal studies and the scarce clinical trials available that have been conducted suggest that bioactive surfaces on dental implants could improve the osseointegration of... (Review)
Review
Animal studies and the scarce clinical trials available that have been conducted suggest that bioactive surfaces on dental implants could improve the osseointegration of such implants. The purpose of this systematic review was to compare the effectiveness of osseointegration of titanium (Ti) dental implants using bioactive surfaces with that of Ti implants using conventional surfaces such as sandblasted large-grit acid-etched (SLA) or similar surfaces. Applying the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, the MEDLINE, PubMed Central and Web of Science databases were searched for scientific articles in April 2020. The keywords used were "dental implants", "bioactive surfaces", "biofunctionalized surfaces", and "osseointegration", according to the question: "Do bioactive dental implant surfaces have greater osseointegration capacity compared with conventional implant surfaces?" Risk of bias was assessed using the Cochrane Collaboration tool. 128 studies were identified, of which only 30 met the inclusion criteria: 3 clinical trials and 27 animal studies. The average STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) and ARRIVE (Animal Research: Reporting of In Vivo Experiments) scores were 15.13 ± 2.08 and 17.7±1.4, respectively. Implant stability quotient (ISQ) was reported in 3 studies; removal torque test (RTT)-in 1 study; intraoral periapical X-ray and microcomputed tomography radiological evaluation (RE)-in 4 studies; shear force (SF)-in 1 study; bone-to-implant contact (BIC)-in 12 studies; and BIC and bone area (BA) jointly-in 5 studies. All animal studies reported better bone-to-implant contact surface for bioactive surfaces as compared to control implants with a statistical significance of < 0.05. Regarding the bioactive surfaces investigated, the best results were yielded by the one where mechanical and chemical treatment methods of the Ti surfaces were combined. Hydroxyapatite (HA) and calcium-phosphate (Ca-Ph) were the most frequently used bioactive surfaces. According to the results of this systematic review, certain bioactive surfaces have a positive effect on osseointegration, although certain coating biomolecules seem to influence early peri-implant bone formation. Further and more in-depth research in this field is required to reduce the time needed for osseointegration of dental implants.
PubMed: 32610687
DOI: 10.3390/jcm9072047 -
Cureus Mar 2024Lower limb amputation is a common orthopedic surgery in the United States and can be performed either above or below the knee. Prosthetics are typically externally... (Review)
Review
Lower limb amputation is a common orthopedic surgery in the United States and can be performed either above or below the knee. Prosthetics are typically externally fitted to the patient's residual stump; however, osseointegrated implants offer a potential alternative to this process. Transcutaneous limb osseointegration involves the intramedullary anchoring of an implant that can later attach to a prosthetic via a stoma in the residual limb. There are proposed benefits to this, including decreased skin and soft tissue complications as well as an increased sense of stability. As this is a relatively new procedure, the complications and efficacy are not well supported by the literature at this time. The primary aim of this analysis was to synthesize the currently available data on transfemoral and transtibial osseointegration in order to improve our understanding of the potential complications of the procedure. A literature search was performed in the following databases: Biomedical Reference Collection, CINAHL, Cochrane Library, and PubMed/MEDLINE. Articles were screened by three independent reviewers for studies written or available in English, study design, and study outcomes, including complications. No filter was applied for publication date, publication national origin, or sample size. A total of 20 articles were selected for the final qualitative analysis. This review demonstrates an overall low or non-inferior rate of both minor and severe complications in transtibial and transfemoral osseointegration. This procedure should be considered as an option during preoperative planning in the context of above-the-knee and below-the-knee amputations. However, continued studies with larger sample sizes and extended postoperative follow-up are necessary for a greater strength of recommendation.
PubMed: 38681289
DOI: 10.7759/cureus.57045 -
BioMed Research International 2017. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from... (Meta-Analysis)
Meta-Analysis Review
. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient. . The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque. . The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants. . A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants ( = 0.373; 95% CI: -0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants ( = 0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants ( = 0.021; 95% CI: -0.973 to -0.080). . Acid etched zirconia implants may serve as a possible substitute for successful osseointegration.
Topics: Acid Etching, Dental; Bone and Bones; Dental Implants; Dental Prosthesis Design; Humans; Osseointegration; Surface Properties; Titanium; Torque; Zirconium
PubMed: 28299337
DOI: 10.1155/2017/9246721 -
Journal of Oral & Maxillofacial Research 2016To systematically review risks of mechanical impact on peri-implant strain and prosthetic influence on stability across finite element studies. (Review)
Review
OBJECTIVES
To systematically review risks of mechanical impact on peri-implant strain and prosthetic influence on stability across finite element studies.
MATERIAL AND METHODS
An online literature search was performed on MEDLINE and EMBASE databases published between 2011 and 2016. Following keywords tiered screening and selection of the title, abstract and full-text were performed. Studies of finite element analysis (FEA) were considered for inclusion that were written in English and revealed stress concentrations or strain at peri-implant bone level.
RESULTS
There were included 20 FEA studies in total. Data were organized according to the following topics: bone layers, type of bone, osseointegration level, bone level, design of implant, diameter and length of implant, implant-abutment connection, type of supra-construction, loading axis, measurement units. The stress or strain at implant-bone contact was measured over all studies and numerical values estimated. Risks of overloading were accented as non-axial loading, misfits, cantilevers and the stability of peri-implant bone was related with the usage of platform switch connection of abutment.
CONCLUSIONS
Peri-implant area could be affected by non-axial loading, cantilever prosthetic elements, crown/implant ratio, type of implant-abutment connection, misfits, properties of restoration materials and antagonistic tooth. The heterogeneity of finite element analysis studies limits systematization of data. Results of these studies are comparable with other findings of , , prospective and retrospective studies.
PubMed: 27833729
DOI: 10.5037/jomr.2016.7304 -
Clinical Oral Implants Research Nov 2018The presence of titanium (Ti) particles around dental implants has been reported in the literature for decades. The prospective presence of Ti debris on soft tissues... (Review)
Review
OBJECTIVES
The presence of titanium (Ti) particles around dental implants has been reported in the literature for decades. The prospective presence of Ti debris on soft tissues surrounding dental implants has not been systematically investigated and remains to be explored. Hence, this review aimed to evaluate the origin, presence, characteristics, and location of Ti particles in relation to dental implants.
MATERIAL AND METHODS
Literature searches were conducted by two reviewers independently based on the PRISMA guidelines. The systematic review identified studies on Ti particles derived from dental implants. We evaluated several parameters, including anatomical location, and the suspected methods of Ti particles release.
RESULTS
The search resulted in 141 articles, of which 26 were eligible and included in the systematic review of the literature. The investigations reported Ti and metal-like particles in the soft (i.e., epithelial cells, connective tissue, and inflammatory cells) and hard (bone crest and bone marrow) tissues around the dental implants. Shape and size of the particles varied. The current literature reported a size range from 100 nm to 54 µm identified by multiple particles identification methods.
CONCLUSION
Ti particles surrounding peri-implant tissues are a common finding. Peri-implantitis sites presented a higher number of particles compared to healthy implants. The particles were mostly around the implants and inside epithelial cells, connective tissue, macrophages, and bone. Various mechanisms were described as causes of Ti release, including friction during implant insertion, corrosion of the implant surface, friction at the implant-abutment interface, implantoplasty, and several methods used for implant surface detoxification.
PubMed: 30280418
DOI: 10.1111/clr.13372 -
Maxillofacial Plastic and... Jul 2022After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with... (Review)
Review
After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. Heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. Clinical differences between anorganic bone substitutes and collagen-preserving materials are not well documented in the literature but understanding these differences could clarify how processing protocols influence biomaterial behavior in situ. This systematic review of the literature compares the dimensional changes and histological features of ABXs versus CBXs in ridge preservation procedures to promote awareness of different bone xenograft efficacies in stimulating the healing of post-extraction sockets.
PubMed: 35821286
DOI: 10.1186/s40902-022-00349-3 -
BMC Medical Imaging Aug 2020This study aimed to develop evidence-based clinical imaging guidelines to assess the proper implant location following implant surgery and identify potential... (Review)
Review
BACKGROUND
This study aimed to develop evidence-based clinical imaging guidelines to assess the proper implant location following implant surgery and identify potential complications during follow-up.
METHODS
The guideline development process employed an adaptation methodology in accordance with the Korean clinical imaging guidelines (K-CIG). Core (Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, and Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched used to retrieve guidelines, and two reviewers analyzed the retrieved articles. The articles were included in this review using well-established inclusion criteria.
RESULTS
Our online search identified 66 articles, of which 3 were selected for the development of the guidelines. Consequently, based on these three guidelines, we formulated distinct recommendations regarding the appropriate imaging modalities that should be used following implant placement.
CONCLUSIONS
Conventional imaging (e.g., periapical or panoramic radiography) should be the first choice for assessing the implant following its placement and osseointegration. The metal artifacts in Cone Beam Computed Tomography (CBCT) should be considered. However, CBCT is recommended for patients with sensory abnormalities following dental implant surgery to evaluate and identify the underlying cause of implant complications and to determine the appropriate treatment.
Topics: Cone-Beam Computed Tomography; Dental Implants; Evidence-Based Dentistry; Humans; Osseointegration; Practice Guidelines as Topic; Radiography, Panoramic
PubMed: 32867728
DOI: 10.1186/s12880-020-00501-3