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Panayotov IV, Végh AG, Martin M, Vladimirov B, Larroque C, Gergely C, Cuisinier FJG, Estephan E. Improving dental epithelial junction on dental implants with bioengineered peptides. Front Bioeng Biotechnol 2023; 11:1165853. [PMID: 37409165 PMCID: PMC10318435 DOI: 10.3389/fbioe.2023.1165853] [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: 02/14/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction: The functionalization of titanium (Ti) and titanium alloys (Ti6Al4V) implant surfaces via material-specific peptides influence host/biomaterial interaction. The impact of using peptides as molecular linkers between cells and implant material to improve keratinocyte adhesion is reported. Results: The metal binding peptides (MBP-1, MBP-2) SVSVGMKPSPRP and WDPPTLKRPVSP were selected via phage display and combined with laminin-5 or E-cadherin epithelial cell specific peptides (CSP-1, CSP-2) to engineer four metal-cell specific peptides (MCSPs). Single-cell force spectroscopy and cell adhesion experiments were performed to select the most promising candidate. In vivo tests using the dental implant for rats showed that the selected bi functional peptide not only enabled stable cell adhesion on the trans-gingival part of the dental implant but also arrested the unwanted apical migration of epithelial cells. Conclusion: The results demonstrated the outstanding performance of the bioengineered peptide in improving epithelial adhesion to Ti based implants and pointed towards promising new opportunities for applications in clinical practice.
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Affiliation(s)
- Ivan V. Panayotov
- LBN, University Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
| | - Attila G. Végh
- Biological Research Centre, Institute of Biophysics, Eötvös Lóránd Research Network (ELKH), Szeged, Hungary
| | - Marta Martin
- L2C, University Montpellier, CNRS, Montpellier, France
| | - Boyan Vladimirov
- Department of Maxillofacial Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Christian Larroque
- Department of Nephrology, CHU Montpellier, Hôpital Lapeyronie, IRMB, University of Montpellier, INSERM U1183, Montpellier, France
| | | | | | - Elias Estephan
- LBN, University Montpellier, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Spinato S, Bernardello F, Lombardi T, Soardi CM, Messina M, Zaffe D, Stacchi C. Influence of apico-coronal positioning of tissue-level implants on marginal bone stability during supracrestal tissue height establishment: A multi-center prospective study. Clin Implant Dent Relat Res 2022; 24:611-620. [PMID: 36000363 DOI: 10.1111/cid.13128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/24/2022] [Accepted: 08/06/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Supracrestal tissue height establishment is a crucial factor influencing peri-implant marginal bone modifications prior to prosthesis delivery. If mucosal thickness is insufficient, peri-implant marginal bone resorption occurs to allow appropriate supracrestal tissue height formation. This study evaluates if marginal bone resorption occurring around tissue-level implants before prosthetic loading could be compensated by adapting apico-coronal positioning to mucosal thickness. METHODS Patients requiring placement of one single implant in the posterior mandible were treated with tissue-level implants with a 3-mm high transmucosal machined component and moderately rough implant body. Based upon vertical mucosal thickness measured after buccal flap reflection, implants were placed with the treated part: (group 1) 2 mm below crestal level in presence of thin mucosa (<2.5 mm); (group 2) 1 mm below the crestal level in presence of medium mucosa (2.5-3.5 mm); (group 3) at equicrestal level in presence of thick mucosa (>3.5 mm). RESULTS Forty-nine implants, placed in 49 patients were included in final analysis (group 1: 18 implants; group 2: 16 implants; group 3: 15 implants). Mean marginal bone resorption after 5 months of healing was 0.66 ± 0.49 mm, 0.32 ± 0.41 mm, and 0.22 ± 0.52 mm in groups 1, 2, and 3, respectively. Inter-group analysis highlighted significant differences between the three groups after ANOVA test (p = 0.025). However, adaptation of apico-coronal implant positioning in relation to mucosal thickness, allowed to avoid early exposure of the treated surface in 100%, 93.7%, and 53.3% of the implants in groups 1, 2, and 3, respectively. CONCLUSION During supracrestal tissue height formation, tissue-level implants inserted adapting apico-coronal positioning in relation to mucosal thickness exhibited greater marginal bone resorption at sites with thin mucosa than at sites with medium or thick mucosa. However, anticipating supracrestal tissue height establishment by adapting apico-coronal implant positioning in relation to mucosal thickness may effectively prevent unwanted exposure of treated implant surface.
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Affiliation(s)
| | | | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | | | | | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Canullo L, Penarrocha Oltra D, Pesce P, Zarauz C, Lattanzio R, Penarrocha Diago M, Iezzi G. Soft tissue integration of different abutment surfaces: An experimental study with histological analysis. Clin Oral Implants Res 2021; 32:928-940. [PMID: 34036644 DOI: 10.1111/clr.13782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/21/2021] [Accepted: 05/12/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate whether abutment surface and surface bio-activation have an effect on soft tissue morphogenesis. MATERIALS AND METHODS 36 patients (36 implants) were included. Abutments were randomly divided into 4 groups (n = 9): Smooth Surface-MAChined (MAC), Ultrathin Threaded Microsurface (UTM), MAC Plasma of Argon activated (Plasma-MAC), and UTM Plasma of Argon activated (Plasma-UTM). After 2 months of healing, soft tissue samples were collected and prepared for histological analysis. The margin of the peri-implant mucosa (PM), the apical extension of the barrier epithelium (aJE), and the apical location of the abutment (AM) were identified. Significances of differences among groups were tested by means of the Kruskal-Wallis test and between pairs of results by means of the Mann-Whitney test. RESULTS The mean (SD) vertical dimension of the mucosa was 2.5mm (1.0), including a connective tissue portion (CTP) of 0.8mm (0.8) in the MAC group; 3.6mm (0.2) with a CTP of 1.6mm (0.4) in the Plasma-MAC group; 3.2mm (1.0), with a CPT of 0.5mm (0.6) in the UTM; and 3.3mm (0.8), with a CPT of 0.9mm (0.7) in the Plasma-UTM group. Statistically significant differences were observed in the aJE-AM height and PM-aJE profile among the four experimental groups (p = .042 and p = .039, respectively). The Mann-Whitney test indicated differences between the Plasma-abutments and the untreated abutments both for PM-AM (p = .025) and AjE-AM (p = .021). The differences appeared more evident when the preoperative soft tissue thickness was ≤2mm. CONCLUSIONS Within its limits, the study demonstrated a favorable effect of the plasma treatment on the connective tissue portion tissues. Plasma-MAC group highlighted the best performance. This behavior appeared strictly correlated with the soft tissue thickness.
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Affiliation(s)
- Luigi Canullo
- Department of Oral Surgery and Implants, University of Valencia, Valencia, Spain
| | | | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Cristina Zarauz
- Department of Fixed Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Rossano Lattanzio
- Department of Innovative Technologies in Medicine & Dentistry, Center for Advanced Studies and Technology (CAST), 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Oskarsson M, Otsuki M, Welander M, Abrahamsson I. Peri-implant tissue healing at implants with different designs and placement protocols: An experimental study in dogs. Clin Oral Implants Res 2018; 29:873-880. [PMID: 30009476 DOI: 10.1111/clr.13339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the peri-implant tissue response to subcrestal or crestal placement of implants with or without "platform-switched" implant/abutment connections. MATERIAL AND METHODS On each side of the mandible in six Labrador dogs, two "platform-switched" (PS) implants and two implants with matching implant/abutment diameters (PM) were placed in a crestal or a 1.5 mm subcrestal position. Sulcus formers/abutments were connected, baseline radiographs obtained and the distance between the abutment-fixture junction (A/F) and the marginal bone level (B) was determined. Five months later, radiographic and clinical examinations were repeated and biopsies were obtained and processed for histological analysis. RESULTS The radiographic analysis showed that marginal bone level changes occurred during the first observation period (13 weeks). PS-implants showed minor marginal bone level alterations during the full observation period (20 weeks), regardless of placement depth. For PM-implants, placement had a significant impact on bone level changes; crestal placement resulted in a mean bone loss of 0.4 mm and subcrestal placement in a 1.5 mm bone loss. The histometric measurements resulted in a distance A/F-B of 0.6 and 0.0 mm for PS implants, placed in a crestal or subcrestal position, respectively. The corresponding distance at PM-implants was 1.5 mm irrespective of placement protocol. The peri-implant mucosa was thicker at subcrestally placed implants as compared to a crestal placement. CONCLUSIONS Bone remodeling occurred within the early healing phase. During the full 20 weeks of observation, PS-implants demonstrated significantly less crestal bone loss compared to PM-implants.
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Affiliation(s)
- Monika Oskarsson
- Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Motohiro Otsuki
- Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Maria Welander
- Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ingemar Abrahamsson
- Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Canullo L, Caneva M, Tallarico M. Ten-year hard and soft tissue results of a pilot double-blinded randomized controlled trial on immediately loaded post-extractive implants using platform-switching concept. Clin Oral Implants Res 2016; 28:1195-1203. [DOI: 10.1111/clr.12940] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 01/09/2023]
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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.
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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
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Schweikert MT, Botticelli D, Sbricoli L, Antunes A, Favero V, Salata LA. Sequential Healing at Implants with Different Configuration and Modified Surfaces: An Experimental Study in the Dog. Clin Implant Dent Relat Res 2015; 18:439-48. [DOI: 10.1111/cid.12330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Daniele Botticelli
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
- UNESP - Faculty of Dentistry of Araçatuba; São Paulo State University; São Paulo Brazil
- ARDEC; Ariminum Odontologica; Rimini Italy
| | - Luca Sbricoli
- School of Dentistry; University of Padua; Padova Italy
| | - Antonio Antunes
- Faculty of Dentistry of Ribeirão Preto; São Paulo University (USP); São Paulo Brazil
| | | | - Luiz A. Salata
- Faculty of Dentistry of Ribeirão Preto; São Paulo University (USP); São Paulo Brazil
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Galindo-Moreno P, León-Cano A, Monje A, Ortega-Oller I, O'Valle F, Catena A. Abutment height influences the effect of platform switching on peri-implant marginal bone loss. Clin Oral Implants Res 2015; 27:167-73. [PMID: 25678247 DOI: 10.1111/clr.12554] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances. MATERIAL AND METHODS This retrospective study included 108 patients in whom 228 implants were placed, 180 with diameter of 4.5 mm and 48 with diameter of 5 mm. All patients received OsseoSpeed™ implants with internal tapered conical connection (Denstply Implants). Different mismatching distances were obtained, given that all implants were loaded with the same uni-abutment type (Lilac; Denstply Implants). Data were gathered on age, gender, bone substratum, smoking habits, previous history of periodontitis, and prosthetic features. MBL was analyzed radiographically at 6 and 18 months post-loading. RESULTS Mixed linear analysis of mesial and distal MBL values yielded significant effects of abutment, implant diameter, follow-up period, bone substratum, smoking, and abutment × time interaction. MBL was greater at 18 vs. 6 months, for short vs. long abutments, for grafted vs. pristine bone, for a heavier smoking habit, and for implants with a diameter of 5.0 vs. 4.5 mm. CONCLUSION Greater mismatching does not minimize the MBL; abutment height, smoking habit, and bone substratum may play a role in the MBL over the short- and medium term.
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Affiliation(s)
- Pablo Galindo-Moreno
- Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain
| | - Ana León-Cano
- Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Inmaculada Ortega-Oller
- Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain
| | - Francisco O'Valle
- Department of Pathology, School of Medicine & IBIMER, University of Granada, Granada, Spain
| | - Andrés Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
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Lee J, Fiorini T, Gamborena I, Wenzel BA, Schüpbach P, Wikesjö UME, Susin C. Effect of Platform Shift/Switch on Crestal Bone Levels and Mucosal Profile Following Flapless Surgery and Crestal/Subcrestal Implant Placement. Clin Implant Dent Relat Res 2014; 18:73-81. [PMID: 24889401 DOI: 10.1111/cid.12243] [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: 11/27/2022]
Abstract
BACKGROUND Crestal remodeling/bone loss appears a common sequel to dental implant placement. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocol uncertain. OBJECTIVE The objective of the present study was to provide a histologic record of crestal versus subcrestal implant placement on crestal remodeling and mucosal profile comparing platform shift/switch and standard abutments following flapless implant surgery using a dog model. METHODS Four dental implants each were placed into the left and right edentulated posterior mandibles in five adult male hound-Labrador mongrel dogs using a flapless approach including crestal versus subcrestal placement and using platform shift versus standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. RESULTS Both crestal and subcrestal implant installation resulted in significant crestal remodeling and bone loss, in particular at buccal sites, without significant differences between platform shift/switch and standard abutments. Implants installed subcrestally exhibited a significantly taller mucosal profile over crestal-level implants without significant differences between platform shift/switch and standard abutments; the epithelial attachment at all times arrested on the abutment surface. CONCLUSIONS Comparing platform shift/switch versus standard abutments using a minimally invasive flapless approach including crestal or subcrestal implant placement, the platform shift/switch abutments offer no selective advantage over standard abutments.
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Affiliation(s)
- Jaebum Lee
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Tiago Fiorini
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Inãki Gamborena
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA.,Clinica Dental Gamborena, San Sebastian, Spain
| | - Brent A Wenzel
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Peter Schüpbach
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA.,Peter Schüpbach GmbH, Horgen, Switzerland
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal and Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
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Alves CC, Muñoz F, Cantalapiedra A, Ramos I, Neves M, Blanco J. Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection--a dog model study. Clin Oral Implants Res 2014; 26:983-91. [PMID: 24735458 DOI: 10.1111/clr.12385] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The effect on the marginal peri-implant tissues following repeated platform switching abutment removal and subsequent reconnection was studied. MATERIAL AND METHODS Six adult female Beagle dogs were selected, and Pm3 and Pm4 teeth, both left and right sides, were extracted and the sites healed for 3 months. At this time, 24 bone level (BL) (Straumann, Basel, Switzerland) Ø 3.3/8 mm implants were placed, 2 in each side on Pm3 and Pm4 regions. In one side (control group), 12 bone level conical Ø 3.6 mm healing abutments and, on the other side (test group), 12 Narrow CrossFit (NC) multibase abutments (Straumann) , Basel, Switzerland) were connected at time of implant surgery. On test group, all prosthetic procedures were carried out direct to multibase abutment without disconnecting it, where in the control group, the multibase abutment was connected/disconnected five times (at 6/8/10/12/14 weeks) during prosthetic procedures. Twelve fixed metal bridges were delivered 14 weeks after implant placement. A cleaning/control appointment was scheduled 6 months after implant placement. The animals were sacrificed at 9 months of the study. Clinical parameters and peri-apical x-rays were registered in every visit. Histomorphometric analysis was carried out for the 24 implants. The distance from multibase abutment shoulder to the first bone implant contact (S-BIC) was defined as the primary histomorphometric parameter. RESULTS Wilcoxon comparison paired test (n = 6) found no statistically significant differences (buccal P = 0.917; Lingual P = 0.463) between test and control groups both lingually and buccally for S-BIC distance. Only Pm3 buccal aBE-BC (distance from the apical end of the barrier epithelium to the first bone implant contact) (P = 0.046) parameter presented statistically significant differences between test and control groups. Control group presented 0.57 mm more recession than test group, being this difference statistically significant between the two groups (P < 0.001). CONCLUSION It can be conclude, within the limits of this animal study, that the connection/disconnection of platform switching abutments during prosthetic phase of implant treatment does not induce bone marginal absorption. Furthermore, it may present a negative influence in the buccal connective tissue attachment that becomes shorter anyway preventing marginal hard tissue resorption, especially in thin biotypes.
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Affiliation(s)
- Célia C Alves
- Department of Estomatology, University of Santiago de Compostela, Santiago, Spain
| | - Fernando Muñoz
- School of Veterinary of Lugo, University of Santiago de Compostela, Santiago, Spain
| | | | - Isabel Ramos
- Department of Estomatology, University of Santiago de Compostela, Santiago, Spain
| | | | - Juan Blanco
- Department of Estomatology, University of Santiago de Compostela, Santiago, Spain
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Gamborena I, Lee J, Fiorini T, Wenzel BA, Schüpbach P, Wikesjö UME, Susin C. Effect of Platform Shift/Switch and Concave Abutments on Crestal Bone Levels and Mucosal Profile following Flap and Flapless Implant Surgery. Clin Implant Dent Relat Res 2014; 17:908-16. [PMID: 25881715 DOI: 10.1111/cid.12208] [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: 11/29/2022]
Abstract
BACKGROUND Crestal remodeling/bone loss appears to be a common sequel to dental implant placement. Several hypotheses/clinical strategies have been proposed to explain/avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of these clinical approaches uncertain. OBJECTIVE The objective of the present study was to provide a histological account of crestal bone levels and mucosal profile at platform shift/switch and concave abutments following flapless and conventional flap surgery and subcrestal implant placement using a dog model. METHODS Four dental implants each were placed in the left/right mandibular posterior jaw quadrants in five adult male Hound/Labrador mongrel dogs using flap surgery with a 1 × 5 mm gap defect or using a flapless approach, both involving placement 2 mm subcrestally and platform shift/switch versus concave abutments. Block biopsies for histological/histometric analysis were collected at 8 weeks. RESULTS No significant differences were observed regarding crestal bone levels, with all groups showing mean bone levels above the implant platform. Similarly, crestal bone-implant contact was not significantly different among groups. Moreover, peri-implant mucosal profiles were not statistically different among groups for buccal sites; average mucosal height reached 4.1 to 4.9 mm above the implant platform. Comparison between buccal and lingual sites showed a nonsignificant tendency toward greater crestal resorption at buccal sites, adjusting for other factors. Mean crestal bone-implant contact level approximated the implant platform for lingual sites while consistently remaining below the platform at the buccal sites. Peri-implant mucosal height was significantly higher at buccal than at lingual sites, with the epithelial attachment located a significant distance away from the implant platform at buccal sites. CONCLUSIONS The surgical approaches (subcrestal implant placement by flap surgery or a flapless approach) and abutment designs (platform shift/switch or concave) used in this study seem to have a limited impact on crestal remodeling, associated bone loss, and mucosal profile. Bioclinical strategies should be developed to circumvent the limitations of current clinical protocol.
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Affiliation(s)
- Inãki Gamborena
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA.,Clinica Dental Gamborena, San Sebastian, Spain
| | - Jaebum Lee
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Tiago Fiorini
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA.,Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Brent A Wenzel
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Peter Schüpbach
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA.,Peter Schüpbach GmbH, Horgen, Switzerland
| | - Ulf M E Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
| | - Cristiano Susin
- Laboratory for Applied Periodontal & Craniofacial Regeneration, Georgia Regents University, Augusta, GA, USA
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Wang YC, Kan JYK, Rungcharassaeng K, Roe P, Lozada JL. Marginal bone response of implants with platform switching and non-platform switching abutments in posterior healed sites: a 1-year prospective study. Clin Oral Implants Res 2014; 26:220-7. [PMID: 24383912 PMCID: PMC4309512 DOI: 10.1111/clr.12312] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This 1-year prospective study evaluated the implant success rate and marginal bone response of non-submerged implants with platform and non-platform switching abutments in posterior healed sites. MATERIAL AND METHODS Nineteen patients (9 male, 10 female) with posterior partially edentulous spaces, between the ages of 23 and 76 (mean = 55.4 years), were included in this study. A total of 30 implants (15 implants restored with platform switching [PS] abutments [control] and 15 implants restored with non-platform switching [NPS] abutments [test]) were assigned between two groups using a randomization procedure. The definitive abutments with conical connections were placed at the time of surgery, and the definitive restorations were placed at 3 months. All patients were evaluated clinically and radiographically using standardized radiographs at time of implant placement (0), 3, 6 and 12 months after implant placement. Data were analyzed using Friedman test with post hoc pairwise comparisons, Mann-Whitney U-test, and Pearson's chi-square test at the significance level of α = 0.05. RESULTS At 12 months, all 30 implants remained osseointegrated corresponding to a 100% success rate. The overall mean marginal bone level change at 12 months was -0.04 ± 0.08 mm for PS group and -0.19 ± 0.16 mm for NPS group. Statistically significant difference in the marginal bone level change was observed between groups at 0 to 12 months and 3 to 12 months (P < 0.05). CONCLUSIONS This 1-year randomized control study suggests that when a conical implant-abutment connection is present, similar peri-implant tissue responses can be achieved with platform switching and non-platform switching abutments.
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Affiliation(s)
- Yun-Chi Wang
- Advanced Education in Implant Dentistry, Loma Linda University, School of Dentistry, Loma Linda, CA, USA
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Rea M, Botticelli D, Ricci S, Soldini C, González GG, Lang NP. Influence of immediate loading on healing of implants installed with different insertion torques - an experimental study in dogs. Clin Oral Implants Res 2013; 26:90-5. [DOI: 10.1111/clr.12305] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Massimiliano Rea
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
| | - Daniele Botticelli
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
- Faculdade de Odontologia de Araçatuba; Universidade Estadual Paulista (UNESP); Araçatuba Brasil
- ARDEC; Ariminum Odontologica; Rimini Italy
- Prince Philip Dental Hospital; The University of Hong Kong; Hong Kong China
| | | | | | | | - Niklaus P. Lang
- Prince Philip Dental Hospital; The University of Hong Kong; Hong Kong China
- University of Zurich; Zurich Switzerland
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Bressan E, Lang NP, Corazza B, Ricci S, Almagro Urrutia Z, Botticelli D. The platform switching concept revisited. An experimental study in dogs. Clin Oral Implants Res 2013; 25:1200-6. [PMID: 24016300 DOI: 10.1111/clr.12262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the influence of the configuration of the marginal aspect of implants placed immediately into extraction sockets on peri-implant hard tissue adaptation. MATERIAL AND METHODS In 6 Labrador dogs, endodontic treatments of the mesial roots of 1 M1 were performed and the distal roots were removed. 2 P2 was extracted as well. Implants were immediately placed in the center of the distal alveoli. Cylindrical straight implants were installed in the right side of the mandible (Control), while, in the left side, implants with a reduced diameter in the coronal portion, yielding an indentation in the surface continuity (Test), were installed. Cover screws were affixed, and the flaps were sutured to allow non-submerged healing. After 4 months of healing, histological slides were obtained for assessments. RESULTS A buccal resorption of 1.58 ± 1.28 and 1.90 ± 1.93 mm at the control and of 0.26 ± 0.90 and 0.14 ± 0.66 mm at the test sites was observed at the premolar and molar regions, respectively. The buccal coronal level of osseointegration was located apically to the margin of the smooth/rough surface border by 2.40 ± 0.90 and 3.70 ± 0.87 mm at the control sites and 1.19 ± 0.45 and 2.16 ± 0.96 mm at the test sites at the premolar and molar sites, respectively. All differences yielded statistical significance. CONCLUSIONS The use of implants with a reduced diameter in their coronal aspect may contribute to preservation of the buccal bony crest in a more coronal level compared with conventional implants. Thus, the study confirmed the efficacy of the "platform switching" concept.
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Affiliation(s)
- Eriberto Bressan
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba; School of Dentistry, University of Padua, Padova, Italy
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