1
|
Deng C, Xiong C, Huo J, Liu Y, Man Y, Qu Y. Posterior open wound healing in immediate implant placement using reactive soft tissue versus absorbable collagen sponge: a retrospective cohort study. Int J Oral Maxillofac Surg 2024; 53:436-443. [PMID: 38103945 DOI: 10.1016/j.ijom.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/13/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
The soft and hard tissue healing of open wounds in immediate implant placement are yet to be explored. The aim of this study was to compare the clinical outcomes of open wound healing using reactive soft tissue (RST) and absorbable collagen sponge (ACS). Forty implants placed immediately in posterior sockets were included; autologous RST was used in 20 and ACS substitute was used in 20. Soft tissue healing was primarily assessed through a novel scoring system and the evaluation of gingival recession. The horizontal bone width (HBW) and interproximal marginal bone level (MBL) were measured on radiographs to observe the hard tissue healing. No significant difference in total soft tissue healing score was observed at 2 weeks postoperatively. Notably, the ACS group showed better tissue colour (P = 0.016) but worse fibrous repair (P = 0.043) scores than the RST group. Gingival recession levels were comparable in the two groups, both before tooth extraction and after placement of the restoration. Regarding hard tissue, HBW and MBL changes showed no intergroup differences. Within the limitations of this study, both RST and ACS seemed effective for open wound closure, achieving ideal soft and hard tissue healing in immediate implant placement.
Collapse
Affiliation(s)
- C Deng
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - C Xiong
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - J Huo
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Liu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Man
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Qu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
2
|
Chen Z, Li J, Wei CX, Mendonca G, Wang HL. Accuracy of open-sleeved vs. closed-sleeved static computer-assisted implant systems in immediate maxillary molar implant placement: An in vitro study. Clin Oral Implants Res 2024. [PMID: 38587183 DOI: 10.1111/clr.14265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The objective of this study is (1) to compare the accuracy of an open-sleeved static computer-assisted implant system (sCAIS) with a closed-sleeve sCAIS and free-hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. MATERIALS AND METHODS Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open-sleeves, sCAIS with closed-sleeves, and free-hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. RESULTS The 3D deviations of sCAIS were significantly influenced by the socket and sleeve types. Both guided groups exhibited significantly less deviation than the free-hand approach. Type A and C sockets resulted in better implant positions than type B socket sites. In type B sockets, the open-sleeve group achieved significantly less deviation compared to the closed-sleeve group, with respect to apical global (1.34 ± 0.53 vs. 1.84 ± 0.59 mm), coronal horizontal (0.68 ± 0.36 vs. 0.93 ± 0.34 mm), apical horizontal (1.21 ± 0.59 vs. 1.74 ± 0.63 mm), and angular (3.30 ± 1.41 vs. 4.41 ± 1.96°) deviations. CONCLUSIONS Guided implant surgery significantly reduces deviations during molar IIP compared to free-hand procedures. Furthermore, the use of open-sleeve sCAIS appears to be more effective in minimizing deviations in type B sockets when compared with the closed-sleeve guided system.
Collapse
Affiliation(s)
- Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Junying Li
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Chen Xuan Wei
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonca
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
3
|
Jia S, Wang G, Zhao Y, Wang X. Autonomous robotic system for the assisted immediate placement of a maxillary anterior implant: A clinical report. J Prosthet Dent 2024:S0022-3913(24)00196-3. [PMID: 38570281 DOI: 10.1016/j.prosdent.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 04/05/2024]
Abstract
Precise reproduction of the preoperatively designed 3-dimensional (3D) implant position is key to seating a prefabricated restoration and restoring esthetics. Static and dynamic computer-aided implant surgery (CAIS) based on the fusion of 3D imaging files have been used to improve implant accuracy. However, both techniques have shortcomings that can be remedied by a robotic system. This clinical report describes the immediate placement of an implant in the anterior esthetic zone by using an autonomous dental implant robotic system (ADIR).
Collapse
Affiliation(s)
- Shasha Jia
- Postgraduate student, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, China; School of Stomatology, Qingdao University, Qingdao, PR China
| | - Guowei Wang
- Associate Professor, Department of Stomatology, No. 971 Hospital of the Chinese Navy, Qingdao, Shandong, PR China
| | - Yimin Zhao
- Professor, Department of Prosthodontics, School of Stomatology, Air Force Medical University, Shannxi, PR China
| | - Xiaojing Wang
- Professor, Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, PR China; School of Stomatology of Qingdao University. Qingdao, PR China; Department of Stomatology, Lingshui Li Autonomous County People's Hospital, Lingshui, Hainan, China.
| |
Collapse
|
4
|
Godani A, Iyer J, Nadgere J, Mohite A, Gaikwad A. Impact of immediate interim restoration on peri-implant tissues around immediately placed single dental implants in the esthetic region: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00045-3. [PMID: 38355364 DOI: 10.1016/j.prosdent.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
STATEMENT OF PROBLEM Immediate implant placement with an immediate interim restoration is a well-established protocol. Nevertheless, a consensus regarding the impact of immediate interim restoration on peri-implant tissues around single dental implants is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to address the research question: "Does the placement of an immediate interim restoration influence the mid-facial mucosal (MFM) marginal and interdental papilla (IDP) levels around single dental implants placed in the anterior esthetic region by using an immediate implant placement protocol?" MATERIAL AND METHODS A comprehensive literature search was made in the Medline/PubMed, Scopus, Cochrane, and Science Direct electronic databases for articles published in English evaluating the impact of immediate interim restoration on peri-implant tissues around single dental implants in the anterior esthetic region. The primary outcomes assessed were changes in the MFM marginal and IDP levels. Additional outcomes were marginal bone (MB) loss, esthetic outcomes involving the pink and white esthetic scores (PES and WES), implant survival rates, and patient reported outcome measures (PROMs). The risk of bias assessment was performed by using the RoB 2 tool for randomized trials and the Newcastle-Ottawa scale for nonrandomized studies. Meta-analysis was performed by using random and fixed effects model (α=.05) in the RevMan software program. RESULTS Sixteen studies were included that analyzed 836 single dental implants involving 823 patients. The meta-analysis showed no significant differences in implants with and without interim restoration in terms of MFM marginal level (MD=0.01; 95% CI=-1.23 to 1.25; P=.98), mesial IDP level (MD=0.12; 95% CI=-0.23 to 0.47; P=.50), distal IDP level (MD=0.20; 95% CI=-0.40 to 0.79; P=.52), and MB loss (MD=0.01; 95% CI=-0.42 to 0.43; P=.97). The systematic analysis for survival rates determined no notable difference in implants with or without an interim restoration. However, the esthetic outcomes and PROMs substantially improved with immediate interim restorations. The RoB 2 tool showed a moderate to low risk of bias, and the Newcastle-Ottawa scale indicated high-quality studies. CONCLUSIONS After a 12-month follow-up, immediate interim restoration had no significant impact on peri-implant soft (MFM marginal and IDP levels) and hard tissues (MB loss) around immediately placed single dental implants. Nevertheless, additional well-designed and well-implemented clinical trials with long-term follow-up periods are needed to provide more precise evidence-based recommendations.
Collapse
Affiliation(s)
- Aashi Godani
- Postgraduate student, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani Iyer
- Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Jyoti Nadgere
- Professor and Head, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Anuradha Mohite
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Amit Gaikwad
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India; Doctoral Researcher, Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany; and Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hanover Medical School, Hanover, Germany
| |
Collapse
|
5
|
Muzikin MI, Iordanishvili AK, Losev FF, Grigoriev SG. [Reparative potential of bone tissue and associated influencing factors]. STOMATOLOGIIA 2024; 103:41-49. [PMID: 38741534 DOI: 10.17116/stomat202410302141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The aim of the sthudy. To study the influence of general and local factors on the regenerative potential of bone tissue to optimize augmentation mechanisms in the treatment of jaw atrophy. MATERIALS AND METHODS The influence of general and local factors on the regenerative potential of the bone during the augmentation operation of the alveolar process (part) of the jaw in 68 patients was studied. The survival rate of dental implants and the incidence of complications after completion of dental rehabilitation in the long-term follow-up period (more than 5 years) were evaluated. 18 indicators were studied, which were evaluated by qualitative and quantitative methods. The study of the effect of indicators on regeneration was carried out using an accurate Fischer test for conjugacy tables. The assessment of the strength of the influence was calculated as the ratio of the chances of developing an unfavorable outcome of bone grafting and dental implantation. RESULTS He highest chances of developing adverse outcomes were found in smoking patients with diabetes mellitus, high body mass index, low survival of bone walls, severe bone atrophy (5.6 and higher class according to Cawood & Howell), three-dimensional bone defect, in the absence of 3 or more bone walls, the presence of subcompensated and decompensated psychological state the patient. In the course of histological examination, the influence of these factors on the mechanisms of reparative osteogenesis morphologically manifested a lower degree of progress of regenerative processes and a lower degree of maturity of bone tissue. CONCLUSION To reduce the chances of developing an unfavorable outcome, in the presence of negative general and local factors, it is not advisable to use dental implantation simultaneously with bone augmentation procedures. In order to reduce the pathophysiological impact of negative factors during sinus lifting, increase the proportion of autosteal material for potentiating the metabolic activity of bone tissue, as well as prescribe antioxidant, antihypoxant and membrane stabilizing therapy before surgery and in the early postoperative period.
Collapse
Affiliation(s)
- M I Muzikin
- Saint-Petersburg Medico-Social Institute, St. Petersburg, Russia
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia
- S.M. Kirov Military-Medical Academy, St. Petersburg, Russia
| | - A K Iordanishvili
- Saint-Petersburg Medico-Social Institute, St. Petersburg, Russia
- S.M. Kirov Military-Medical Academy, St. Petersburg, Russia
- I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - F F Losev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - S G Grigoriev
- S.M. Kirov Military-Medical Academy, St. Petersburg, Russia
| |
Collapse
|
6
|
Lin X, Yu X, Wang F, Wu Y. Marginal bone level change of immediately restored implants with simultaneous guided bone regeneration: A systematic review. Clin Implant Dent Relat Res 2023; 25:1112-1137. [PMID: 37555385 DOI: 10.1111/cid.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
AIM To assess marginal bone level change (MBLc), clinical outcomes for soft tissue, and survival rates for immediately restored implants with simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS Electronic and manual searches were conducted in PubMed/MEDLINE, EMBASE, and CENTRAL for studies that investigated immediately restored implants in simultaneously grafted sites with a mean follow-up of over 12 months. MBLc was the primary outcome. Soft tissue clinical parameters and implant survival rate (ISR) were the secondary outcomes. RESULTS Twenty-five studies (5 randomized controlled trials, 6 prospective studies, 2 retrospective studies, and 12 case series) were included, from which 692 immediately restored implants were analyzed. For studies that investigated bone grafts in the gap between the implant and the peripheral bone wall, the weighted mean MBLc was -0.73 ± 1.52 mm (range: -1.50 to 0.26 mm) for 475 implants. Pink esthetic score (PES) was improved in eight studies and the weighted cumulative ISR was 98.99% (Median: 100%) in 622 implants. Mean MBLc was -1.19 ± 0.26 mm for 30 implants in studies that reported gap with dehiscence and/or fenestration augmentation. Weighted cumulative ISR was 97.25% in 70 implants. A meta-analysis was not possible due to the lack of studies with an eligible control group. Therefore, the data should be interpreted with caution. CONCLUSION Less marginal bone loss and more predictable soft tissue parameters can be achieved for immediately restored implants with simultaneous peri-implant gap filling compared with gap with dehiscence/fenestration grafting. Increased ISR for implants with gap filling was observed. However, more evidence is needed to confirm whether immediate provisional prostheses should be utilized when bone defects are simultaneously augmented around the implants.
Collapse
Affiliation(s)
- Xinyan Lin
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinbo Yu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Wang
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yiqun Wu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| |
Collapse
|
7
|
Zhang H, Yuan Y, Wu X, Xue H, Yu R, Huang H. Application of Immediate Implant Placement Techniques in Peri-implantitis Modeling. J Craniofac Surg 2023; 34:2544-2550. [PMID: 37427926 DOI: 10.1097/scs.0000000000009515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 05/17/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES To explore the use of immediate implant placement technique in peri-implantitis modeling, shorten the modeling period, and obtain similar effects. MATERIALS AND METHODS Eighty rats were divided into 4 groups: immediate placement (IP), delayed placement (DP), IP-ligation (IP-L) and DP-ligation (DP-L). In the DP and DP-L groups, implants were placed 4 weeks after tooth extraction. In the IP and IP-L groups, implants were placed immediately. Four weeks later, the implants were ligated to induce peri-implantitis in the DP-L and IP-L groups. RESULTS Nine implants were lost (3 in the IP-L and 2 each in the IP, DP, and DP-L group). The bone level decreased after ligation, and the buccal and lingual bone levels were lower in IP-L versus DP-L. The implant pullout strength was decreased after ligation. Micro-CT showed bone parameters were decreased after ligation, and the percent bone volume was higher in IP versus DP. Histology showed that the percent of CD4 + cells and IL-17 + cells was increased after ligation and higher in IP-L versus DP-L. CONCLUSIONS We successfully introduced immediate implant placement into the modeling of peri-implantitis and observed similar bone resorption and more soft tissue inflammation in a shorter time.
Collapse
Affiliation(s)
- Hongming Zhang
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Yun Yuan
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Xiaolin Wu
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Hanxiao Xue
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Runping Yu
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Hui Huang
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
| |
Collapse
|
8
|
Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
Collapse
Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
9
|
De Souza AB, Papaspyridakos P, Weber HP, Vazouras K, Matarazzo F. Effect of dental implant therapy on the preservation of orofacial tissues: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:240-256. [PMID: 37750525 DOI: 10.1111/clr.14106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Fundamentally, this review addresses the following question: In partially or fully edentulous patients, do implant-supported dental prostheses preserve orofacial tissues when compared to conventional prostheses or no therapy? MATERIALS AND METHODS This study was conducted according to the 2020 PRISMA guidelines for systematic reviews. Electronic searches were conducted at PubMed and Embase databases followed by manual search. Clinical studies comparing the effect of implant-supported prostheses with conventional rehabilitation or no treatment on alveolar bone resorption, remaining teeth, and jaw muscle thickness were considered for inclusion. A qualitative synthesis was conducted with all included studies, and data from selected studies were pooled quantitatively to perform a meta-analysis. RESULTS A total of 14 studies were selected for analysis. Six studies reported on the effect of implant therapy on alveolar bone resorption (n = 453), six on the remaining teeth (n = 1014), while four studies evaluated masseter muscle thickness (n = 158). The results of the meta-analyses assessing alveolar bone resorption in the posterior mandible and in the anterior area of the maxilla, both fixed and random effects models, yielded no benefit of rehabilitation with implant-supported prostheses when compared to conventional prostheses. For masseter bone thickness, however, a significant benefit for implant-supported prosthesis was observed. CONCLUSIONS This systematic review and meta-analysis were unable to unequivocally answer the focus question. There are some indicators of the benefit of implant-supported prostheses over conventional prostheses or no therapy in preserving orofacial tissues, particularly for masseter muscle thickness. However, the evidence is still insufficient to confirm such perception.
Collapse
Affiliation(s)
- André B De Souza
- Department of Periodontology, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| |
Collapse
|
10
|
Amid R, Kadkhodazadeh M, Moscowchi A. Immediate implant placement in compromised sockets: A systematic review and meta-analysis. J Prosthet Dent 2023; 130:307-317. [PMID: 34772483 DOI: 10.1016/j.prosdent.2021.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the treatment outcome in terms of the implant survival rate and success parameters of immediate implant placement in compromised extraction sockets. MATERIAL AND METHODS An electronic search was conducted in PubMed, Embase, Cochrane Library, and ISI Web of Science up to January 2021. Studies evaluating implant survival rate and main success parameters were included for a qualitative and quantitative analysis (risk ratio and mean difference). RESULTS In total, 43 studies with analysis of 4825 sockets were included. Compared with the noncompromised sockets, the compromised group showed no significant differences in implant survival rates (risk ratio=0.992; 95% confidence interval (CI)=0.979 to 1.005; P=.246). No significant statistical differences were found in marginal bone level at ≤12 months (mean difference [MD]=0.033; 95% CI=-0.012 to 0.078; P=.154) or esthetic parameters. CONCLUSIONS Immediate implant placement in compromised sites does not appear to decrease the survival and success rates. However, randomized clinical trials with large sample sizes should be conducted to draw a definite conclusion about the efficacy and safety of this treatment protocol in compromised sockets.
Collapse
Affiliation(s)
- Reza Amid
- Associate Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Assistant Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
11
|
Comuzzi L, Tumedei M, Di Pietro N, Romasco T, Heydari Sheikh Hossein H, Montesani L, Inchingolo F, Piattelli A, Covani U. A Comparison of Conical and Cylindrical Implants Inserted in an In Vitro Post-Extraction Model Using Low-Density Polyurethane Foam Blocks. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5064. [PMID: 37512339 PMCID: PMC10384017 DOI: 10.3390/ma16145064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15-20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey's post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT.
Collapse
Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemiano-Conegliano, 31020 Treviso, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Hamid Heydari Sheikh Hossein
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Villa Serena Foundation for Research, Via Leonardo Petruzzi 42, 65013 Città Sant'Angelo, Italy
| | | | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
| |
Collapse
|
12
|
Praveen AA, Venkadassalapathy S, Victor DJ, Prakash PSG, Umesh SG, Ali Baeshen H, Balaji TM, Patil S, Reda R, Testarelli L. Efficacy of Two Different Hydrodynamic Sinus Lift Systems for Atraumatic Elevation in Immediate Implant Placement. Patient Prefer Adherence 2023; 17:1197-1207. [PMID: 37180467 PMCID: PMC10167956 DOI: 10.2147/ppa.s403036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/03/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose To evaluate the efficacy of two hydrodynamic sinus lifting procedures and to successfully place immediate implants in maxillary posterior sites that have a compromised native bone as a result of periodontal or endodontic disease. Patients and Methods A total of 26 patient sites were enrolled with 13 sites each in the Minimally Invasive Antral Membrane Balloon Elevation (MIAMBE) and Drill Integrated Hydrodynamics for the transcrestal sinus floor elevation (DIHSFE) groups who received transcrestal sinus floor elevation followed by immediate implant placement. Clinical parameters such as sinus membrane perforations, nasal bleeding, postoperative sinusitis, VAS scores at Day-7 for pain and discomfort, primary implant stability and time taken were evaluated. Results The DIHSFE had greater sinus membrane perforations and incidence of nasal bleeding when compared with MIAMBE with (p = 0.066) and (p = 0.141). Post-operative sinusitis was evident in both the groups with (p = 0.619). The mean VAS score was statistically significant between both the groups (p ≤ 0.005). The insertion torque values, and mean time taken for surgical procedure was not statistically significant between groups. Conclusion The present study highlighted that MIAMBE is superior to DIHSFE in its ability to cause less severe patient morbidities and post-operative complications.
Collapse
Affiliation(s)
| | | | | | - P S G Prakash
- Department of Periodontics, SRM Dental College, Chennai, TN, India
| | | | - Hosam Ali Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | | | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, 84095, USA
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
| |
Collapse
|
13
|
Quisiguiña Salem C, Ruiz Delgado E, Crespo Reinoso PA, Robalino JJ. Alveolar ridge preservation: A review of concepts and controversies. Natl J Maxillofac Surg 2023; 14:167-176. [PMID: 37661984 PMCID: PMC10474543 DOI: 10.4103/njms.njms_224_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 09/05/2023] Open
Abstract
The loss of thickness and height of the alveolar process after tooth extraction is a significant impediment to implant placement, which limits the aesthetic results of many restorative treatments. Alveolar ridge preservation can reduce bone resorption. Knowing how beneficial this procedure is can help clinicians decide if it is worth doing. The purpose of this article is to present a contemporary review of the different approaches to preserving the dimensions of the alveolar ridge. We analyze the alveolar healing process, atraumatic extraction techniques, graft materials, and controversies.
Collapse
Affiliation(s)
- Cinthya Quisiguiña Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
| | - Emilio Ruiz Delgado
- Department of Prosthodontics and Implantology, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - Pablo A. Crespo Reinoso
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - James Jerez Robalino
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
| |
Collapse
|
14
|
Menchini-Fabris GB, Cosola S, Toti P, Hwan Hwang M, Crespi R, Covani U. Immediate Implant and Customized Healing Abutment for a Periodontally Compromised Socket: 1-Year Follow-Up Retrospective Evaluation. J Clin Med 2023; 12:jcm12082783. [PMID: 37109120 PMCID: PMC10144425 DOI: 10.3390/jcm12082783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/02/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (-0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients' rehabilitation and soft tissue preservation to replace a hopeless tooth.
Collapse
Affiliation(s)
- Giovanni-Battista Menchini-Fabris
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- San Rossore Dental Unit, San Rossore Private Hospital, 56122 Pisa, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Saverio Cosola
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
| | - Paolo Toti
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Myoung Hwan Hwang
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- New Smiles Dental Implant Center Galleria, 2930 Chimney Rock Rd, Houston, TX 77057, USA
| | - Roberto Crespi
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| |
Collapse
|
15
|
Gehrke SA, Scarano A, Cortellari GC, Fernandes GVO, Mesquita AMM, Bianchini MA. Marginal Bone Level and Biomechanical Behavior of Titanium-Indexed Abutment Base of Conical Connection Used for Single Ceramic Crowns on Morse-Taper Implant: A Clinical Retrospective Study. J Funct Biomater 2023; 14:jfb14030128. [PMID: 36976052 PMCID: PMC10057670 DOI: 10.3390/jfb14030128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
The goal of this retrospective clinical study was to evaluate the behavior of Morse-taper indexed abutments by analyzing the marginal bone level (MBL) after at least 12 months of function. Patients rehabilitated with single ceramic crowns between May 2015 and December 2020 received single Morse-taper connection implants (DuoCone implant) with two-piece straight abutment baseT used for at least 12 months, presenting periapical radiograph immediately after crown installation were enrolled. The position of the rehabilitated tooth and arch (maxilla or mandible), crown installation period, implant dimensions, abutment transmucosal height, installation site (immediate implant placement or healed area), associated with bone regeneration, immediate provisionalization, and complications after installation of the final crown were analyzed. The initial and final MBL was evaluated by comparing the initial and final X-rays. The level of significance was α = 0.05. Seventy-five patients (49 women and 26 men) enrolled had a mean period of evaluation of 22.7 ± 6.2 months. Thirty-one implant-abutment (IA) sets had between 12–18 months, 34 between 19–24 months, and 44 between 25–33 months. Only one patient failed due to an abutment fracture after 25 months of function. Fifty-eight implants were placed in the maxilla (53.2%) and 51 in the mandible (46.8%). Seventy-four implants were installed in healed sites (67.9%), and 35 were in fresh socket sites (32.1%). Thirty-two out of these 35 implants placed in fresh sockets had the gap filled with bone graft particles. Twenty-six implants received immediate provisionalization. The average MBL was −0.67 ± 0.65 mm in mesial and −0.70 ± 0.63 mm in distal (p = 0.5072). The most important finding was the statistically significant difference comparing the values obtained for MBL between the abutments with different transmucosal height portions, which were better for abutments with heights greater than 2.5 mm. Regarding the abutments’ diameter, 58 had 3.5 mm (53.2%) and 51 had 4.5 mm (46.8%). There was no statistical difference between them, with the following means and standard deviation, respectively, −0.57 ± 0.53 mm (mesial) and −0.66 ± 0.50 mm (distal), and −0.78 ± 0.75 mm (mesial) and −0.746 ± 0.76 mm (distal). Regarding the implant dimensions, 24 implants were 3.5 mm (22%), and 85 implants (78%) had 4.0 mm. In length, 51 implants had 9 mm (46.8%), 25 had 11 mm (22.9%), and 33 implants were 13 mm (30.3%). There was no statistical difference between the abutment diameters (p > 0.05). Within the limitations of this study, it was possible to conclude that better behavior and lesser marginal bone loss were observed when using abutment heights greater than 2.5 mm of transmucosal portion and when placed implants with 13 mm length. Furthermore, this type of abutment showed a little incidence of failures within the period analyzed in our study.
Collapse
Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n., 03202 Elche, Spain
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
- Department of Materials Engineering, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, Brazil
- Correspondence: (S.A.G.); (G.V.O.F.); Tel./Fax: +598-29015634 (S.A.G.)
| | - Antonio Scarano
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
- Correspondence: (S.A.G.); (G.V.O.F.); Tel./Fax: +598-29015634 (S.A.G.)
| | | | - Marco Aurélio Bianchini
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis 88040-900, Brazil
| |
Collapse
|
16
|
Liu J, Hua F, Zhang H, Hu J. Influence of using collagen on the soft and hard tissue outcomes of immediate dental implant placement: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101385. [PMID: 36642247 DOI: 10.1016/j.jormas.2023.101385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/10/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To compare the effects of bone grafting materials, collagen-infused grafting materials, and no grafting materials on the soft and hard tissue outcomes when an immediate implant is placed. MATERIALS AND METHODS In addition to hand searching, electronic searches were performed in Pubmed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Only RCTs were included in our review. The Cochrane ROB 2.0 tool was used to assess the risk of bias (ROB). Two subgroups were used to evaluate implant failure rate, buccal bone resorption, soft tissue thickness, and esthetic scores. In the meta-analysis, both the fixed-effects model and the random-effects model were employed. RESULT 7 RCTs were selected after screening 580 studies, and 205 patients were included in the review, with 279 implants. Two RCTs were at low bias of risk, three were at moderate bias, and two were deemed at high risk of bias. The failure rate (95% CI: 0.17 to 11.84) and soft tissue thickness were not significantly different between collagen with bone grafting materials and without bone grafting materials. On the basis of the failure rate and buccal bone thickness, there was no significant difference between collagen with bone grafting materials and bone grafting materials. While we found collagen with bone grafting materials could have a significant advantage on the buccal bone thickness (MD: -0.43,95% CI -0.72 to -0.41) and esthetic outcome (MD: -1.23,95% CI -1.90 to -0.55). CONCLUSION In the statement of immediate implant implantation, the thickness of the buccal bone and esthetic outcomes did significantly benefit from bone grafting materials with collagen inserted in the "jumping gap".
Collapse
Affiliation(s)
- Jingmei Liu
- Department of Prosthodontics Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Haiwen Zhang
- Department of Prosthodontics Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jian Hu
- Department of Prosthodontics Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| |
Collapse
|
17
|
Can the Immediate Implantation With Immediate Loading Achieve an Acceptable Esthetic Outcome? A Prospective Observational Clinical Study. J Craniofac Surg 2023; 34:e79-e84. [PMID: 35996220 DOI: 10.1097/scs.0000000000008876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/04/2022] [Indexed: 01/11/2023] Open
Abstract
The trending protocol in implantology aims at integrating the esthetic on par with function while reducing discomfort and treatment time with optimal results. The purpose of this study was to evaluate the pink esthetic score in sites treated by graftless instant implantation that was boosted by instant provisionalization with a 2 to 3 mm jumping distance. Thirty-five implants were inserted in the extraction sockets of teeth of 29 healthy qualified patients (22 females and 7 males) with an age range of 23 to 60 years [mean±SD age 41.11±9.9 y). Preoperative assessment was complemented clinically and radiographically for each patient. The used system was Medentika dental implant (Germany). Osstell implant stability quotient was used to measure implant stability at the time of surgery (baseline) and at 16 weeks. Four implants in 3 patients failed. The implant survival rate was 88.6%. The protocol of this study produced a significant decrease in the jumping distance which is 2 to 3 mm at cone-beam computed tomography evaluation with satisfactory esthetic outcomes clinically. Further comparative studies with long-term and larger samples are needed to confirm the conclusion of this study.
Collapse
|
18
|
Platelet-Rich Plasma Lysate-Incorporating Gelatin Hydrogel as a Scaffold for Bone Reconstruction. Bioengineering (Basel) 2022; 9:bioengineering9100513. [PMID: 36290482 PMCID: PMC9598158 DOI: 10.3390/bioengineering9100513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
In implant dentistry, large vertical and horizontal alveolar ridge deficiencies in mandibular and maxillary bone are challenges that clinicians continue to face. One of the limitations of porous blocks for reconstruction of bone in large defects in the oral cavity, and in the musculoskeletal system, is that fibrin clot does not adequately fill the interior pores and does not persist long enough to accommodate cell migration into the center of the block. The objective of our work was to develop a gelatin-based gel incorporating platelet-rich plasma (PRP) lysate, to mimic the role that a blood clot would normally play to attract and accommodate the migration of host osteoprogenitor and endothelial cells into the scaffold, thereby facilitating bone reconstruction. A conjugate of gelatin (Gtn) and hydroxyphenyl propionic acid (HPA), an amino-acid-like molecule, was commended for this application because of its ability to undergo enzyme-mediated covalent cross-linking to form a hydrogel in vivo, after being injected as a liquid. The initiation and propagation of cross-linking were under the control of horseradish peroxidase and hydrogen peroxide, respectively. The objectives of this in vitro study were directed toward evaluating: (1) the migration of rat mesenchymal stem cells (MSCs) into Gtn–HPA gel under the influence of rat PRP lysate or recombinant platelet-derived growth factor (PDGF)-BB incorporated into the gel; (2) the differentiation of MSCs, incorporated into the gel, into osteogenic cells under the influence of PRP lysate and PDGF-BB; and (3) the release kinetics of PDGF-BB from gels incorporating two formulations of PRP lysate and recombinant PDGF-BB. Results: The number of MSCs migrating into the hydrogel was significantly (3-fold) higher in the hydrogel group incorporating PRP lysate compared to the PDGF-BB and the blank gel control groups. For the differentiation/osteogenesis assay, the osteocalcin-positive cell area percentage was significantly higher in both the gel/PRP and gel/PDGF-BB groups, compared to the two control groups: cells in the blank gels grown in cell expansion medium and in osteogenic medium. Results of the ELISA release assay indicated that Gtn–HPA acted as an effective delivery vehicle for the sustained release of PDGF-BB from two different PRP lysate batches, with about 60% of the original PDGF-BB amount in the two groups remaining in the gel at 28 days. Conclusions: Gtn–HPA accommodates MSC migration. PRP-lysate-incorporating hydrogels chemoattract increased MSC migration into the Gtn–HPA compared to the blank gel. PRP-lysate- and the PDGF-BB-incorporating gels stimulate osteogenic differentiation of the MSCs. The release of the growth factors from Gtn–HPA containing PRP lysate can extend over the period of time (weeks) necessary for bone reconstruction. The findings demonstrate that Gtn–HPA can serve as both a scaffold for cell migration and a delivery vehicle that allows sustained and controlled release of the incorporated therapeutic agent over extended periods of time. These findings commend Gtn–HPA incorporating PRP lysate for infusion into porous calcium phosphate blocks for vertical and horizontal ridge reconstruction, and for other musculoskeletal applications.
Collapse
|
19
|
A Novel Muco-Gingival Approach for Immediate Implant Placement to Obtain Soft- and Hard-Tissue Augmentation. J Clin Med 2022; 11:jcm11174985. [PMID: 36078914 PMCID: PMC9456498 DOI: 10.3390/jcm11174985] [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: 07/12/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
The aim of this article is to describe a novel approach combining muco-gingival, regenerative and prosthetics concepts for immediate implant insertion that overcomes the limits traditionally considered as contraindications for Type 1 flapless implant positioning, simultaneously obtaining soft- and hard-tissue augmentation. After pre-surgical CBCT evaluation, the surgical technique consisted in the execution of a lateral-approach coronally advanced envelope flap, with oblique submarginal interproximal incisions directed towards the flap’s center of rotation (the tooth to be extracted); after buccal-flap elevation, the atraumatic extraction of the tooth was performed. Following guided implant insertion, a mixture of biomaterial and autologous bone was placed, stabilized by a pericardium membrane and a connective-tissue graft sutured in the inner aspect of the buccal flap. The peri-implant soft tissues were conditioned with a provisional crown until the shape and position for the mucosal scallop to resemble the gingival margin of the adjacent corresponding tooth were obtained; then, the definitive screw-retained restoration was placed. Within the limitations of this case report, the proposed immediate implant placement approach combining CTG application and buccal bone regeneration showed the possibility of obtaining 1-year-follow-up implant success, stable bone level, good esthetic results and high patient satisfaction.
Collapse
|
20
|
Araújo MG, Hürzeler MB, Dias DR, Matarazzo F. Minimal invasiveness in the alveolar ridge preservation, with or without concomitant implant placement. Periodontol 2000 2022; 91:65-88. [PMID: 35913046 DOI: 10.1111/prd.12441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
The aim of this systematic review was to evaluate the benefit of ridge preservation (RP) with minimally invasive (MI) approaches with or without concomitant implant placement on morbidity, esthetics, and patient-related outcomes. Three Internet sources were used to search for appropriate papers. The search strategy was designed to include any clinical study published on RP with MI approaches such as flapless surgery, socket shield and socket sealing techniques and, use of biological agents. Characteristics of the individual studies, regarding methodological aspects, quantitative and qualitative data were extracted. The potential risk of bias was estimated, and the acquired evidence was graded. Independent screening of 860 reports resulted in 26 included original articles. Nine publications evaluated MI approaches for RP without concomitant implant placement. Eleven studies evaluated interventions for RP with immediate implant placement (IIP). Six studies compared RP with IIP vs RP without IIP. This systematic review found that MI approaches in most of the studies failed to improve clinical variables regarding morbidity, esthetics, and patient-related outcomes. Based on the limited number of studies analyzed and the methodological discrepancies observed, it is not possible to confirm that MI approaches promote a significant benefit when applied to RP procedures.
Collapse
Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Markus B Hürzeler
- Private Practice Hürzeler/Zuhr, Munich, Germany.,Department of Operative Dentistry and Periodontology, Albert Ludwigs University, Freiburg, Germany
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| |
Collapse
|
21
|
What Does Bone Corticalization around Dental Implants Mean in Light of Ten Years of Follow-Up? J Clin Med 2022; 11:jcm11123545. [PMID: 35743625 PMCID: PMC9225429 DOI: 10.3390/jcm11123545] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/06/2023] Open
Abstract
The phenomenon of peri-implant bone corticalization after functional loading does not yet have a definite clinical significance and impact on prognosis. An attempt was made to assess the clinical significance of this phenomenon. This prospective study included 554 patients. Standardized intraoral radiographs documenting the jawbone environment of 1556 implants were collected. The follow-up period was 10 years of functional loading. Marginal alveolar bone loss (MBL) and radiographic bone structure (bone index, BI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. After five years, bone structure abnormalities expressed by a reduction of BI to 0.47 ± 0.21 and MBL = 0.88 ± 1.27 mm were observed. Both values had an inverse relationship with each other (p < 0.0001). Reference cancellous bone showed BI = 0.85 ± 0.18. The same relationship was observed after ten years of functional loading: BI = 0.48 ± 0.21, MBL = 1.49 ± 1.94 mm, and again an inverse relationship (p < 0.0001). Increasing corticalization (lower BI) is strongly associated with increasing marginal bone loss and increasing corticalization precedes future marginal bone loss. Marginal bone loss will increase as corticalization progresses.
Collapse
|
22
|
Puisys A, Deikuviene J, Vindasiute-Narbute E, Razukevicus D, Zvirblis T, Linkevicius T. Connective tissue graft vs porcine collagen matrix after immediate implant placement in esthetic area: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:141-150. [PMID: 35324053 DOI: 10.1111/cid.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of connective tissue graft (CTG) with immediate implant placement and provisionalisation have shown promising results. It is not clear if the same outcome could be achieved using porcine-derived collagen matrix (PDCM) as grafting material. OBJECTIVES This study aimed to assess the esthetic and functional outcomes of immediate temporization of immediately placed fully tapered implants combined with bone and soft tissue augmentation, using either a CTG or a PDCM, in fresh extraction sockets of the anterior sites. MATERIALS AND METHODS Patients with a failing anterior tooth were included in this study. After extraction, they received an immediate implant with simultaneous hard and soft tissue augmentation and immediate provisional restoration. Patients were randomly assigned to one of the group. Soft tissue augmentation in the control group (CTG) consisted of a CTG, whereas PDCM was used in the test group. After 4 months, definitive restorations were delivered, and pink esthetic score (PES) was evaluated at T1, prosthetic delivery, and at 12-month follow-up (T2). In addition, crestal bone change, probing depth, bleeding on probing, plaque index, bleeding on provisional removal, and implant stability quotient were also recorded. RESULTS A total of 45 patients received the intended treatment (22 controls and 23 tests) 45 implants totally, with no implant failures at T2. PES mean ± SD after 1 year was noted to be 12.9 ± 1.2 for the CTG group and 12.1 ± 1.3 for the PDCM group (p = 0.507). CONCLUSION Within the limits of this trial, both treatment protocols resulted in comparable esthetic outcomes, with results showing PES >12 and stable clinical parameters after 1 year of follow-up.
Collapse
Affiliation(s)
| | | | | | | | - Tadas Zvirblis
- Department of Mechanical and Material Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | | |
Collapse
|
23
|
Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res 2022; 33:634-655. [PMID: 35318752 DOI: 10.1111/clr.13924] [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: 02/05/2021] [Revised: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. MATERIALS AND METHODS Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. RESULTS Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001). CONCLUSIONS Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
Collapse
Affiliation(s)
- Algirdas Puisys
- Vilnius Research Group, Private Practice VIC Clinic, Vilnius, Lithuania
| | | | | | | | | | | |
Collapse
|
24
|
Staas TA, Groenendijk E, Bronkhorst E, Verhamme L, Raghoebar GM, Meijer GJ. Does initial buccal crest thickness affect final buccal crest thickness after flapless immediate implant placement and provisionalization: A prospective cone beam computed tomogram cohort study. Clin Implant Dent Relat Res 2022; 24:24-33. [PMID: 34981616 PMCID: PMC9306851 DOI: 10.1111/cid.13060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Flapless immediate implant placement and provisionalization (FIIPP) in the aesthetic zone is still controversial. Especially, an initial buccal crest thickness (BCT) of ≤1 mm is thought to be disruptive for the final buccal crest stability jeopardizing the aesthetic outcome. PURPOSE To radiographically assess the BCT and buccal crest height (BCH) after 1 year and to calculate the correlation between initial and final achieved BCT. MATERIALS AND METHODS The study was designed as a prospective study on FIIPP. Only patients were included in whom one maxillary incisor was considered as lost. In six centers, 100 consecutive patients received FIIPP. Implants were placed in a maximal palatal position of the socket, thereby creating a buccal space of at least 2 mm, which was subsequently filled with a bovine bone substitute. Files of preoperative (T0), peroperative (T1) and 1-year postoperative (T3) cone beam computed tomogram (CBCT) scans were imported into the Maxillim™ software to analyze the changes in BCT-BCH over time. RESULTS Preoperatively, 85% of the cases showed a BCT ≤1 mm, in 25% of the patients also a small buccal defect (≤5 mm) was present. Mean BCT at the level of the implant-shoulder increased from 0.6 mm at baseline to 3.3 mm immediate postoperatively and compacted to 2.4 mm after 1 year. Mean BCH improved from 0.7 to 3.1 mm peroperatively, and resorbed to 1.7 mm after 1 year. The Pearson correlation of 0.38 between initial and final BCT was significant (p = 0.01) and therefore is valued as moderate. If only patients (75%) with an intact alveolus were included in the analysis, still a "moderate correlation" of 0.32 (p = 0.01) was calculated. CONCLUSIONS A "moderate correlation" was shown for the hypothesis that "thinner preoperative BCT's deliver thinner BCT's" 1 year after performing FIIPP.
Collapse
Affiliation(s)
- Tristan Ariaan Staas
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center (RadboudUMC), Nijmegen, The Netherlands
| | - Edith Groenendijk
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center (RadboudUMC), Nijmegen, The Netherlands
| | - Ewald Bronkhorst
- Department of Preventive and Curative Dentistry, Radboud University Medical Center (RadboudUMC), Nijmegen, The Netherlands
| | - Luc Verhamme
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center (RadboudUMC), Nijmegen, The Netherlands
| | - Gerry Max Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerrit Jacobus Meijer
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center (RadboudUMC), Nijmegen, The Netherlands.,Department of Dentistry, Radboud University Medical Center, Radboud UMC, Nijmegen, The Netherlands
| |
Collapse
|
25
|
Capparé P, Ferrini F, Ruscica C, Pantaleo G, Tetè G, Gherlone EF. Digital versus Traditional Workflow for Immediate Loading in Single-Implant Restoration: A Randomized Clinical Trial. BIOLOGY 2021; 10:1281. [PMID: 34943196 PMCID: PMC8698626 DOI: 10.3390/biology10121281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.
Collapse
Affiliation(s)
- Paolo Capparé
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Francesco Ferrini
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Corrado Ruscica
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
| | - Giuseppe Pantaleo
- UniSR-Social.Lab, Faculty of Psychology, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Giulia Tetè
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| |
Collapse
|
26
|
Ji H, Wang Y, Liu H, Liu Y, Zhang X, Xu J, Li Z, Luo E. Programmed core-shell electrospun nanofibers to sequentially regulate osteogenesis-osteoclastogenesis balance for promoting immediate implant osseointegration. Acta Biomater 2021; 135:274-288. [PMID: 34492371 DOI: 10.1016/j.actbio.2021.08.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/06/2021] [Accepted: 08/29/2021] [Indexed: 02/05/2023]
Abstract
The biology of immediate post-extraction implant osseointegration is mediated by a coordinated cascade of osteoblast-osteoclast interactions. The aim of this study was to develop a dual-delivery system that allowed sequential release of substance P (SP) to promote bone regeneration and alendronate (ALN) to reduce bone resorption, which will improve the implant osseointegration. We used coaxial electrospinning to fabricate the core-shell poly lactic-co-glycolic acid (PLGA)/gelatin nanofibers, which consists of SP in the shell and ALN in the core. This programmed delivery system was shown to release SP and ALN sequentially to match the spatio-temporal specificity of bone healing. The migration assay demonstrated that the SP-ALN dual-delivery system increased bone marrow mesenchymal stem cells (BMSCs) transmigration. Besides, the expression of osteogenic/osteoclastic markers, Alizarin Red staining, tartrate-resistant acid phosphatase (TRAP) staining, F-actin staining and bone resorption experiment showed that the dual-delivery system can render a microenvironment favorable for osteogenic differentiation and adverse to osteoclastogenesis. Using a rat immediate implant model, we validated the promoted osteogenic property and osseointegration around the implants of SP-ALN dual-delivery system by micro-computed tomography (micro-CT) and histological analysis. These findings suggest that the dual-delivery system with time-controlled release of SP and ALN by core-shell nanofibers provides a promising strategy to facilitate immediate implant osseointegration through favorable osteogenesis. STATEMENT OF SIGNIFICANCE: Immediate implant placement is potentially challenged by the difficulties in achieving primary implant stability and early osteogenesis. Initial period of osteointegration is regulated by osteoblastic/osteoclastic cells resulting in a coordinated healing process. To have an efficient bone regeneration, the coaxial electrospinning was used to fabricate a programmed dual-delivery system. The SP released rapidly and favored for BMSCs migration and osteogenic differentiation, while the sustained release of ALN can reduce the bone resorption. The rat immediate implant model indicated that the SP-ALN dual-delivery system could present the promoted peri‑implant osteogenic property and osseointegration through modulating the osteogenesis-osteoclastogenesis balance. This work highlights the sequential dual delivery of SP and ALN has a promising potential of achieving enhanced osseointegration for immediate implant placement.
Collapse
Affiliation(s)
- Huanzhong Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Yiyao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China; Department of Oral and Maxillofacial Surgery, Sichuan Hospital of Stomatology, Chengdu 610031, PR China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Yao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Xiaohui Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Jiazhuang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - Zhongming Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - En Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China.
| |
Collapse
|
27
|
Ridge preservation in maxillary molar extraction sites with severe periodontitis: a prospective observational clinical trial. Clin Oral Investig 2021; 26:2391-2399. [PMID: 34622309 DOI: 10.1007/s00784-021-04204-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing. MATERIAL AND METHODS Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets. RESULTS Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases. CONCLUSIONS Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing. CLINICAL RELEVANCE Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.
Collapse
|
28
|
Zaki J, Yusuf N, El‐Khadem A, Scholten RJPM, Jenniskens K. Efficacy of bone-substitute materials use in immediate dental implant placement: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:506-519. [PMID: 34118175 PMCID: PMC8453723 DOI: 10.1111/cid.13014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/25/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the efficacy of using a bone substitute material (BSM) in the fixture-socket gap in patients undergoing tooth extraction and immediate implant placement. MATERIALS AND METHODS MEDLINE, EMBASE, and CENTRAL databases were searched for randomized controlled trials (RCTs). RCTs were screened for eligibility, and data were extracted by two authors independently. Risk of bias (ROB) was assessed using Cochrane's ROB tool 2.0. Primary outcomes were implant failure, overall complications, and soft-tissue esthetics. Secondary outcomes were vertical buccal bone resorption, vertical interproximal bone resorption, horizontal buccal bone resorption, and mid-buccal mucosal recession. Meta-analysis was performed using random-effects model with generic inverse variance weighing. GRADE was used to grade the certainty of the evidence. RESULTS After screening 19 544 potentially eligible references, 20 RCTs were included in this review, with a total of 848 patients (916 sites). Most included RCTs were deemed of some concerns (53%) or at low (38%) risk of bias, except for overall complications (high ROB). Implant failure did not differ significantly RR = 0.92 (confidence intervals [CI] 0.34 to 2.46) between using a BSM compared with not using a BSM (NoBSM). BSM use resulted in less horizontal buccal bone resorption (MD = -0.52 mm [95% CI -0.74 to -0.30]), a higher esthetic score (MD = 1.49 [95% CI 0.46 to 2.53]), but also more complications (RR = 3.50 [95% CI 1.11 to 11.1] compared with NoBSM. Too few trials compared types of BSMs against each other to allow for pooled analyses. The certainty of the evidence was considered moderate for all outcomes except implant failure (low), overall complications (very low), and vertical interproximal bone resorption (very low). CONCLUSION BSM use during immediate implant placement reduces horizontal buccal bone resorption and improves the periimplant soft-tissue esthetics. Although BSM use increases the risk of predominantly minor complications.
Collapse
Affiliation(s)
- John Zaki
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Maidan Dental ClinicKuwait
| | - Nermin Yusuf
- Department of Periodontology, Faculty of DentistryCairo UniversityGizaEgypt
| | - Ahmed El‐Khadem
- The Centre for Evidence‐Based Dentistry, Faculty of DentistryCairo UniversityGizaEgypt
- Department of Pediatric Dentistry, Faculty of DentistryCairo UniversityGizaEgypt
| | - Rob J. P. M. Scholten
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Kevin Jenniskens
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| |
Collapse
|
29
|
Hyun YK, Lee CY, Keerthana S, Ramasamy S, Song SY, Shim JS, Ryu JJ. Horizontal alteration of anterior alveolar ridge after immediate implant placement: A retrospective cone beam computed tomography analysis. J Adv Prosthodont 2021; 13:117-125. [PMID: 34025960 PMCID: PMC8110735 DOI: 10.4047/jap.2021.13.2.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the labio-lingual alterations of the alveolar bone where the implant was placed immediately after tooth extraction. MATERIALS AND METHODS Implants were placed immediately after tooth extraction on anterior alveolar ridges in the maxilla and mandible. The pin-guide system was used to help determine the location and path of implants during the surgical process. The horizontal distance from implants to the outer border of alveolar bone was measured at the rim and middle of the implants in the cone beam computed tomography images. The alteration of alveolar bone was evaluated comparing the horizontal distances measured immediately after surgery and 3 months after surgery. RESULTS The results show that more resorption occurred towards the labial bone than the lingual bone in the maxilla. A similar amount of labial and lingual bone resorption was observed in the mandible. CONCLUSION Considering the horizontal alteration of alveolar bone, labio-lingual positioning of the implant towards the lingual bone in the maxilla and at the center of the alveolar ridge in the mandible is recommended when it is placed immediately after tooth extraction.
Collapse
Affiliation(s)
| | - Chung Yun Lee
- Korea University Graduate School, Clinical Dentistry, Seoul, Republic of Korea
| | | | | | - So-Yeon Song
- Department of Dentistry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ji Suk Shim
- Department of Dentistry, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea
| |
Collapse
|
30
|
Effect of Platelet-Rich Plasma on Bone Healing in Immediate Implants Analyzed by Cone Beam Computerized Tomography: A Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6685991. [PMID: 33791377 PMCID: PMC7985239 DOI: 10.1155/2021/6685991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
The possibility of platelet-rich plasma (PRP) on the improvement of bone and adjacent tissue recovery has previously been validated. However, there is insufficient data supporting the use of platelet-rich plasma to improve the healing of bone and adjacent tissues around an implant in the oral cavity. The purpose of this randomized controlled trial was to observe the effect of platelet-rich plasma (PRP) concentrate on marginal bone loss and bone density around immediate implant placement using Cone Beam Computerized Tomography (CBCT). This clinical study was conducted over a period of six months on 12 subjects, who were equally categorized into two groups. Group I was the control, whereas the subjects in Group II received PRP therapy at the surgical site. All subjects were given a standard treatment with a single implant system (DIO UFII hybrid sandblasted acid-etched implants). Inserted implants were analyzed through CBCT, and records were registered at baseline, at the 12th week before functional loading and the 26th week after functional loading. The bone loss was calculated at the proximal (mesial and distal) side of the implant and bone density at baseline, 12th week, and 26th week after implant placement. SPSS version 23.0 was used for statistical analysis of data. The changes in bone levels were measured and compared between the two groups using the Mann-Whitney U test, with no significant difference. Bone density was analyzed by an independent sample t-test, p value ≤ 0.05 was considered statistically significant. Again, no significant difference in bone density was observed between both groups at all three instances. Therefore, it can be concluded that local injection of PRP after immediate implant placement did not show any decrease in marginal bone loss or improvement in bone density. This trial is registered with NCT04650763.
Collapse
|
31
|
Meijndert CM, Raghoebar GM, Vissink A, Meijer HJA. Alveolar ridge preservation in defect sockets in the maxillary aesthetic zone followed by single-tooth bone level tapered implants with immediate provisionalization: a 1-year prospective case series. Int J Implant Dent 2021; 7:18. [PMID: 33604747 PMCID: PMC7892651 DOI: 10.1186/s40729-021-00292-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background Clinical studies of single-tooth replacement in compromised bone using bone level tapered implants in the aesthetic zone are scarce. Aim To assess clinically, radiographically and aesthetically over 1 year the performance of a bone level tapered implant in the maxillary aesthetic zone in sites after alveolar ridge preservation. Material and methods Thirty patients (16 male, 14 female) with a failing tooth and large bone defect after removal received alveolar ridge preservation. After 3 months, implants were placed with immediate provisionalization. Definitive restorations were placed after 3 months. The treatment was evaluated 1 year following the definitive restoration. Results All the patients attended the 1-year follow-up. One implant was lost (96.7% implant survival rate). The mean implant stability quotient value was 68.9 ± 8.74 at implant placement. The mean marginal bone level change was minor (− 0.07 ± 0.12 mm). The mean mid-buccal mucosa changed with + 0.01 ± 0.45 mm. The median Pink Esthetic Score and White Esthetic Score after 1 year were 6 [4; 7] and 8 [7; 9], respectively. The patients’ mean overall satisfaction (0–100 VAS scale) was 86.6 ± 10.3. Conclusion Bone level tapered implants with immediate provisionalization perform well after alveolar ridge preservation in the maxillary aesthetic zone, according to implant stability, clinical, radiographic, aesthetic and patient-centred outcomes. Trial registration NTR, NL8755. Registered on 1 January 2016
Collapse
Affiliation(s)
- Caroliene M Meijndert
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
32
|
Abdel Hamid MA, Zaied AA, Zayet MK, Abdelmageed H, Hassan EA, Amaroli A. Efficacy of Flat-Top Hand-Piece Using 980 nm Diode Laser Photobiomodulation on Socket Healing after Extraction: Split-Mouth Experimental Model in Dogs. Photochem Photobiol 2020; 97:627-633. [PMID: 33190304 DOI: 10.1111/php.13356] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022]
Abstract
The objective was to evaluate the effect of photobiomodulation (PBM) using 980 nm diode laser therapy (0.60 W, 0.77 W cm-2 , 36 J, 46 J cm-2 , 60 s) irradiated in continuous wave mode by flat-top hand-piece on socket healing in the maxilla and mandible. A split-mouth experimental design was performed on 6 dogs. The 3rd premolar tooth was extracted from the maxilla and mandibles for both sides. The right-sided sockets were irradiated (PBM group), and the left-sided sockets were kept as control. Irradiation was done after extraction and at 48-h interval for 14 days. Both the buccal and lingual sides were irradiated to reach a total irradiation time of 120 s. Bone density was evaluated at 3, 4 and 5 weeks using cone beam computed tomography. We showed that maxillary sockets in the PBM group had higher bone density compared to control one at 3, 4, 5 weeks (P = 0.029, <0.001, <0.001), respectively. Mandibular sockets revealed no significant difference between PBM and control at 3 weeks (P = 0.347), while at 4 and 5 weeks PBM group showed higher bone density (P = 0.004, <0.001). In both groups, there was a significant increase (P < 0.001) in bone density by time which was higher in the PBM group. We concluded that PBM using a flat-top hand-piece of 980-nm improved the bone density of extraction sockets.
Collapse
Affiliation(s)
- Mohamed A Abdel Hamid
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Amira A Zaied
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | - Mohamed Khalifa Zayet
- Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, New Giza University, Giza, Egypt
| | - Hany Abdelmageed
- Laser Therapy Centre, Department of Surgical and Diagnostic Sciences (DISC), University of Genoa, Genoa, Italy
| | - Elham A Hassan
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Andrea Amaroli
- Faculty of Dentistry, Department of Orthopaedic Dentistry, First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
33
|
A Double Case: Socket Shield and Pontic Shield Techniques on Aesthetic Zone. Case Rep Dent 2020; 2020:8891772. [PMID: 33178465 PMCID: PMC7647738 DOI: 10.1155/2020/8891772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/09/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022] Open
Abstract
When a tooth is extracted, a bone remodeling of the alveolar process occurs irretrievably. Various techniques have emerged over time to maintain the thickness of the bone crest in fixed prosthetics on teeth and implants. The socket shield and pontic shield techniques are aimed at minimizing buccal bone remodeling, especially in the aesthetic area. We present a case of an aesthetic sector rehabilitated with partial fixed denture using the socket shield and pontic shield techniques.
Collapse
|
34
|
Clinical and radiographic findings without the use of bone substitute materials in extraction sockets and delayed implant placement- A case series. J Oral Biol Craniofac Res 2020; 10:141-145. [PMID: 32489812 DOI: 10.1016/j.jobcr.2020.03.011] [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: 02/18/2020] [Accepted: 03/31/2020] [Indexed: 11/23/2022] Open
Abstract
Aim To observe clinically and radiographically (CBCT), the extent of bone resorption in extraction socket without the use of bone graft substitutes and delayed implant placement. Material and methods 50 compliant patients were selected for study. All the patients who were advised extraction were followed up for entire duration of the treatment, at 5th week CBCT showed horizontal and vertical bone loss. To prevent further bone resorption, after 5 weeks implant was placed along with bone graft. Results Bone resorption after extraction is an unavoidable phenomenon. Clinical and radiographic (CBCT) analysis showed massive bone resorption by 5th week. At 5 month CBCT, all patients showed stable implant integration. There was no implant failure at the end of the study. Conclusion Alveolar preservation is proven to slow down socket wall collapse with the use of a bone substitute material without which larger procedures maybe needed to restore alveolar integrity and harmony. Immediate implant placement is effective when bone graft is placed in the jumping distance.
Collapse
|
35
|
Yang X, Zhou Z, Mao Z, Shen M, Chen N, Miao D. Role of p53 deficiency in socket healing after tooth extractions. J Mol Histol 2020; 51:55-65. [PMID: 32006186 DOI: 10.1007/s10735-020-09856-x] [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: 10/22/2019] [Accepted: 01/26/2020] [Indexed: 12/17/2022]
Abstract
p53 is known to advance the cell arrest and cell senescence in human tumors. In this study, we displayed that osteogenic ability of p53-knockout (p53-/-) mice was significantly increased in the tooth extraction socket compared with wild-type (WT) counterparts. Bone marrow mesenchymal stem cells (BM-MSCs) from mandibular were collected and exhibited with elevated proliferation potential and colony-forming units compared with the control, as well as stronger mineral deposits and osteogenic markers. Besides, the bone mass and bone parameter in p53-/- mice were markedly enhanced compared with the counterpart after extractions by micro-CT. Masson's trichrome staining and immunohistochemistry also revealed that new bone filling and osterix/osteocalcin (Osx/OCN)-immunopositive staining in p53-/- mice were remarkably increased at each time point. Furthermore, consistent with the enhanced osteogenic markers, the angiogenic marker of blood vessels (alpha smooth muscle actin, α-SMA) was significantly elevated in p53-/- mice in contrast to WT mice. Importantly, we found that the osteoclast numbers exhibited an increased trend in p53-/- mice compared with WT mice during socket healing. Collectively, our result suggest that p53 deficiency could promote the osteogenesis and angiogenesis in the tooth extraction socket and might lend possibility for p53-based therapeutic approaches in acceleration of extraction bone healing.
Collapse
Affiliation(s)
- Xiaohan Yang
- The Research Center for Bone and Stem Cells, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, No. 140, Han Zhong Road, Nanjing, 210029, People's Republic of China.,Department of Stomatology, The Second Affiliated Hospital of Nanjing Medical University, No. 262, Zhong Shan North Road, Nanjing, 210003, People's Republic of China
| | - Zhixuan Zhou
- Department of Polyclinic, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 136, Han Zhong Road, Nanjing, 210029, People's Republic of China
| | - Zhiyuan Mao
- The Research Center for Bone and Stem Cells, Nanjing Medical University, Nanjing, China.,Department of Stomatology, The Second Affiliated Hospital of Nanjing Medical University, No. 262, Zhong Shan North Road, Nanjing, 210003, People's Republic of China
| | - Ming Shen
- Department of Polyclinic, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 136, Han Zhong Road, Nanjing, 210029, People's Republic of China
| | - Ning Chen
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, No. 140, Han Zhong Road, Nanjing, 210029, People's Republic of China. .,Department of Dental Implant, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 136, Han Zhong Road, Nanjing, 210029, People's Republic of China.
| | - Dengshun Miao
- The Research Center for Bone and Stem Cells, Nanjing Medical University, Nanjing, China. .,Department of Stomatology, The Second Affiliated Hospital of Nanjing Medical University, No. 262, Zhong Shan North Road, Nanjing, 210003, People's Republic of China.
| |
Collapse
|
36
|
Abstract
This volume of Periodontology 2000, entitled "Treatment Trends in Periodontics", evaluates the importance of nonsurgical periodontal therapy and defines its role as the key etiologic treatment of the disease. The need for scaling and root planing is mandatory step during the initial phase of therapy, as is self-care by the patient. Only after reevaluation of the outcome achieved by nonsurgical procedures should surgery be considered, and the concept of "critical probing depth" is emphasized. The chapters in this volume discuss different aspects of periodontal surgery, including regeneration and plastic periodontal procedures, and, looking toward the future, cell therapy in periodontics is explored. The impact of periodontal therapy on systemic diseases is reviewed, and the role of occlusion in periodontal disease is revisited and discussed. Topics on implants include their placement in fresh extraction sockets, socket healing with or without implant placement, and research on osseointegration. The important topic of maintenance care of teeth and implants for long-term therapeutic success is thoroughly evaluated, as is the efficacy of dentifrices in oral hygiene. The editors convey a nutshell review of the concepts of what periodontal treatment should entail, based on scientific evidence generated during half-a-century of work in periodontics.
Collapse
Affiliation(s)
- Raúl G Caffesse
- Postgraduate Periodontics, Faculty of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Josė J Echeverría
- Periodontics, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| |
Collapse
|