1
|
Zhang Y, Jia S, Wen G, Xie S, Song Z, Qi M, Liang Y, Bi W, Dong W. Zoledronate Promotes Peri-Implant Osteogenesis in Diabetic Osteoporosis by the AMPK Pathway. Calcif Tissue Int 2023; 113:329-343. [PMID: 37392365 DOI: 10.1007/s00223-023-01112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023]
Abstract
Together with diabetic osteoporosis (DOP), diabetes patients experience poor peri-implant osteogenesis following implantation for dentition defects. Zoledronate (ZOL) is widely used to treat osteoporosis clinically. To evaluate the mechanism of ZOL for the treatment of DOP, experiments with DOP rats and high glucose-grown MC3T3-E1 cells were used. The DOP rats treated with ZOL and/or ZOL implants underwent a 4-week implant-healing interval, and then microcomputed tomography, biomechanical testing, and immunohistochemical staining were performed to elucidate the mechanism. In addition, MC3T3-E1 cells were maintained in an osteogenic medium with or without ZOL to confirm the mechanism. The cell migration, cellular actin content, and osteogenic differentiation were evaluated by a cell activity assay, a cell migration assay, as well as alkaline phosphatase, alizarin red S, and immunofluorescence staining. The mRNA and protein expression of adenosine monophosphate-activated protein kinase (AMPK), phosphorylated AMPK (p-AMPK), osteoprotegerin (OPG), receptor activator of nuclear factor kappa B ligand (RANKL), bone morphogenetic protein 2 (BMP2), and collagen type I (Col-I) were detected using real-time quantitative PCRs and western blot assays, respectively. In the DOP rats, ZOL markedly improved osteogenesis, enhanced bone strength and increased the expression of AMPK, p-AMPK, and Col-I in peri-implant bones. The in vitro findings showed that ZOL reversed the high glucose-induced inhibition of osteogenesis via the AMPK signaling pathway. In conclusion, the ability of ZOL to promote osteogenesis in DOP by targeting AMPK signaling suggests that therapy with ZOL, particularly simultaneous local and systemic administration, may be a unique approach for future implant repair in diabetes patients.
Collapse
Affiliation(s)
- Yan Zhang
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Shunyi Jia
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Guochen Wen
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Shanen Xie
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Zhiqiang Song
- Oral and Maxillofacial Surgery, TangShan BoChuang Stomatology Hospital, Tangshan, 063000, Hebei, China
| | - Mengchun Qi
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Yongqiang Liang
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Wenjuan Bi
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China
| | - Wei Dong
- School of Stomatology, North China University of Science and Technology, Tangshan, 063210, Hebei, China.
- Institute of Stomatology, Chinese PLA General Hospital, Fuxing Lu 28#, Beijing, 100853, China.
| |
Collapse
|
2
|
Ferro F, Azzolin F, Spelat R, Bevilacqua L, Maglione M. Considering the Value of 3D Cultures for Enhancing the Understanding of Adhesion, Proliferation, and Osteogenesis on Titanium Dental Implants. Biomolecules 2023; 13:1048. [PMID: 37509084 PMCID: PMC10377630 DOI: 10.3390/biom13071048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Individuals with pathologic conditions and restorative deficiencies might benefit from a combinatorial approach encompassing stem cells and dental implants; however, due to the various surface textures and coatings, the influence of titanium dental implants on cells exhibits extensive, wide variations. Three-dimensional (3D) cultures of stem cells on whole dental implants are superior in testing implant properties and were used to examine their capabilities thoroughly. MATERIALS AND METHODS The surface micro-topography of five titanium dental implants manufactured by sandblasting with titanium, aluminum, corundum, or laser sintered and laser machined was compared in this study. After characterization, including particle size distribution and roughness, the adhesion, proliferation, and viability of adipose-derived stem cells (ADSCs) cultured on the whole-body implants were tested at three time points (one to seven days). Finally, the capacity of the implant to induce ADSCs' spontaneous osteoblastic differentiation was examined at the same time points, assessing the gene expression of collagen type 1 (coll-I), osteonectin (osn), alkaline phosphatase (alp), and osteocalcin (osc). RESULTS Laser-treated (Laser Mach and Laser Sint) implants exhibited the highest adhesion degree; however, limited proliferation was observed, except for Laser Sint implants, while viability differences were seen throughout the three time points, except for Ti Blast implants. Sandblasted surfaces (Al Blast, Cor Blast, and Ti Blast) outpaced the laser-treated ones, inducing higher amounts of coll-I, osn, and alp, but not osc. Among the sandblasted surfaces, Ti Blast showed moderate roughness and the highest superficial texture density, favoring the most significant spontaneous differentiation relative to all the other implant surfaces. CONCLUSIONS The results indicate that 3D cultures of stem cells on whole-body titanium dental implants is a practical and physiologically appropriate way to test the biological characteristics of the implants, revealing peculiar differences in ADSCs' adhesion, proliferation, and activity toward osteogenic commitment in the absence of specific osteoinductive cues. In addition, the 3D method would allow researchers to test various implant surfaces more thoroughly. Integrating with preconditioned stem cells would inspire a more substantial combinatorial approach to promote a quicker recovery for patients with restorative impairments.
Collapse
Affiliation(s)
- Federico Ferro
- Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy
| | - Federico Azzolin
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Renza Spelat
- Neurobiology Sector, International School for Advanced Studies (SISSA), 34136 Trieste, Italy
| | - Lorenzo Bevilacqua
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Michele Maglione
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| |
Collapse
|
3
|
Tan SJ, Baharin B, Mohd N, Nabil S. Effect of Anti-Diabetic Medications on Dental Implants: A Scoping Review of Animal Studies and Their Relevance to Humans. Pharmaceuticals (Basel) 2022; 15:ph15121518. [PMID: 36558969 PMCID: PMC9784528 DOI: 10.3390/ph15121518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Animal studies have ascertained that hyperglycemia adversely affects bone metabolism and dental implant osseointegration. However, diabetic patients show low occurrence of unfavorable hard or soft peri-implant tissue changes, differences that are possibly due to treatment with anti-diabetic medications. This scoping review aimed to systematically examine the effects of these drugs on implant outcomes and explore the predictive modality of animal studies for clinical practice according to type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Three electronic databases (MEDLINE, EBSCOHost, and Cochrane) were searched according to the PRISMA-ScR standards for studies on diabetic animals that received titanium implants and anti-diabetic treatments. Risk assessment was performed using the SYRCLE Risk-of-Bias (RoB) tool. Twenty-one papers were included, encompassing six types of medications. Fifteen studies were on T1DM animals, and only six involved T2DM models. T1DM animals were treated with non-insulin drugs in four investigations, while insulin was utilized in 11 other studies. In T2DM experiments, five administered non-insulin drugs, and only one applied locally delivered insulin. Only insulin in T1DM studies produced a positive influence on bone-implant contact (BIC), bone mineral content, and removal torque values. Inappropriate drug selection, inadequate glycemic control, and high RoB depict a mismatch between the research focus and the translational rationale to clinical practice. There remains a knowledge gap regarding T2DM investigations due to the lack of studies. More data are needed concerning intraoral implants and the performance of osseointegrated implants in patients with a later onset of diabetes. Future research should reflect the pathophysiology and treatment of each type of diabetes to ensure clinical applicability.
Collapse
Affiliation(s)
- Sze Jun Tan
- KPJ Ambulatory Care Centre Kinrara, 33, 35 & 37, Jalan BK 5a/2, Bandar Kinrara, Puchong 47180, Malaysia
| | - Badiah Baharin
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
- Correspondence:
| | - Nurulhuda Mohd
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Syed Nabil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| |
Collapse
|
4
|
Ferro F, Azzolin F, Spelat R, Bevilacqua L, Maglione M. Assessing the Efficacy of Whole-Body Titanium Dental Implant Surface Modifications in Inducing Adhesion, Proliferation, and Osteogenesis in Human Adipose Tissue Stem Cells. J Funct Biomater 2022; 13:jfb13040206. [PMID: 36412847 PMCID: PMC9680380 DOI: 10.3390/jfb13040206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although the influence of titanium implants' micro-surface properties on titanium discs has been extensively investigated, the research has not taken into consideration their whole-body effect, which may be considered possible using a combinatorial approach. METHODS Five titanium dental implants with a similar moderate roughness and different surface textures were thoroughly characterized. The cell adhesion and proliferation were assessed after adipose-tissue-derived stem cells (ADSCs) were seeded on whole-body implants. The implants' inductive properties were assessed by evaluating the osteoblastic gene expression. RESULTS The surface micro-topography was analyzed, showing that hydroxyapatite (HA)-blasted and bland acid etching implants had the highest roughness and a lower number of surface particles. Cell adhesion was observed after 24 h on all the implants, with the highest score registered for the HA-blasted and bland acid etching implants. Cell proliferation was observed only on the laser-treated and double-acid-etched surfaces. The ADSCs expressed collagen type I, osteonectin, and alkaline phosphatase on all the implant surfaces, with high levels on the HA-treated surfaces, which also triggered osteocalcin expression on day seven. CONCLUSIONS The findings of this study show that the morphology and treatment of whole titanium dental implants, primarily HA-treated and bland acid etching implants, impact the adherence and activity of ADSCs in osteogenic differentiation in the absence of specific osteo-inductive signals.
Collapse
Affiliation(s)
- Federico Ferro
- Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy
- Correspondence:
| | - Federico Azzolin
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Renza Spelat
- Neurobiology Sector, International School for Advanced Studies (SISSA), 34136 Trieste, Italy
| | - Lorenzo Bevilacqua
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| | - Michele Maglione
- Department of Medical, Surgery and Health Sciences, University of Trieste, 34125 Trieste, Italy
| |
Collapse
|
5
|
Nunes F, Oliveira P, Bergamo E, Kjellin P, Novaes A, Ghiraldini B, Bezerra F, Scombatti de Souza S. Effect of Smoke Exposure on Gene Expression in Bone Healing around Implants Coated with Nanohydroxyapatite. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3737. [PMID: 36364513 PMCID: PMC9653954 DOI: 10.3390/nano12213737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This study evaluated the effect of smoke exposure on the expression of genes related to bone metabolism in implants coated with nanohydroxyapatite (NHA). A total of 36 rats were exposed to cigarette smoke for 60 days. The animals were allocated into three groups: machined implants (MAC), dual acid-etched implants (DAE), and NHA-coated implants (NHA). Implants were installed in the left tibia of the rats after 30 days of smoke exposure. The implants were retrieved 7 and 30 days after implantation, and the adjacent bone analyzed using a real-time polymerase chain reaction for gene expression of alkaline phosphatase (ALP), osteopontin (OPN), receptor activator of the nuclear factor kappa ligand (RANKL), osteoprotegerin (OPG), the RANKL/OPG ratio, osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). After 7 days, Runx2, OPN and OPG expression demonstrated significantly higher levels for the NHA surface treatment relative to DAE and MAC surfaces. NHA presented the lowest RANKL and RANKL/OPG levels. After 30 days, NHA-coated implants showed significantly higher levels of Runx2, ALP, OPN, OPG, OC, RANKL and RANKL/OPG relative to DAE and MAC implants. The results indicated a greater osteogenic and high osteoclastic activity around NHA implants, in comparison to DAE and MAC implants.
Collapse
Affiliation(s)
- Felipe Nunes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14021-630, SP, Brazil
| | - Paula Oliveira
- Department of Periodontology, School of Dentistry, University Center of State of Para, Belem 66060-575, PA, Brazil
| | - Edmara Bergamo
- Department of Prosthodontics and Periodontology, School of Dentistry of Bauru, University of São Paulo, Bauru 17012-901, SP, Brazil
| | - Per Kjellin
- Promimic AB, AstraZeneca BioventureHub, 431 83 Mölndal, Sweden
| | - Arthur Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14021-630, SP, Brazil
| | - Bruna Ghiraldini
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14021-630, SP, Brazil
| | - Fabio Bezerra
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14021-630, SP, Brazil
| | - Sergio Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14021-630, SP, Brazil
| |
Collapse
|
6
|
Dahihandekar C, Pisulkar SG, Sathe S, Godbole S, Bansod AV, Purohit H. Assessment of Bone Mineral Density in Type 2 Diabetes: A Cone Beam Computed Tomography (CBCT) Study. Cureus 2022; 14:e28035. [PMID: 36120233 PMCID: PMC9473639 DOI: 10.7759/cureus.28035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The main purpose of the study was to assess and compare bone mineral density (BMD) at prospective implant sites in the mandible in type 2 diabetes mellitus (T2DM) and non-diabetic patients using cone beam computed tomography (CBCT). Material and methodology A total of 40 patients were included in this type of cross-sectional study. They were divided into two groups, A and B, according to their haemoglobin A1c values. Group A consisted of patients with HbA1c between the range of 6.1%-8% and group B had patients with no history of T2DM. CBCT scans were made of the mandibular arches of both the patients to evaluate the BMD at lingual and buccal cortical plates and the trabecular regions in two successive slices with the assistance of PlanMeca Romexis software (PlanMeca Romexis®, Helsinki, Finland). The Shapiro-Wilk test was used to determine the normality of continuous data. The Mann-Whitney U test was used to compare the groups. Results There were no differences that were statistically significant between the two cohorts according to the Mann-Whitney U test at buccal cortical plate points 1 and 2. However, the diabetes group's mean bone density at implant sites-A, B, C, D, and E at trabeculae points 1 and 2 was considerably (7p>0.001) lower than the non-diabetic groups. The mean bone density of the diabetes group was marginally but significantly (p=0.009) lower than the non-diabetic group at lingual cortical plates. Conclusion Individuals with type 2 diabetes mellitus show significantly lower bone mineral density in the lingual cortical plate and trabecular region, however, implant therapy can be performed with certain mentioned guidelines in such regions. In the buccal cortical region, the bone mineral density is seen to be unaffected.
Collapse
|
7
|
Nourah D, Aldahlawi S, Andreana S. Should the Quality of Glycemic Control Guide Dental Implant Therapy in Patients with Diabetes? Focus on Implant Survival. Curr Diabetes Rev 2022; 18:e060821195367. [PMID: 34365929 DOI: 10.2174/1573399817666210806120300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/21/2021] [Accepted: 07/01/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Optimal glycemic control is crucial to dental implant long-term functional and esthetic success. Despite HbA1c levels of 7% or lower used is as an indicator for good glycemic control, however, this level may not be attainable for all diabetic patients. Most dentists do not consider patients with poor glycemic control candidates for implant therapy due to higher implant failure, infection or other complications. AIM This review challenges the concept of one size fits all and aims to critically appraise the evidence for the success or failure rate of dental implants and peri-implant health outcomes in patients with less than optimal glycemic control. DISCUSSION Evidence suggests that estimating glycemic control from HbA1c measurement alone is misleading. Moreover, elevated preoperative HbA1c was not associated with increased mortality and morbidity after major surgical procedures. Literature for the survival or success of implants in diabetic patients is inconsistent due to a lack of standardized reporting of clinical data collection and outcomes. While a number of studies report that implant treatment in patients with well controlled diabetes has a similar success rate to healthy individuals, other studies suggest that the quality of glycemic control in diabetic patients does not make a difference in the implant failure rate or marginal bone loss. This discrepancy could indicate that risk factors other than hyperglycemia may contribute to the survival of implants in diabetic patients. CONCLUSION In the era of personalized medicine, the clinician should utilize individualized information and analyze all risk factors to provide the patient with evidence-based treatment options.
Collapse
Affiliation(s)
- Dalia Nourah
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | | |
Collapse
|
8
|
Zeng Y, Liang H, Guo Y, Feng Y, Yao Q. Adiponectin regulates osteocytic MLO-Y4 cell apoptosis in a high-glucose environment through the AMPK/FoxO3a signaling pathway. J Cell Physiol 2021; 236:7088-7096. [PMID: 33792917 DOI: 10.1002/jcp.30381] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/09/2022]
Abstract
Clinical studies have shown that persistent hyperglycemia following oxidative stress is associated with the apoptosis of osteocytes in diabetics. Adiponectin (APN) can ameliorate oxidative stress, and its receptors have been identified in bone-forming cells. However, the relationship between APN and osteocyte apoptosis has not been fully elucidated. This study aimed to investigate whether APN could prevent osteocyte apoptosis and regulate reactive oxygen species (ROS) generation in a high-glucose environment. Hoechst staining and fluorescence microscopy were used to observe the apoptosis of osteocytic MLO-Y4 cells. Real-time quantitative polymerase chain reaction and Western blot analysis were used to detect the expression of Caspase 3, Caspase 8, and Bcl-2. ROS generation was investigated with an active oxygen kit and fluorescence microscopy. Furthermore, the expression of proteins in the AMPK/FoxO3A signaling pathway was also studied by Western blot analysis. In a high-glucose environment, APN promoted the proliferation of MLO-Y4 osteocytes and the expression of Bcl-2 but inhibited the expression of Caspase 3, Caspase 8, and ROS in a dose-dependent manner. APN promoted the activation of p-AMPK and p-AMPK/AMPK, which reached their highest levels at 10 min and returned to baseline at 30 min. The expression of p-FoxO3A/FoxO3A in both the cytoplasm and nucleus peaked at 15 min, and this expression was returned to baseline at 60 min. In summary, APN has an antiapoptotic effect and regulates ROS generation in MLO-Y4 osteocytes in a high-glucose environment. The AMPK/FoxO3A signaling pathway might be a key signaling pathway that participates in the effect of APN on regulating osteocyte apoptosis in diabetics.
Collapse
Affiliation(s)
- Yuanyuan Zeng
- Center of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,Department of Stomatology, Shaoyang Central Hospital, Shaoyang, Hunan, China
| | - Hengxing Liang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yue Guo
- Center of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunzhi Feng
- Center of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qianqian Yao
- Center of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| |
Collapse
|
9
|
Tan SJ, Baharin B, Nabil S, Mohd N, Zhu Y. DOES GLYCEMIC CONTROL HAVE A DOSE-RESPONSE RELATIONSHIP WITH IMPLANT OUTCOMES? A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 21:101543. [PMID: 34391557 DOI: 10.1016/j.jebdp.2021.101543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To comprehensively evaluate implant survival, clinical and biochemical parameters, as well as possible dose-response relationship with hemoglobin A1c (HbA1c) in patients with differing diabetic control. METHODOLOGY Five electronic databases were searched for studies that compared implant outcomes in patients with differing HbA1c values. Research quality was evaluated using Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Narrative synthesis and meta-analysis were performed for survival rate, plaque index (PI), bleeding on probing (BOP), probing pocket depth, and marginal bone loss (MBL). Categorical dose-response meta-analysis (DRMA) was conducted according to length of follow-up. RESULTS Twenty-two studies met the inclusion criteria. Prospective studies were mostly of moderate quality, but non-prospective papers had serious to critical risk of bias. Survival rate was high for the first 3 years (92.6%-100%) for patients with HbA1c less than 8%. Meta-analysis revealed worsening clinical parameters with increasing HbA1c. DRMA further established a significant dose-response relationship between glycemic control with BOP (10% more bleeding, 95% CI 0.05-0.16, P = .008) and MBL (0.05 mm more bone loss, 95% CI 0.01-0.09, P = .002) per HbA1c category, but no association with probing pocket depth. Osseointegration progressed at a slower rate, and inflammatory cytokines and bone biomarkers were adversely affected in patients with HbA1c above 8%. CONCLUSION Moderate evidence suggests a high short-term survival but possible dose-response trend of worsening BOP and MBL in association with glycemic control. Clinically, HbA1c values must be considered for risk assessment before placement and throughout the lifespan of the implant placed in a patient with diabetes.
Collapse
Affiliation(s)
- Sze Jun Tan
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Badiah Baharin
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Syed Nabil
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nurulhuda Mohd
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Yingying Zhu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
10
|
Zhang J, Wang YN, Jia T, Huang H, Zhang D, Xu X. Genipin and insulin combined treatment improves implant osseointegration in type 2 diabetic rats. J Orthop Surg Res 2021; 16:59. [PMID: 33446235 PMCID: PMC7809857 DOI: 10.1186/s13018-021-02210-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) has a harmful effect on the stability and osseointegration of dental implants. T2DM induces mitochondrial damage by inhibiting AMPK signaling, resulting in oxidative stress and poor osteogenesis in the peri-implant bone area. Genipin is a major component of gardenia fruits with strong antioxidant, anti-inflammation, and antidiabetic actions, and it also can activate mitochondrial quality control via the AMPK pathway. The purpose of this study was to investigate the effects of genipin and insulin treatment on implant osseointegration in T2DM rats and explore the underlying mechanisms. METHODS Streptozotocin-induced diabetic rats received implant surgery in their femurs and were then assigned to five groups that were subjected to different treatments for three months: control group, T2DM group, insulin-treated T2DM group (10 IU/kg), genipin-treated T2DM group (50 mg/kg), and the genipin and insulin combination-treated T2DM group. Then, we regularly assessed the weight and glucose levels of the animals. Rats were euthanized at 3 months after the implantation procedure, and the femora were harvested for microscopic computerized tomography analysis, biomechanical tests, and different histomorphometric assessment. RESULTS The results indicated that the highest blood glucose and oxidative stress levels were measured for the T2DM group, resulting in the poorest osseointegration. The combination-treated T2DM group mitigated hyperglycemia and normalized, reactivated AMPK signaling, and alleviated oxidative stress as well as reversed the negative effect of osseointegration. There were beneficial changes observed in the T2DM-genipin and T2DM-insulin groups, but these were less in comparison to the combination treatment group. CONCLUSION Our study suggests that treatment with genipin in combination with insulin could be an effective method for promoting implant osseointegration in T2DM rats, which may be related to AMPK signaling.
Collapse
Affiliation(s)
- Jiajia Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China
| | - Ya-Nan Wang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China
| | - Tingting Jia
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China
| | - Haiyun Huang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China
| | - Dongjiao Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China.
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, No. 44-1, Wenhua Road West, Jinan, 250012, Shandong Province, China.
| |
Collapse
|
11
|
Yuan Q. [Oral implant treatment for elderly patients]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:616-621. [PMID: 33377336 DOI: 10.7518/hxkq.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With the advance of materials and technologies, modern oral implantology developed rapidly. Dental implant has become the first choice to restore the missing teeth. Although it achieves a high success rate among healthy adults, for elderly patients, with the decline of physical function and other systemic diseases, the risks of implant treatment increase accordingly. Doctors should pay more attention to the factors that may affect the implant treatment of the elderly and ways of preventing possible risks and complications. Here we discuss the specificity, success rate, effect of systemic diseases and drug considerations of implant treatments in elderly patients.
Collapse
Affiliation(s)
- Quan Yuan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
12
|
Hua Y, Bi R, Li Z, Li Y. Resveratrol treatment promotes titanium implant osseointegration in diabetes mellitus rats. J Orthop Res 2020; 38:2113-2119. [PMID: 32141632 DOI: 10.1002/jor.24651] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/04/2019] [Accepted: 03/01/2020] [Indexed: 02/05/2023]
Abstract
Type II diabetes mellitus (T2DM) is the most common metabolic disorder; it is characterized by hyperglycemia and causes implant failure by influencing implant osseointegration. Resveratrol promotes bone formation, but it is unclear if resveratrol improves implant osseointegration. Thirty 12-week-old Sprague-Dawley rats were divided into control (CTL), diabetes mellitus (DM), and resveratrol treatment (DM + Res) groups. In the DM and DM + Res groups (n = 10 each), T2DM was induced via streptozotocin injections; the remaining 10 rats were considered the CTL group. Eight weeks after the insertion of a rod-like Ti implant with a 12-mm length and 1-mm diameter in the left leg, the rats were euthanized. We analyzed implant osseointegration using microcomputed tomography (micro-CT), histological analyses, and biomechanical tests. The parameters showed that T2DM negatively influenced implant osseointegration in the tibia. Compared to that in the DM group, the bone loss of peri-implant bone mass in the DM + Res group was decreased significantly. However, resveratrol still did not induce the same level of implant osseointegration as that observed in the CTL group according to the histological and micro-CT analyses. These results indicated that resveratrol reduced the influence of DM in implant osseointegration, resulting in increased peri-implant bone density, improved trabecular architecture, and enhanced biomechanical fixation.
Collapse
Affiliation(s)
- Yunwei Hua
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zheru Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yunfeng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
13
|
Ma XY, Ma TC, Feng YF, Xiang G, Lei W, Zhou DP, Yu HL, Xiang LB, Wang L. Promotion of osteointegration by silk fibroin coating under diabetic conditions on 3D printed porous titanium implants via ROS-mediated NF-κB pathway. Biomed Mater 2020; 16. [PMID: 32726758 DOI: 10.1088/1748-605x/abaaa1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 07/29/2020] [Indexed: 01/29/2023]
Abstract
The clinical evidence indicates the compromised application of titanium implants (TI) in diabetics, associated with reactive oxygen species (ROS) overproduction at the bone-implant interface. Silk fibroin has exerted impressive biocompatibility in application of biomedical material and optimal anti-diabetic effect as oriental medicine. We proposed that SF coated titanium implant (STI) could alleviate diabetes-induced compromised osteointegration, which had been rarely reported before. To confirm the hypothesis and explore the underlying mechanisms, rat osteoblasts cultured on 3-dimensional (3D) printed TI and STI were subjected to normal serum (NS), diabetic serum (DS), DS with NAC (a ROS inhibitor) or SN50 (a NF-κB inhibitor). In vivo study was performed on diabetic sheep implanted with TI or STI into the bone defect on crista iliaca. Results demonstrated that ROS overproduction induced by diabetes lead to osteoblast dysfunctions and cellular apoptosis on TI substrate, associated with activation of NF-κB signaling pathway in osteoblasts. Importantly, STI substrate significantly attenuated ROS production and NF-κBp65 phosphorylation, through which the osteoblast biological dysfunctions were ameliorated. These results were further confirmed in vivo by the improved osteointegration of STI evidenced by Micro-CT and histological examinations compared with TI. These results demonstrated that ROS-mediated NF-κB signaling pathway played a crucial role in diabetes-induced implant destabilization. Importantly, SF coating as a promising material for biomaterial-engineering markedly improved clinical treatment effect of TI under diabetic conditions, possibly associated with the suppression of NF-κB pathway.
Collapse
Affiliation(s)
- Xiang-Yu Ma
- General Hospital of Northern Theater Command of PLA, Shenyang, CHINA
| | - Tian-Cheng Ma
- The First Affiliated Hospital of Air Force Medical University, Xi'an, CHINA
| | - Ya-Fei Feng
- The First Affiliated Hospital of Air Force Medical University, Xi'an, CHINA
| | - Geng Xiang
- The First Affiliated Hospital of Air Force Medical University, Xi'an, CHINA
| | - Wei Lei
- The First Affiliated Hospital of Air Force Medical University, Xi'an, CHINA
| | - Da-Peng Zhou
- General Hospital of Northern Theater Command of PLA, Shenyang, CHINA
| | - Hai-Long Yu
- General Hospital of Northern Theater Command of PLA, Shenyang, CHINA
| | - Liang-Bi Xiang
- Department of Orthopedics, General Hospital of Northern Theater Command of PLA, Shenyang, Liaoning, CHINA
| | - Lin Wang
- The First Affiliated Hospital of Air Force Medical University, Xi'an, CHINA
| |
Collapse
|
14
|
Liu X, Niu Y, Xie W, Wei D, Du Q. Comparative investigations of in vitro and in vivo bioactivity of titanium vs. Ti-24Nb-4Zr-8Sn alloy before and after sandblasting and acid etching. RSC Adv 2020; 10:23582-23591. [PMID: 35517345 PMCID: PMC9054740 DOI: 10.1039/d0ra00280a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/22/2020] [Indexed: 01/25/2023] Open
Abstract
To avoid the failure of clinical surgery due to "stress shielding" and the loosening of an implant, a new type of alloy, Ti-24Nb-4Zr-8Sn (TNZS), with a low Young's modulus acted as a new implant material in this work. Meanwhile, the surface characteristics, MC3T3-E1 cell behavior and in vivo osseointegration of the titanium and TNZS before and after sandblasting and acid etching were studied comparatively. TNZS and Ti had the same microstructure based on the transmission electron microscopy results. Meanwhile, the TNZS alloy had a lower Young's modulus and surface nanohardness compared with pure titanium. However, the corrosion resistance of Ti was better than that of the TNZS sample in simulated body fluid solution. In addition, the TNZS alloy after sandblasting and acid etching (SLATNZS) had excellent cell adhesion, proliferation, differentiation, ALP activity and in vivo osseointegration ability such as there being almost no soft tissue as compared with other implants. Based on the current results, the new type of Ti-24Nb-4Zr-8Sn alloy showed good potential and promising application prospects in its biochemical aspects.
Collapse
Affiliation(s)
- Xin Liu
- Department of Prosthodontics, The First Affiliated Hospital of Harbin Medical University Harbin Heilongjiang Province China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University Harbin Heilongjiang Province China
| | - Weili Xie
- Department of Prosthodontics, The First Affiliated Hospital of Harbin Medical University Harbin Heilongjiang Province China
| | - Daqing Wei
- Harbin Institute of Technology School of Materials Science and Engineering Harbin Heilongjiang Province China
| | - Qing Du
- Harbin Institute of Technology School of Materials Science and Engineering Harbin Heilongjiang Province China
| |
Collapse
|
15
|
Concentrate Growth Factors Regulate Osteogenic Dysfunction of MC3T3-E1 Cells Induced by High Glucose Through PI3K/Akt Signaling Pathway. IMPLANT DENT 2019; 28:478-483. [PMID: 31241545 DOI: 10.1097/id.0000000000000921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study is to investigate the effects of Concentrate Growth Factors Extract (CGF-e) on the proliferation and osteogenic differentiation of MC3T3-E1 cells under high glucose condition. MATERIALS AND METHODS MC3T3-E1 cells were divided into 4 groups including normal glucose (5.5-mM) group (control), high glucose (25.5-mM) group, normal glucose + CGF-e group, and high glucose + CGF-e group. The proliferation, osteogenic differentiation and mineralization of osteoblasts were evaluated, respectively, by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, cytoskeleton analysis, alkaline phosphatase activity assay, alizarin red staining, and real-time polymerase chain reaction. Western blots analysis was used to explore the role of PI3K/Akt pathway. RESULTS The viability, osteogenic differentiation, and mineralization of MC3T3-E1 cells were significantly decreased by high glucose. All observed osteogenic dysfunction were inhibited by CGF-e. Moreover, the PI3K/Akt pathway was activated by CGF-e. CONCLUSIONS It was concluded that the soluble factors released by CGF could significantly attenuate high glucose-mediated MC3T3-E1 cells osteogenic dysfunction through the PI3K/Akt pathway.
Collapse
|
16
|
Lagunov VL, Sun J, George R. Evaluation of biologic implant success parameters in type 2 diabetic glycemic control patients versus health patients: A meta-analysis. ACTA ACUST UNITED AC 2019; 10:e12478. [PMID: 31638347 DOI: 10.1111/jicd.12478] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/19/2019] [Accepted: 09/21/2019] [Indexed: 01/24/2023]
Abstract
AIM The aim of the present systematic literature review was to evaluate bleeding on probing (BOP), pocket depth (PD), and marginal bone loss (MBL) in type 2 diabetes mellitus (T2DM) control patients. METHODS An electronic literature search was conducted through PubMed, Web of Science, Cochrane, Embase, and ScienceDirect. The search included prospective human clinical studies that analyzed the success of dental implants in T2DM control patients. For inclusion, studies should have had a minimum of 1-year follow up and should have assessed the following parameters: MBL, BOP and PD. Prior to meta-analysis, all of the studies were assessed for quality, bias, and heterogeneity. RESULTS Risk of bias analysis indicated that all studies were of moderate quality. After a full-text evaluation, only seven studies met the inclusion criteria for this meta-analysis, with a combined total of 443 patients and 530 dental implants. The meta-analysis indicated a statistically significant difference between parameters of implants placed in the glycemic-controlled group and healthy group in MBL (P < .001), BOP (P < .04), and PD (P < .001). CONCLUSION The results of the present study indicated that, despite being glycemic controlled, patients with T2DM were associated with a higher risk of peri-implant disease.
Collapse
Affiliation(s)
- Victor L Lagunov
- School of Dentistry and Oral Health, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Roy George
- School of Dentistry and Oral Health, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
17
|
ELsyad MA, Abdraboh AE, Aboelnagga MM, Ghali RM, Lebshtien IT. Effect of Low-Level Laser Irradiation on Stability and Marginal Bone of Narrow Implants Retaining Overdentures in Moderately Controlled Diabetic Patients. J ORAL IMPLANTOL 2019; 45:391-397. [PMID: 31389750 DOI: 10.1563/aaid-joi-d-18-00263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The researchers investigated the influence of low-level laser irradiation (LLLI) on implant stability and marginal bone of small-diameter implants retaining mandibular overdentures in patients with moderately controlled diabetes. Twenty patients (mean age = 59.32 ± 4.1 years) with moderately controlled diabetes mellitus (glycated hemoglobin A1c [HbA1c] = 8.1%-10.0 %) were rehabilitated by maxillary and mandibular conventional dentures. Two small-diameter implants (3 × 12 mm) were inserted in the canine areas of the mandible and immediately loaded by mandibular dentures. In a split-mouth design, LLLI was applied to 1 of the 2 implants in a random order (study group [SG]); the other implant was left as a control (control group [CG]). For each patient, gallium aluminum-arsenide diode low-level laser (940-nm wavelength, 0.50 ± 2 mW output power, 0.004 cm2 spot size; Epic, Biolase, Inc, San Clemente, Calif) was applied around each implant with total delivered energy of 90 J (equally divided by 6 irradiation points) in 3 sessions. The application was done immediately after implant insertion, 3 days and 1 week after surgery. Implant stability (measured by Periotest) and marginal bone loss (MBL; measured by cone beam computerized tomography) were evaluated at implant loading (T1), 6 months (T6), and 12 months (T12). One implant failed in the CG and no failures occurred in the SG, resulting in 95% and 100% survival rates, respectively. The SG recorded higher Periotest values than the CG at all observation times. However, the difference was significant (P = .039) at T6 only. The SG recorded lower MBL values than the CG. No difference in MBL was detected between groups or peri-implant sites (mesial, distal, buccal, and lingual) at T6 and T12. Within the limits of this study, LLLI had no effect on marginal bone around immediately loaded small-diameter implants retaining overdentures in patients with moderately controlled diabetes. However, it was beneficial in improving implant stability 6 months after overdenture insertion.
Collapse
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, University of Mansoura, University of Delta, Eldakahlia, Egypt
| | | | - Mona M Aboelnagga
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
| | - Rami Maher Ghali
- Department of Removable Prosthodontics, University of Ain Shams, Cairo, Egypt
| | | |
Collapse
|
18
|
WISDOM CATE, CHEN CASEY, YUCA ESRA, ZHOU YAN, TAMERLER CANDAN, SNEAD MALCOLML. Repeatedly Applied Peptide Film Kills Bacteria on Dental Implants. JOM (WARRENDALE, PA. : 1989) 2019; 71:1271-1280. [PMID: 31178649 PMCID: PMC6550465 DOI: 10.1007/s11837-019-03334-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 12/31/2018] [Indexed: 05/03/2023]
Abstract
The rising use of titanium dental implants has increased the prevalence of peri-implant disease that shortens their useful life. A growing view of peri-implant disease suggests that plaque accumulation and microbiome dysbiogenesis trigger a host immune inflammatory response that destroys soft and hard tissues supporting the implant. The incidence of peri-implant disease is difficult to estimate, but with over 3 million implants placed in the USA alone, and the market growing by 500,000 implants/year, such extensive use demands additional interceptive approaches. We report a water-based, nonsur-gical approach to address peri-implant disease using a bifunctional peptide film, which can be applied during initial implant placement and later reapplied to existing implants to reduce bacterial growth. Bifunctional peptides are based upon a titanium binding peptide (TiBP) optimally linked by a spacer peptide to an antimicrobial peptide (AMP). We show herein that dental implant surfaces covered with a bifunctional peptide film kill bacteria. Further, using a simple protocol for cleaning implant surfaces fouled by bacteria, the surface can be effectively recoated with TiBP-AMP to regain an antimicrobial state. Fouling, cleansing, and rebinding was confirmed for up to four cycles with minimal loss of binding efficacy. After fouling, rebinding with a water-based peptide film extends control over the oral microbiome composition, providing a novel nonsurgical treatment for dental implants.
Collapse
Affiliation(s)
- CATE WISDOM
- Bioengineering Program, Institute for Bioengineering Research, University of Kansas, Lawrence, USA
| | - CASEY CHEN
- Herman Ostrow School of Dentistry of USC, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, USA
| | - ESRA YUCA
- Bioengineering Program, Institute for Bioengineering Research, University of Kansas, Lawrence, USA
- Molecular Biology and Genetics Department, Yildiz Technical University, Istanbul, Turkey
| | - YAN ZHOU
- Herman Ostrow School of Dentistry of USC, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, USA
| | - CANDAN TAMERLER
- Bioengineering Program, Institute for Bioengineering Research, University of Kansas, Lawrence, USA
- Mechanical Engineering Department, University of Kansas, Lawrence, USA
| | - MALCOLM L. SNEAD
- Herman Ostrow School of Dentistry of USC, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, USA
| |
Collapse
|
19
|
Zhao Q, Yi L, Hu A, Jiang L, Hong L, Dong J. Antibacterial and osteogenic activity of a multifunctional microporous coating codoped with Mg, Cu and F on titanium. J Mater Chem B 2019; 7:2284-2299. [PMID: 32254677 DOI: 10.1039/c8tb03377c] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
As preferred materials for bone tissue repair and replacement, titanium (Ti) and its alloys have been widely applied in clinical practice. However, since these materials are bioinert, synostosis cannot occur between these materials and natural bone. Therefore, modifying the surface of Ti with bioactive elements has been the subject of intense research. In the present study, a magnesium-copper-fluorine (Mg-Cu-F) codoped titanium dioxide microporous coating (MCFMT) was prepared on the surface of Ti by micro-arc oxidation (MAO). The coating had a micro/nanoporous structure and was uniformly doped with Mg, Cu and F. In vitro, the MCFMT could promote the adhesion, proliferation, differentiation, mineralization and apoptosis of MC3T3-E1 osteoblasts. In addition, MCFMT could inhibit the growth of Staphylococcus, providing a good antibacterial effect. Further studies showed that MCFMT promoted MAPK expression and might promote osteogenesis through ERK1/2 signaling. Therefore, establishing an MCFMT coating on the Ti surface is a feasible and effective way to improve the biological activity of Ti. This study provides a new concept and method for improving the biological activity of Ti and thus has important theoretical significance and potential applications.
Collapse
Affiliation(s)
- Quanming Zhao
- Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
| | | | | | | | | | | |
Collapse
|
20
|
MEZA MAURÍCIO J, MIRANDA TS, ALMEIDA ML, SILVA HD, FIGUEIREDO LC, DUARTE PM. An umbrella review on the effects of diabetes on implant failure and peri-implant diseases. Braz Oral Res 2019; 33:e070. [DOI: 10.1590/1807-3107bor-2019.vol33.0070] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/13/2019] [Indexed: 01/07/2023] Open
|
21
|
Duan Y, Ma W, Li D, Wang T, Liu B. Enhanced osseointegration of titanium implants in a rat model of osteoporosis using multilayer bone mesenchymal stem cell sheets. Exp Ther Med 2017; 14:5717-5726. [PMID: 29250137 PMCID: PMC5729390 DOI: 10.3892/etm.2017.5303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 03/17/2017] [Indexed: 12/26/2022] Open
Abstract
The present study aimed to investigate whether bone marrow-derived mesenchymal stem cell (BMSC) sheets combined with titanium implants enhanced implant osseointegration in an ovariectomized (OVX) rat model of osteoporosis. Sprague-Dawley rats were randomly assigned into a test group and control group. Allogenic BMSCs were collected from the rats, cultured and stored via cryopreservation. At 6 months post-ovariectomy, establishment of the OVX model was confirmed by micro-computed tomography (CT) measurements. BMSC sheets were subsequently layered and wrapped over titanium implants for implantation. Unmodified implants served as the control. At 8 weeks post-implantation, samples were observed by micro-CT reconstruction and histomorphometric evaluation. Micro-CT reconstruction identified a marked improvement in the surrounding bone volume following treatment, with data analyses indicating a significant increase in bone volume in the BMSC-implant group compared with the control implant group (P<0.05). In addition, histological staining identified new bone formation and an increased rate of bone-implant contact surrounding the BMSC-implant constructs. These results indicate that the use of BMSC sheets as a novel tissue engineering approach improves the osseointegration of titanium implants in an osteoporosis model. This method may expand the operative indications in patients with osteoporosis and improve the success rate of clinical dental implant treatments.
Collapse
Affiliation(s)
- Yan Duan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Dental Implants, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Wei Ma
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Dental Implants, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Dehua Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Dental Implants, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Tongfei Wang
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710038, P.R. China
| | - Baolin Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Dental Implants, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| |
Collapse
|
22
|
Tan N, Liu X, Cai Y, Zhang S, Jian B, Zhou Y, Xu X, Ren S, Wei H, Song Y. The influence of direct laser metal sintering implants on the early stages of osseointegration in diabetic mini-pigs. Int J Nanomedicine 2017; 12:5433-5442. [PMID: 28814861 PMCID: PMC5546787 DOI: 10.2147/ijn.s138615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background High failure rates of oral implants have been reported in diabetic patients due to the disruption of osseointegration. The aim of this study was to investigate whether direct laser metal sintering (DLMS) could improve osseointegration in diabetic animal models. Methods Surface characterizations were carried out on two types of implants. Cell morphology and the osteogenic-related gene expression of MG63 cells were observed under conditions of DLMS and microarc oxidation (MAO). A diabetes model in mini-pigs was established by intravenous injection of streptozotocin (150 mg/kg), and a total of 36 implants were inserted into the mandibular region. Micro-computed tomography (micro-CT) and histologic evaluations were performed 3 and 6 months after implantation. Results The Ra (the average of the absolute height of all points) of MAO surface was 2.3±0.3 µm while the DLMS surface showed the Ra of 27.4±1.1 µm. The cells on DLMS implants spread out more podia than those on MAO implants through cell morphology analysis. Osteogenic-related gene expression was also dramatically increased in the DLMS group. Obvious improvement was observed in the micro-CT and Van Gieson staining analyses of DLMS implants compared with MAO at 3 months, although this difference disappeared by 6 months. DLMS implants showed a higher bone–implant contact percentage (33.2%±11.2%) at 3 months compared with MAO group (18.9%±7.3%) while similar results were showed at 6 months between DLMS group (42.8%±10.1%) and MAO group (38.3%±10.8%). Conclusion The three-dimensional environment of implant surfaces with highly porous and fully interconnected channel and pore architectures can improve cell spreading and accelerate the progress of osseointegration in diabetic mini-pigs.
Collapse
Affiliation(s)
- Naiwen Tan
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China.,Department of Stomatology, Hospital 463 of PLA, Xi'an, Shaanxi, China
| | - Xiangwei Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yanhui Cai
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Sijia Zhang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Bo Jian
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yuchao Zhou
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xiaoru Xu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shuai Ren
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hongbo Wei
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yingliang Song
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Xi'an, Shaanxi, China.,Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| |
Collapse
|
23
|
Yamawaki I, Taguchi Y, Komasa S, Tanaka A, Umeda M. Effects of glucose concentration on osteogenic differentiation of type II diabetes mellitus rat bone marrow-derived mesenchymal stromal cells on a nano-scale modified titanium. J Periodontal Res 2017; 52:761-771. [PMID: 28321876 DOI: 10.1111/jre.12446] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus (DM) is a common disease worldwide. Patients with DM have an increased risk of losing their teeth compared with other individuals. Dental implants are a standard of care for treating partial or full edentulism, and various implant surface treatments have recently been developed to increase dental implant stability. However, some studies have reported that DM reduces osseointegration and the success rate of dental implants. The purpose of this study was to determine the effects of high glucose levels for hard tissue formation on a nano-scale modified titanium surface. MATERIAL AND METHODS Titanium disks were heated at 600°C for 1 h after treatment with or without 10 m NaOH solution. All disks were incubated with type II DM rat bone marrow-derived mesenchymal stromal cells before exposure to one of four concentrations of glucose (5.5, 8.0, 12.0 or 24.0 mm). The effect of different glucose concentrations on bone marrow-derived mesenchymal stromal cell osteogenesis and inflammatory cytokines on the nano-scale modified titanium surface was evaluated. RESULTS Alkaline phosphatase activity decreased with increasing glucose concentration. In contrast, osteocalcin production and calcium deposition were significantly decreased at 8.0 mm glucose, but increased with glucose concentrations over 8.0 mm. Differences in calcium/phosphate ratio associated with the various glucose concentrations were similar to osteocalcin production and calcium deposition. Inflammatory cytokines were expressed at high glucose concentrations, but the nano-scale modified titanium surface inhibited the effect of high glucose concentrations. CONCLUSION High glucose concentration increased hard tissue formation, but the quality of the mineralized tissue decreased. Furthermore, the nano-scale modified titanium surface increased mineralized tissue formation and anti-inflammation, but the quality of hard tissue was dependent on glucose concentration.
Collapse
Affiliation(s)
- I Yamawaki
- Department of Periodontology, Osaka Dental University, Osaka, Japan
| | - Y Taguchi
- Department of Periodontology, Osaka Dental University, Osaka, Japan
| | - S Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Osaka, Japan
| | - A Tanaka
- Department of Oral Pathology, Osaka Dental University, Osaka, Japan
| | - M Umeda
- Department of Periodontology, Osaka Dental University, Osaka, Japan
| |
Collapse
|
24
|
Cheung MC, Kao PLH, Lee N, Sivathasan D, Vong CW, Zhu J, Polster A, Darby I. Interest in dental implantology and preferences for implant therapy: a survey of Victorian dentists. Aust Dent J 2016; 61:455-463. [DOI: 10.1111/adj.12411] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 01/14/2023]
Affiliation(s)
- MC Cheung
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - PLH Kao
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - N Lee
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - D Sivathasan
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - CW Vong
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - J Zhu
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - A Polster
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - I Darby
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| |
Collapse
|
25
|
Wang L, Hu X, Ma X, Ma Z, Zhang Y, Lu Y, Li X, Lei W, Feng Y. Promotion of osteointegration under diabetic conditions by tantalum coating-based surface modification on 3-dimensional printed porous titanium implants. Colloids Surf B Biointerfaces 2016; 148:440-452. [DOI: 10.1016/j.colsurfb.2016.09.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/31/2022]
|
26
|
King S, Klineberg I, Levinger I, Brennan-Speranza TC. The effect of hyperglycaemia on osseointegration: a review of animal models of diabetes mellitus and titanium implant placement. Arch Osteoporos 2016; 11:29. [PMID: 27637755 DOI: 10.1007/s11657-016-0284-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/26/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED Patients with type 2 diabetes mellitus have a higher risk of dental and/or orthopaedic implant failure. However, the mechanism behind this phenomenon is unclear, and animal studies may prove useful in shedding light on the processes involved. This review considers the available literature on rat models of diabetes and titanium implantation. INTRODUCTION The process of osseointegration whereby direct contact is achieved between bone and an implant surface depends on healthy bone metabolism. Collective evidence suggests that hyperglycaemia adversely affects bone turnover and the quality of the organic matrix resulting in an overall deterioration in the quality, resilience and structure of the bone tissue. This in turn results in compromised osseointegration in patients receiving dental and orthopaedic implants. The incidence of diabetes mellitus (DM), which is a chronic metabolic disorder resulting in hyperglycaemia, is rising. Of particular significance is the rising incidence of adult onset type 2 diabetes mellitus (T2DM) in an ageing population. Understanding the effects of hyperglycaemia on osseointegration will enable clinicians to manage health outcomes for patients receiving implants. Much of our understanding of how hyperglycaemia affects osseointegration comes from animal studies. METHODS In this review, we critically analyse the current animal studies. RESULTS Our review has found that most studies used a type 1 diabetes mellitus (T1DM) rodent model and looked at a young male population of rodents. The pathophysiology of T1DM is however very different to that of T2DM and is not representative of T2DM, the incidence of which is rising in the ageing adult population. Genetically modified rats have been used to model T2DM, but none of these studies have included female rats and the metabolic changes in bone for some of these models used are not adequately characterized. CONCLUSIONS Therefore, the review suggests that the study population needs to be broadened to include both T1DM and T2DM models, older rats as well as young rats, and importantly animals from both sexes to reflect more accurately clinical practice.
Collapse
Affiliation(s)
- Shalinie King
- Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Iven Klineberg
- Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Itamar Levinger
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Tara C Brennan-Speranza
- Department of Physiology and Bosch Institute for Medical Research, University of Sydney, Sydney, NSW, 2006, Australia.
| |
Collapse
|
27
|
Abstract
Several systemic diseases (and relative medications) have been reported to impair or in some cases complicate dental implant surgery. In broader terms, when dealing with patients suffering from systemic diseases, the monitoring of the medical condition and of the related post-operative complications is of great importance in order to avoid risks which could jeopardise the health of the patient. In this review, the available evidence on implant survival/success, as well as relevant surgical recommendations in patients affected by systemic diseases, are evaluated and when possible, practical suggestions for the clinician are provided.
Collapse
|
28
|
Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
|
29
|
Evaluation of the effects of platelet-rich fibrin on bone regeneration in diabetic rabbits. J Craniomaxillofac Surg 2016; 44:126-33. [DOI: 10.1016/j.jcms.2015.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/14/2015] [Accepted: 11/20/2015] [Indexed: 01/05/2023] Open
|
30
|
Differentiating success from survival in modern implantology – key considerations for case selection, predicting complications and obtaining consent. Br Dent J 2016; 220:31-8. [DOI: 10.1038/sj.bdj.2016.26] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 01/09/2023]
|
31
|
Dai X, Zhang X, Xu M, Huang Y, Heng BC, Mo X, Liu Y, Wei D, Zhou Y, Wei Y, Deng X, Deng X. Synergistic effects of elastic modulus and surface topology of Ti-based implants on early osseointegration. RSC Adv 2016. [DOI: 10.1039/c6ra04772f] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Elastic modulus and surface micro-scale topographical structure of Ti alloy implants have a synergistic effect on cell attachment, osteogenic differentiation of rBMSCs in vitro and early osseointegration in vivo.
Collapse
|
32
|
Berberine in Combination with Insulin Has Additive Effects on Titanium Implants Osseointegration in Diabetes Mellitus Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:824259. [PMID: 26783411 PMCID: PMC4691484 DOI: 10.1155/2015/824259] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/09/2015] [Accepted: 11/25/2015] [Indexed: 02/05/2023]
Abstract
This study evaluated the effects of berberine in combination with insulin on early osseointegration of implants in diabetic rats. Fifty male Sprague-Dawley rats were randomly divided into 5 groups: healthy rats were used as control (HC), and streptozotocin-induced diabetic rats were treated with insulin, berberine, berberine + insulin (IB), or no treatment. Each rat received one machined-surface cp-Ti implant into the right tibia and was given insulin injection and/or gavage feeding with berberine daily for 8 weeks until being sacrificed. Serum levels of alkaline phosphatase (ALP) and bone gamma-carboxyglutamic acid-containing protein (BGP) were analyzed in each group. Peri-implant mineral apposition was marked by fluorochrome double-labeling and osseointegration was histomorphologically examined. The ALP and BGP levels decreased in diabetic rats but were successfully corrected by insulin and berberine combined treatment. Moreover, untreated diabetic rats had less labeled mineral apposition and impaired osseointegration. In contrast, Groups I, B, and IB were observed with increased peri-implant bone formation. The combination treatment of insulin and berberine was more effective than each administrated as a monotherapy. These results suggest that berberine combined with insulin could promote osseointegration in diabetic rats, thereby highlighting its potential application to patients, though further studies are needed.
Collapse
|
33
|
Gutmacher Z, Levi G, Blumenfeld I, Machtei EE. Soft and Hard Tissue Changes around Tissue-Oriented Tulip-Design Implant Abutments: A 1-Year Randomized Prospective Clinical Trial. Clin Implant Dent Relat Res 2015; 17:891-7. [PMID: 26434929 DOI: 10.1111/cid.12209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The advantages of platform switching using narrower abutments remain controversial. Many researchers suggest that platform switching can yield enhanced clinical results, while others remain skeptical. We hypothesize that the effectiveness of platform switching might be associated with the degree of reduction in size of the abutment. PURPOSE To radiographically and clinically examine a new abutment design created to move the implant-abutment interface farther medially. MATERIALS AND METHODS This was a prospective, randomized controlled clinical trial that included 27 patients (41 MIS Lance Plus® implants; MIS Implant Technologies, Karmiel, Israel). The patients' age ranged from 39 to 75 years. At the second stage of the surgery, the implants were randomly assigned to either the new platform switch Tulip abutment (TA) design or to the standard platform abutment (SA). Implant probing depth (IPD) and bleeding on probing (BOP) were recorded at baseline and after 12 months. Standardized periapical radiographs were taken (at baseline and at 12 months) and the marginal bone height measured. RESULTS All implants were successfully integrated. The mean IPD at 1 year post-op was 2.91 mm for the SA group and 2.69 mm for the TA group (p > .05). Similarly, the BOP at 1 year was almost identical in both groups. The mean values of bone resorption at baseline were 0.98 ± 0.37 mm and 0.69 ± 0.20 for the TA and SA groups, respectively (p > .05). Bone loss (baseline to 12 months) was significantly greater in the SA group compared with the TA group. CONCLUSIONS Use of the new TA, with its significantly downsized diameter, resulted in reduced bone loss at 1 year. Further research will be required to assess the long-term effect of this abutment on peri-implant health.
Collapse
Affiliation(s)
- Zvi Gutmacher
- Department of Maxillofacial Rehabilitation, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Guy Levi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Israel Blumenfeld
- Department of Maxillofacial Rehabilitation, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.,Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
| |
Collapse
|
34
|
Marcantonio C, Nicoli LG, Marcantonio Junior E, Zandim-Barcelos DL. Prevalence and Possible Risk Factors of Peri-implantitis: A Concept Review. J Contemp Dent Pract 2015; 16:750-757. [PMID: 26522602 DOI: 10.5005/jp-journals-10024-1752] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The purpose of this review is to estimate the prevalence of peri-implantitis, as well as to determine possible risk factors associated with its development in patients treated with oral implants. BACKGROUND Although implant therapy has been identified as a successful and predictable treatment for partially and fully edentulous patients, complications and failures can occur. Peri-implantitis is considered a biologic complication that results in bone loss around implants and may lead to implant treatment failure. RESULTS A great variation has been observed in the literature regarding the prevalence of peri-implantitis according to the diagnostic criteria used to define peri-implantitis. The prevalence ranges from 4.7 to 43% at implant level, and from 8.9 to > 56% at patient level. Many risk factors that may lead to the establishment and progression of peri-implantitis have been suggested. There is strong evidence that presence and history of periodontitis are potential risk factors for peri-implantitis. Cigarette smoking has not yet been conclusively established as a risk factor for peri-implantitis, although extra care should be taken with dental implant in smokers. Other risk factors, such as diabetes, genetic traits, implant surface roughness and presence of keratinized mucosa still require further investigation. CONCLUSION Peri-implantitis is not an uncommon complication following implant therapy. A higher prevalence of peri-implantitis has been identified for patients with presence or history of periodontal disease and for smokers. Until now, a true risk factor for peri-implantitis has not been established. Supportive maintenance program is essential for the long-term success of treatments with oral implants. CLINICAL SIGNIFICANCE The knowledge of the real impact of peri-implantitis on the outcome of treatments with oral implants as well as the identification of risk factors associated to this inflammatory condition are essential for the development of supportive maintenance programs and the establishment of prevention protocols.
Collapse
Affiliation(s)
- Claudio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Sao Paulo, Brazil
| | - Lelis Gustavo Nicoli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Sao Paulo, Brazil
| | - Elcio Marcantonio Junior
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Sao Paulo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Assistant Professor, Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Universidade Estadual Paulista, UNESP, Humaita, 1680, Zipcode: 14801-903 Araraquara/Sao Paulo, Brazil, Phone: +55 16 33016508 e-mail:
| |
Collapse
|
35
|
Aguilar-Salvatierra A, Calvo-Guirado JL, González-Jaranay M, Moreu G, Delgado-Ruiz RA, Gómez-Moreno G. Peri-implant evaluation of immediately loaded implants placed in esthetic zone in patients with diabetes mellitus type 2: a two-year study. Clin Oral Implants Res 2015; 27:156-61. [PMID: 25623884 DOI: 10.1111/clr.12552] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate implant survival and primary stability parameters in patients with diabetes with different levels of glycosylated hemoglobin Alc (HbA1c) treated with immediate placement and provisionalization of implant-supported, single-tooth replacements over 2 years. MATERIALS AND METHODS Eighty-five patients were divided into three groups according to their HbA1c levels: 33 patients in Group 1 (<6, control group); 30 patients in Group 2 (6.1-8); and 22 patients in Group 3 (8.1-10). Each patient received one-one-piece implant in the anterior zone of the upper maxillary. The implant survival rate was analyzed for each group, together with three variables to evaluate the general state of peri-implant health: probe depth, bleeding on probing, marginal bone loss. RESULTS Marginal bone loss increased in relation with higher HbA1c levels. For marginal bone loss in Group 1, mean resorption values ranged from 0.51 after 6 months to 0.72 after 2 years in comparison with respective values of 1.33 and 1.92 in Group 3. This pattern was repeated for bleeding on probing, both parameters showing significant differences between groups. For bleeding on probing, mean bleeding levels varied from 0.36 in Group I at 6 months after implant placement, to 0.59 in Group 3 (P = 0.041 between the three groups). Peri-implant pocket depth showed the same tendency to increase in relation to HbA1C but differences between groups did not reach statistical significance. CONCLUSIONS Patients with diabetes can receive implant-based treatments with immediate loading safely, providing they present moderate HbA1c values.
Collapse
Affiliation(s)
- Antonio Aguilar-Salvatierra
- Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - José Luis Calvo-Guirado
- Department of Implant Dentistry, Master of Implant Dentistry and Biomaterials, School of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Maximino González-Jaranay
- Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - Gerardo Moreu
- Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | | | - Gerardo Gómez-Moreno
- Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
36
|
Li X, Ma XY, Feng YF, Ma ZS, Wang J, Ma TC, Qi W, Lei W, Wang L. Osseointegration of chitosan coated porous titanium alloy implant by reactive oxygen species-mediated activation of the PI3K/AKT pathway under diabetic conditions. Biomaterials 2015; 36:44-54. [DOI: 10.1016/j.biomaterials.2014.09.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/10/2014] [Indexed: 12/20/2022]
|
37
|
Monument MJ, Lerman DM, Randall RL. Novel applications of osseointegration in orthopedic limb salvage surgery. Orthop Clin North Am 2015; 46:77-87. [PMID: 25435037 DOI: 10.1016/j.ocl.2014.09.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Osseointegration is a biologic process vital to modern endoprosthetic fixation in orthopedic surgery. Numerous engineering advancements have improved the utilization of this technology in orthopedics; however, issues such as stress shielding, aseptic loosening, and bone loss remain an ongoing challenge. These host responses are especially problematic in limb salvage surgery. Novel applications of osseointegration have been developed to address some of these fixation issues with massive tumor endoprostheses. This articles reviews osseointegration and emerging novel applications of this technology in limb salvage surgery and future prosthetics for amputees.
Collapse
Affiliation(s)
- Michael J Monument
- Sarcoma Services, Department of Orthopaedic Surgery, Huntsman Cancer Institute, Primary Children's Medical Center, University of Utah, 2000 Circle of Hope, Room 4260, Salt Lake City, UT 84112, USA
| | - Daniel M Lerman
- Sarcoma Services, Department of Orthopaedic Surgery, Huntsman Cancer Institute, Primary Children's Medical Center, University of Utah, 2000 Circle of Hope, Room 4260, Salt Lake City, UT 84112, USA
| | - R Lor Randall
- Sarcoma Services, Department of Orthopaedic Surgery, Huntsman Cancer Institute, Primary Children's Medical Center, University of Utah, 2000 Circle of Hope, Room 4260, Salt Lake City, UT 84112, USA.
| |
Collapse
|
38
|
Wang L, Zhao X, Wei BY, Liu Y, Ma XY, Wang J, Cao PC, Zhang Y, Yan YB, Lei W, Feng YF. Insulin improves osteogenesis of titanium implants under diabetic conditions by inhibiting reactive oxygen species overproduction via the PI3K-Akt pathway. Biochimie 2014; 108:85-93. [PMID: 25308835 DOI: 10.1016/j.biochi.2014.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/02/2014] [Indexed: 10/24/2022]
Abstract
Clinical evidence indicates that insulin therapy improves implant survival rates in diabetic patients; however, the mechanisms responsible for this effect are unknown. Here, we test if insulin exerts anti-oxidative effects, thereby improving diabetes-associated impaired osteoblast behavior on titanium implants. To test this hypothesis, we cultured primary rabbit osteoblasts in the presence of titanium implants and studied the impact of treatment with normal serum (NS), diabetic serum (DS), DS + insulin, DS + tempol (a superoxide dismutase mimetic), DS + insulin + tempol, and DS + insulin + wortmannin. We analyzed cell function, apoptosis, and reactive oxygen species (ROS) production in osteoblasts following the various treatments. Treatment with DS induced osteoblast dysfunction, evidenced by impaired cell attachment and morphology, decreased cell proliferation and ALP activity, and decreased expression of osteogenesis-related genes. We also observed a significant increase in apoptosis. Importantly, treatment with DS resulted in increased production of ROS in osteoblasts. In contrast, treatment with insulin inhibited ROS production, alleviated cell dysfunction, and decreased apoptosis of osteoblasts on the implants. Scavenging ROS with tempol also attenuated cell dysfunction. Compared to insulin treatment alone, the combination of insulin and tempol failed to further improve osteoblast functional recovery. Moreover, the anti-oxidative and pro-osteogenic effects afforded by insulin were almost completely abolished by the phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin. These results demonstrate, for the first time, that insulin treatment alleviates the impaired osteogenesis of titanium implants under diabetic conditions by inhibiting ROS overproduction via a PI3K/Akt-dependent mechanism. Both the anti-oxidative and metabolic properties of insulin should make it a viable therapeutic option to combat diabetic implant failure.
Collapse
Affiliation(s)
- Lin Wang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Xiong Zhao
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Bo-yuan Wei
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Yi Liu
- Department of Implant Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Xiang-yu Ma
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Jian Wang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Peng-chong Cao
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Yang Zhang
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Ya-bo Yan
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China
| | - Wei Lei
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China.
| | - Ya-fei Feng
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, People's Republic of China.
| |
Collapse
|
39
|
Ma XY, Feng YF, Ma ZS, Li X, Wang J, Wang L, Lei W. The promotion of osteointegration under diabetic conditions using chitosan/hydroxyapatite composite coating on porous titanium surfaces. Biomaterials 2014; 35:7259-70. [DOI: 10.1016/j.biomaterials.2014.05.028] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 05/13/2014] [Indexed: 12/13/2022]
|
40
|
Erdogan Ö, Uçar Y, Tatlı U, Sert M, Benlidayı ME, Evlice B. A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes. Clin Oral Implants Res 2014; 26:1267-75. [PMID: 25041273 DOI: 10.1111/clr.12450] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The objective of this prospective, controlled clinical study was to determine the outcomes of dental implant therapy with staged guided bone regeneration procedures in patients with type 2 diabetes. PATIENTS AND METHODS Twenty-four patients were included in the study. Half of the patients were diagnosed with type 2 diabetes mellitus (group 1) while the other half (group 2) of the patients consisted of patients without diabetes. The edentulous maxillary anterior/premolar regions with sufficient vertical height but inadequate horizontal width were treated with staged guided bone regeneration technique and with one or two implant-supported fixed restorations. The patients were followed up at least for 12 months. The parameters that were evaluated were radiographic evaluations on CBCT images and periapical radiographs, histomorphometric analysis, resonance frequency analysis (RFA) and wound-healing parameters. The data were analyzed statistically. RESULTS A total of 43 implants were placed in 24 patients (22 implants in group 1 and 21 implants in group 2). The survival rates of implants were 100% for both groups. The success rate of implants was 95% for group 1 and 100% for group 2. None of the parameters including CBCT findings, RFA values, success rates and wound-healing scores showed a significant difference between the two groups. CONCLUSION Staged guided bone regeneration is a feasible augmentation procedure for the treatment of horizontal bone deficiencies of the maxillary anterior/premolar regions in well-controlled type 2 diabetic patients.
Collapse
Affiliation(s)
- Özgür Erdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey.,Faculty of Dental Medicine, Rangsit University, Pathumthani, Bangkok, Thailand
| | - Yurdanur Uçar
- Department of Prosthodontics, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Ufuk Tatlı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Murat Sert
- Department of Endocrinology, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Mehmet Emre Benlidayı
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Burcu Evlice
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| |
Collapse
|
41
|
|
42
|
Influence of an Antidiabetic Drug on Biomechanical and Histological Parameters Around Implants in Type 2 Diabetic Rats. IMPLANT DENT 2014; 23:264-9. [DOI: 10.1097/id.0000000000000021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Gómez-Moreno G, Aguilar-Salvatierra A, Rubio Roldán J, Guardia J, Gargallo J, Calvo-Guirado JL. Peri-implant evaluation in type 2 diabetes mellitus patients: a 3-year study. Clin Oral Implants Res 2014; 26:1031-5. [PMID: 24684438 DOI: 10.1111/clr.12391] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the changes produced in peri-implant tissues in type 2 diabetes mellitus patients with different glycemia levels, measured by monitoring glycated hemoglobin A1c (HbA1c), over a period of 3 years following dental implant placement. MATERIALS AND METHODS Sixty-seven patients were divided into four groups according to their HbA1c levels: 21 patients in Group 1 (<6); 24 patients in Group 2 (6.1-8); and 11 patients in Group 3 (8.1-10) and Group 4 (>10.1). Each patient received one implant. All implants were placed in the anterior zone of the maxilla. The variables selected to assess the general state of patients' peri-implant health were as follows: probing depth, bleeding on probing, and marginal bone loss. RESULTS Marginal bone loss was found to increase in relation to increases in HbA1c levels. Bleeding on probing showed statistically significant differences between groups. When the peri-implant area was probed, mean levels of bleeding varied from 0.43 in Group 1 at 1 year after implant surgery to 0.62 in Group 4 (P = 0.042 between the four study groups). After the second year, greater bleeding on probing was observed in Group 4 (0.63) in comparison with groups with lower HbA1c levels. Peri-implant pocket depths presented values that were too low to be considered pathological and without statistically significant differences between the study groups. CONCLUSION Implant therapies for diabetic patients can be predictable, providing these patients fall within controlled ranges of glycemia over time, assessed by monitoring HbA1c levels.
Collapse
Affiliation(s)
- Gerardo Gómez-Moreno
- Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - Antonio Aguilar-Salvatierra
- Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - Jerónimo Rubio Roldán
- Periodontology and Implant Dentistry, Faculty of Dentistry, Universidad de Granada, Granada, Spain
| | - Javier Guardia
- Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - Jordi Gargallo
- Department of Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Luis Calvo-Guirado
- Department of Implant Dentistry, Implant Dentistry and Biomaterials, School of Medicine and Dentistry, University of Murcia, Murcia, Spain
| |
Collapse
|
44
|
Zhou W, Liu Z, Yao J, Chi F, Dong K, Yue X, Teng T, Rausch X. The Effects of Exenatide Microsphere on Serum BGP and ALP Levels in ZDF Rats after Implantation. Clin Implant Dent Relat Res 2013; 17:765-70. [PMID: 24299614 DOI: 10.1111/cid.12184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this project is to investigate the impact of diabetes mellitus and different glycemic control times on early osseointegration of dental implants by expression and significance of serum bone Gla protein (BGP) and alkaline phosphatase (ALP) levels in Zucker diabetic fatty (ZDF) rats after implantation. MATERIALS AND METHODS The animals were divided into three groups, each group with 11 rats and each rat with two dental implants (33 rats and 66 implants in total): group A, diabetic rats with dental implants (controls); group B, diabetic rats treated with insulin and implants placed simultaneously; and group C, diabetic rats treated with insulin until serum glucose at a constant level and then implants be placed. Levels of BGP and ALP in the serum were measured by enzyme-linked immunosorbent assay in each group. The software program SPSS (version 17.0 for Windows) was used to analyze all data; p < .05 was set as the level of statistical significance. RESULTS At the 7th day, serum levels of BGP in group B and C were lower than that in group A (p > 0.05). At the 14th day, serum levels of BGP in group C were significantly higher (p < 0.05). After 30 days, compared with group A, the serum levels of BGP in group B and C seems to be lower. Compared with group A, the serum levels of ALP in group B and C were significantly higher, whereas the serum levels of ALP in group C seems to be higher than B (p < 0.05). CONCLUSIONS The present results suggest that injection of delayed release microsphere of exenatide on ZDF rats can release exenatide at a steady rate and the blood glucose can be controlled at a constant level. Implant survival rates could be enhanced in DM subjects when blood plasma glucose level is under control; the serum levels of BGP in this study seems to have no relationship with local osseointegration, whereas the serum levels of ALP might offer insights into the activity of osseointegration around the implant surface.
Collapse
Affiliation(s)
- Wenjuan Zhou
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Zhonghao Liu
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Jie Yao
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Fei Chi
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Kai Dong
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Xilong Yue
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Teng Teng
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Xiaohui Rausch
- Department of Dental Implantology, Yantai Stomatological Hospital, Yantai, China
| |
Collapse
|
45
|
Jolly SJ, Hegde C, Shetty NS. Assessment of Maxillary and Mandibular Bone Density in Controlled Type II Diabetes: A Computed Tomography Study. J ORAL IMPLANTOL 2013; 41:400-5. [PMID: 23834616 DOI: 10.1563/aaid-joi-d-12-00248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was undertaken to compare the bone density in nondiabetic and controlled type II diabetes patients using spiral computed tomography. A group of 40 edentulous men, comprising of 20 nondiabetics and 20 controlled type II diabetics between the ages of 50-65 years, were enrolled in the study. Glycemic control of the diabetic patients was assessed by glycosylated hemoglobin level. The controlled diabetic group had an HbA1c level between 6.1-8%. A radiographic stent was prepared by using chemically cured resin. Bone densities at trabecular, buccal, and lingual cortical regions of maxillary and mandibular edentulous arches were measured by a tomography machine. Mean bone density measurements were recorded in Hounsfield units. The data thus obtained from 10 sites of maxillary and mandibular arches were tabulated and analyzed using SPSS statistical software. This study showed no significant changes in bone density between the controlled diabetic and nondiabetic subjects. Within the limitation of this study, it can be concluded that bone density does not seem to be affected in controlled type II diabetics.
Collapse
Affiliation(s)
- Sanju John Jolly
- 1 Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences, Nellikuzhi, Kothamangalam, Ernakulam District, Kerala State, India
| | - Chethan Hegde
- 2 Department of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka State, India
| | - N Sridhar Shetty
- 2 Department of Prosthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka State, India
| |
Collapse
|
46
|
Implants in bone: part I. A current overview about tissue response, surface modifications and future perspectives. Oral Maxillofac Surg 2013; 18:243-57. [PMID: 23435578 DOI: 10.1007/s10006-013-0398-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/04/2013] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of study paper is to present an overview of osseointegration of dental implants, focusing on tissue response, surface modifications and future perspective. DISCUSSION Great progress has been made over the decades in the understanding of osseous peri-implant healing of dental implants, leading to the development of new implant materials and surfaces. However, failures and losses of implants are an indicator that there is room for improvement. Of particular importance is the understanding of the biological interaction between the implant and its surrounding bone. CONCLUSION The survival rates of dental implants in bone of over 90 % after 10 years show that they are an effective and well-established therapy option. However, new implant materials and surface modifications may be able to improve osseointegration of medical implants especially when the wound healing is compromised. Advanced techniques of evaluation are necessary to understand and validate osseointegration in these cases. An overview regarding the current state of the art in experimental evaluation of osseointegration of implants and implant material modifications will be given in Part II.
Collapse
|
47
|
Wu YY, Yu T, Yang XY, Li F, Ma L, Yang Y, Liu XG, Wang YY, Gong P. Vitamin D3 and insulin combined treatment promotes titanium implant osseointegration in diabetes mellitus rats. Bone 2013; 52:1-8. [PMID: 22985888 DOI: 10.1016/j.bone.2012.09.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/01/2012] [Accepted: 09/03/2012] [Indexed: 01/08/2023]
Abstract
This study investigated the effect of insulin and vitamin D(3) (VD(3)) treatment on implant osseointegration in diabetic mellitus (DM) rats. DM was induced by administration of streptozotocin in rats, which received implants insertion in the femur. Then animals were subjected to different treatment and divided to the following group: control, diabetic, insulin-treated diabetic, VD(3)-treated diabetic, insulin and VD(3) combination-treated diabetic rats. The glucose levels and weight of rats were periodically evaluated, and serum 25(OH)D(3) levels in rats were measured at the end of the experiment. Animals were sacrificed at 12 weeks after surgery, the peri-implant trabecular microstructure, implant fixation and implant osseointegration were measured by microscopic computerized tomography (micro-CT) evaluation, push-out test and histomorphometric analysis. Diabetic rats displayed significantly higher blood glucose level, lower body weight, lower serum 25(OH)D(3) levels, and less implant osseointegration than controls. Insulin treatment showed restorative effect on body weight and serum 25(OH)D(3) levels of diabetic rats, but the blood glucose level in diabetic rats were still substantially higher compared to controls after 14 days therapy of insulin. Combined treatment restored hyperglycemia in diabetic rats to be normal, and reversed the impaired osseointegration capacity of implants, with the bone volume ratio and percent osseointegration increased by 1.37-fold and 1.6-fold in micro-CT evaluation, the maximal push-out force and ultimate shear strength by 1.3-fold and 2.1-fold in push-out test, and the bone-to-implant contact and bone area ratio increased by 2.57-fold and 1.44-fold in histomorphometric analysis. Monotreatment also enhanced implant fixation, but less. These results indicated that insulin and VD(3) combined treatment may be an effective approach to enhance implant fixation in diabetic rats, but whether the results could be extrapolated to human needs further study.
Collapse
Affiliation(s)
- Ying-ying Wu
- State Key Laboratory of Oral Disease, Sichuan University, No. 14, Sec. 3, Renminnan Road, Chengdu 610041, Sichuan, People's Republic of China
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
Collapse
Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
| | | | | | | |
Collapse
|
49
|
Becker ST, Beck-Broichsitter BE, Graetz C, Dörfer CE, Wiltfang J, Häsler R. Peri-Implantitis versus Periodontitis: Functional Differences Indicated by Transcriptome Profiling. Clin Implant Dent Relat Res 2012; 16:401-11. [DOI: 10.1111/cid.12001] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Stephan T. Becker
- Department of Oral and Maxillofacial Surgery; Christian-Albrechts University of Kiel; Kiel Germany
| | | | - Christian Graetz
- Department of Conservative Dentistry and Periodontology; Christian-Albrechts University of Kiel; Kiel Germany
| | - Christof E. Dörfer
- Department of Conservative Dentistry and Periodontology; Christian-Albrechts University of Kiel; Kiel Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery; Christian-Albrechts University of Kiel; Kiel Germany
| | - Robert Häsler
- Institute of Clinical Molecular Biology; Christian-Albrechts University of Kiel; Kiel Germany
| |
Collapse
|
50
|
Akhavan A, Noroozi Z, Shafiei AA, Haghighat A, Jahanshahi GR, Mousavi SB. The effect of vitamin D supplementation on bone formation around titanium implants in diabetic rats. Dent Res J (Isfahan) 2012; 9:582-7. [PMID: 23559923 PMCID: PMC3612195 DOI: 10.4103/1735-3327.104877] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Diabetes has become the next most widespread disease after cancer. Recent studies have found that diabetes and moderate to severe vitamin D deficiency are associated with reduced bone mineral content; therefore administration of vitamin D may correct these conditions. The purpose of this research is to compare the effect of vitamin D administration on bone to implant contact in diabetic rats with control group. MATERIALS AND METHODS In this randomized placebo-controlled trial, 48 Wistar rats were rendered diabetic (130≤ blood sugar ≤200 mg/dl) by IV injection of 35 mg/kg Alloxan. Implants were inserted in tibial bone; Then rats were divided into study and control groups and received oral vitamin D3 (160 IU) or placebo respectively for one week. Bone to implant contact value was measured under light microscope at 3 and 6 weeks. RESULTS Analysis of data indicated that vitamin D had no significant effect on bone to implant contact (BIC). At 3 weeks, the control group (n = 5) reported BIC level at 44 ± 19 and study group (n = 7) at 57 ± 20. At 6 weeks, the control group (n = 5) reported BIC level at 70 ± 29, and study group (n = 10) at 65 ± 22. Twenty one samples were missed because of death or incorrect lab processes. CONCLUSION It seems that vitamin D supplement has no significant effect on BIC in 130 mg/dL ≤ blood sugar ≤200 mg/dL (P = 0.703) andwas also not time dependent (P = 0.074).
Collapse
Affiliation(s)
- Ali Akhavan
- Torabinejad Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Noroozi
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Abbas Shafiei
- Veterinary Surgeon, Private Practice, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Haghighat
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam Reza Jahanshahi
- Department of Oral Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Behrouz Mousavi
- Torabinejad Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|