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Cheng YC, Murcko L, Benalcazar-Jalkh EB, Bonfante EA. FHypervitaminosis D is correlated with adverse dental implant outcomes: a retrospective case-control study. J Dent 2024:105137. [PMID: 38901822 DOI: 10.1016/j.jdent.2024.105137] [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: 04/23/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES To investigate vitamin-D levels effect on the survival/success and on marginal bone levels of dental implants. METHODS Patients with peri-implant disease and healthy control patients with functionally loaded dental implants were included in this retrospective case-control study. Forty patients with 201 implants were in the diseased-cohort, while thirty-three patients with 90 implants were in the control-cohort. Patient blood 25(OH)D levels were assessed through quantitative blood test. The correlation between abnormal 25(OH)D levels and disease status of each patient was assessed using Fisher's exact tests. The correlation of each implant's outcomes with vitamin-D status was assessed using Kaplan-Meier survival analysis and Mann-Whitney U tests. RESULTS Patients with blood 25(OH)D levels >70ng/mL (hypervitaminosis-D) had a 21.1-fold increase in the risk of implant failure or severe peri-implant bone loss regarding patients with intermediate (>30, ≤70ng/mL) levels. Kaplan-Meier survival analysis revealed that implants in the hypervitaminosis-D cohort had a survival probability of 73.7% (95% CI:56.5-84.5%) at 19-years after surgery, compared to 95% for implants in patients with intermediate 25(OH)D levels (95% CI:88.3-97.9%). Additionally, implants in the hypervitaminosis-D cohort lost bone faster than implants in the intermediate cohort. These results were specific to the patient cohort with elevated blood 25(OH)D levels and not observed in patients taking vitamin-D supplementation. The impact of hypervitaminosis-D was enriched for implants in the maxilla, and not as apparent for implants in the mandible. CONCLUSIONS Blood 25(OH)D levels >70ng/mL were correlated with adverse implant outcomes, including implant failure and peri-implant bone loss, especially in the maxilla. CLINICAL RELEVANCE These results suggest that hypervitaminosis D may be a previously unidentified risk factor for dental implant complications and should be further investigated to elucidate the underlying mechanism.
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Affiliation(s)
- Yu-Chi Cheng
- School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Laura Murcko
- Implant Dentistry Centre, Boston, Massachusetts, USA
| | - Ernesto B Benalcazar-Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
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Francis JR, Barber HD, Beals D, Siu T. The Relationship of Low-Serum Vitamin D and Early Dental Implant Failure. J ORAL IMPLANTOL 2024; 50:215-218. [PMID: 38530826 DOI: 10.1563/aaid-joi-d-23-00168] [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] [Indexed: 03/28/2024]
Abstract
The study is aimed to assess the effects of serum vitamin D levels and their relationship to early dental implant failures. A total of 174 implants in 109 patients were placed and serum vitamin D levels were noted on the day of implant placement. Implants were followed up until restoration, approximately 3-6 months later, and any implant failure was reported based on 50% or more bone loss or implant mobility. Eight individuals had an implant fail early and their vitamin D levels had a mean of 42.54 ng/mL compared with the successful patients' levels of 31.92 ng/mL. Although not statistically significant, there was no correlation between patients' low serum vitamin D levels and early implant failure.
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Affiliation(s)
- John R Francis
- Midwestern University, College of Dental Medicine-Arizona
| | | | - Douglas Beals
- Midwestern University, College of Dental Medicine-Arizona
| | - Trever Siu
- Midwestern University, College of Dental Medicine-Arizona
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3
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Fahey N, Monkhouse R. The role of the general dental practitioner in the implant journey. Br Dent J 2024; 236:811-816. [PMID: 38789759 DOI: 10.1038/s41415-024-7431-7] [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: 02/18/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
The relationship between referring dentist and implantologist can be crucial in making the treatment journey as efficient and effective as possible for patients. There are a number of considerations to discuss to allow effective communication of options with the patient, as well as the long-term management of these cases once returned to general practice.
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Choukroun E, Parnot M, Surmenian J, Gruber R, Cohen N, Davido N, Simonpieri A, Savoldelli C, Afota F, El Mjabber H, Choukroun J. Bone Formation and Maintenance in Oral Surgery: The Decisive Role of the Immune System-A Narrative Review of Mechanisms and Solutions. Bioengineering (Basel) 2024; 11:191. [PMID: 38391677 PMCID: PMC10886049 DOI: 10.3390/bioengineering11020191] [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: 01/03/2024] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
Based on the evidence of a significant communication and connection pathway between the bone and immune systems, a new science has emerged: osteoimmunology. Indeed, the immune system has a considerable impact on bone health and diseases, as well as on bone formation during grafts and its stability over time. Chronic inflammation induces the excessive production of oxidants. An imbalance between the levels of oxidants and antioxidants is called oxidative stress. This physio-pathological state causes both molecular and cellular damage, which leads to DNA alterations, genetic mutations and cell apoptosis, and thus, impaired immunity followed by delayed or compromised wound healing. Oxidative stress levels experienced by the body affect bone regeneration and maintenance around teeth and dental implants. As the immune system and bone remodeling are interconnected, bone loss is a consequence of immune dysregulation. Therefore, oral tissue deficiencies such as periodontitis and peri-implantitis should be regarded as immune diseases. Bone management strategies should include both biological and surgical solutions. These protocols tend to improve immunity through antioxidant production to enhance bone formation and prevent bone loss. This narrative review aims to highlight the relationship between inflammation, oxidation, immunity and bone health in the oral cavity. It intends to help clinicians to detect high-risk situations in oral surgery and to propose biological and clinical solutions that will enhance patients' immune responses and surgical treatment outcomes.
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Affiliation(s)
| | | | | | - Reinhard Gruber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | | | | | | | | | - Franck Afota
- Private Practice, 06000 Nice, France
- Head and Neck Institute, CHU, 06000 Nice, France
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5
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Buzatu BLR, Buzatu R, Luca MM. Impact of Vitamin D on Osseointegration in Dental Implants: A Systematic Review of Human Studies. Nutrients 2024; 16:209. [PMID: 38257102 PMCID: PMC10819660 DOI: 10.3390/nu16020209] [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: 12/12/2023] [Revised: 12/29/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
This systematic review evaluates the impact of Vitamin D levels on dental implant osseointegration, hypothesizing that optimal Vitamin D enhances success rates, and aims to synthesize data on its relationship with clinical outcomes in implantology. A comprehensive search across PubMed, Cochrane Library, and Web of Science databases included seven peer-reviewed articles meeting the criteria for the review. These studies, conducted between 2008 and 2021, included human subjects and explicitly correlated serum Vitamin D levels with dental implant outcomes, following PRISMA guidelines. The selected studies involved 1462 participants and examined 4450 dental implants. Key findings included a varied implant loss rate ranging from 3.9% to 11.4% across the studies. One study reported a 9.8% implant loss rate, yet found no significant association between Vitamin D receptor polymorphism and implant success. Another study indicated successful implantation following Vitamin D3 supplementation, even in severe deficiency cases. The highest implant loss rate (11.1%) was observed in severely Vitamin D-deficient patients, particularly when compounded by risk factors such as smoking and periodontal disease. Additionally, one study noted significantly improved bone density following post-surgical Vitamin D supplementation for up to 12 weeks. The review supports a link between sufficient Vitamin D levels and successful dental implant osseointegration, suggesting Vitamin D deficiency as a potential risk factor for increased failure and advocating for Vitamin D evaluations in pre-surgical planning to potentially enhance implantology outcomes.
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Affiliation(s)
- Berivan Laura Rebeca Buzatu
- Doctoral School, Department of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Roxana Buzatu
- Department of Dental Aesthetics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Magda Mihaela Luca
- Department of Pediatric Dentistry, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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Alssum LR. Repeated implants failure in young patient with idiopathic nephrotic syndrome: a case report with brief review of the literature. BMC Oral Health 2024; 24:25. [PMID: 38183071 PMCID: PMC10770943 DOI: 10.1186/s12903-023-03772-8] [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: 01/30/2023] [Accepted: 12/13/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Nephrotic syndrome is a chronic disorder characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Idiopathic minimal-change disease is the most common form encountered in children. Corticosteroids are the cornerstone for the treatment of idiopathic nephrotic syndrome (INS), with different regimens depending on the response to therapy and frequency of relapses. This case report presents complications after implant treatment in patient with INS. CASE PRESENTATION 20 years old female patient presented for implant consultation. Medical history includes INS since early childhood, and she is on different medications to control her condition, including long-term steroid use. Dental history revealed that implant treatment was unsuccessful after multiple attempts. She presented with an implant on the area of lower left first mandibular molar, that shows increased mobility and radiolucency on radiographic examination. A diagnosis of implant failure was made, the implant was removed, and the area was cleaned and sutured. The patient decided to replace her missing teeth with fixed partial denture and was referred for prosthodontist. The potential adverse effect of steroid use and the possible underlying mechanism that could affect bone metabolism and implants osseointegration are reviewed. CONCLUSION Clinical practice guidelines are needed for the management of dental implants in chronic steroid users.
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Affiliation(s)
- Lamees R Alssum
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Aghaloo T. How Important Is Nutrition in Oral and Maxillofacial Surgery? J Oral Maxillofac Surg 2023; 81:1321-1322. [PMID: 37634543 DOI: 10.1016/j.joms.2023.08.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Negut I, Gradisteanu-Pircalabioru G, Dinu M, Bita B, Parau AC, Grumezescu V, Ristoscu C, Chifiriuc MC. Bioglass and Vitamin D3 Coatings for Titanium Implants: Osseointegration and Corrosion Protection. Biomedicines 2023; 11:2772. [PMID: 37893145 PMCID: PMC10604371 DOI: 10.3390/biomedicines11102772] [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: 09/19/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The use of MAPLE synthesized thin films based on BG and VD3 for improving the osseointegration and corrosion protection of Ti-like implant surfaces is reported. The distribution of chemical elements and functional groups was shown by FTIR spectrometry; the stoichiometry and chemical functional integrity of thin films after MAPLE deposition was preserved, optimal results being revealed especially for the BG+VD3_025 samples. The morphology and topography were examined by SEM and AFM, and revealed surfaces with many irregularities, favoring a good adhesion of cells. The thin films' cytotoxicity and biocompatibility were evaluated in vitro at the morphological, biochemical, and molecular level. Following incubation with HDF cells, BG57+VD3_ 025 thin films showed the best degree of biocompatibility, as illustrated by the viability assay values. According to the LDH investigation, all tested samples had higher values compared to the unstimulated cells. The evaluation of cell morphology was performed by fluorescence microscopy following cultivation of HDF cells on the obtained thin films. The cultivation of HDF's on the thin films did not induce major cellular changes. Cells cultured on the BG57+VD3_025 sample had similar morphology to that of unstimulated control cells. The inflammatory profile of human cells cultured on thin films obtained by MAPLE was analyzed by the ELISA technique. It was observed that the thin films did not change the pro- and anti-inflammatory profile of the HDF cells, the IL-6 and IL-10 levels being similar to those of the control sample. The wettability of the MAPLE thin films was investigated by the sessile drop method. A contact angle of 54.65° was measured for the sample coated with BG57+VD3_025. Electrochemical impedance spectroscopy gave a valuable insight into the electrochemical reactions occurring on the surface.
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Affiliation(s)
- Irina Negut
- National Institute for Laser, Plasma and Radiation Physics, 409 Atomistilor Street, P.O. Box MG 36, 077125 Magurele, Romania; (I.N.); (B.B.); (V.G.)
| | - Gratiela Gradisteanu-Pircalabioru
- eBio-Hub Research Center, University Politehnica of Bucharest—CAMPUS, 6 Iuliu Maniu Boulevard, 061344 Bucharest, Romania;
- Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050657 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov Str., District 5, 050044 Bucharest, Romania
| | - Mihaela Dinu
- National Institute of Research and Development for Optoelectronics-INOE2000, 409 Atomistilor St., 077125 Magurele, Romania; (M.D.); (A.C.P.)
| | - Bogdan Bita
- National Institute for Laser, Plasma and Radiation Physics, 409 Atomistilor Street, P.O. Box MG 36, 077125 Magurele, Romania; (I.N.); (B.B.); (V.G.)
- Faculty of Physics, University of Bucharest, 077125 Magurele, Romania
| | - Anca Constantina Parau
- National Institute of Research and Development for Optoelectronics-INOE2000, 409 Atomistilor St., 077125 Magurele, Romania; (M.D.); (A.C.P.)
| | - Valentina Grumezescu
- National Institute for Laser, Plasma and Radiation Physics, 409 Atomistilor Street, P.O. Box MG 36, 077125 Magurele, Romania; (I.N.); (B.B.); (V.G.)
| | - Carmen Ristoscu
- National Institute for Laser, Plasma and Radiation Physics, 409 Atomistilor Street, P.O. Box MG 36, 077125 Magurele, Romania; (I.N.); (B.B.); (V.G.)
| | - Mariana Carmen Chifiriuc
- Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050657 Bucharest, Romania;
- Academy of Romanian Scientists, 3 Ilfov Str., District 5, 050044 Bucharest, Romania
- The Romanian Academy, Calea Victoriei 25, District 1, 010071 Bucharest, Romania
- Department of Microbiology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
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9
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Kämmerer PW, Al-Nawas B. Bone reconstruction of extensive maxillomandibular defects in adults. Periodontol 2000 2023; 93:340-357. [PMID: 37650475 DOI: 10.1111/prd.12499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 09/01/2023]
Abstract
Reconstruction of significant maxillomandibular defects is a challenge that has been much discussed over the last few decades. Fundamental principles were developed decades ago (bone bed viability, graft immobilization). Clinical decision-making criteria are highly relevant, including local/systemic factors and incision designs, the choice of material, grafting technique, and donor site morbidity. Stabilizing particulated grafts for defined defects-that is, via meshes or shells-might allow significant horizontal and vertical augmentation; the alternatives are onlay and inlay techniques. More significant defects might require extra orally harvested autologous bone blocks. The anterior iliac crest is often used for nonvascularized augmentation, whereas more extensive defects often require microvascular reconstruction. In those cases, the free fibula flap has become the standard of care. The development of alternatives is still ongoing (i.e., alloplastic reconstruction, zygomatic implants, obturators, distraction osteogenesis). Especially for these complex procedures, three-dimensional planning tools enable facilitated planning and a surgical workflow.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Xu J, Chen C, Gan S, Liao Y, Fu R, Hou C, Yang S, Zheng Z, Chen W. The Potential Value of Probiotics after Dental Implant Placement. Microorganisms 2023; 11:1845. [PMID: 37513016 PMCID: PMC10383117 DOI: 10.3390/microorganisms11071845] [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: 06/29/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Dental implantation is currently the optimal solution for tooth loss. However, the health and stability of dental implants have emerged as global public health concerns. Dental implant placement, healing of the surgical site, osseointegration, stability of bone tissues, and prevention of peri-implant diseases are challenges faced in achieving the long-term health and stability of implants. These have been ongoing concerns in the field of oral implantation. Probiotics, as beneficial microorganisms, play a significant role in the body by inhibiting pathogens, promoting bone tissue homeostasis, and facilitating tissue regeneration, modulating immune-inflammatory levels. This review explores the potential of probiotics in addressing post-implantation challenges. We summarize the existing research regarding the importance of probiotics in managing dental implant health and advocate for further research into their potential applications.
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Affiliation(s)
- Jia Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chenfeng Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuaiqi Gan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yihan Liao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruijie Fu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chuping Hou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuhan Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Zheng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Jinjiang Out-Patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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D'Ambrosio F, Amato A, Chiacchio A, Sisalli L, Giordano F. Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review. Dent J (Basel) 2023; 11:146. [PMID: 37366669 DOI: 10.3390/dj11060146] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this umbrella review is to evaluate what are the most common medications and systemic diseases that can affect bone-implant integration, the success rate and survival rate of dental implants, peri-implant tissue health, and implant loss. Systematic reviews, with meta-analysis or not, about how systemic diseases and medications influence dental implant osseointegration, survival rate, success rate, and peri-implant diseases, published only in the English language, are electronically searched across the most important scientific databases. The present umbrella review includes eight systematic reviews, and osteoporosis and diabetes are the most investigated pathologies. Systemic diseases, such as neurologic disorders, HIV, hypothyroidism, cardiovascular diseases, and drugs, such as beta blockers, anti-hypertensives, or diuretics do not show a decreased rate of implant osseointegration. It seems that drugs, such as proton-pump inhibitors (PPIs) or serotonin reuptake inhibitors (SSRIs), negatively affect implant osseointegration. Few studies compare the effects of drugs and systemic diseases on the parameters considered in this overview. It is important to underline how the results of this review need to be validated with subsequent and more reviews.
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Affiliation(s)
- Francesco D'Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Chiacchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Laura Sisalli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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The role of Vitamin D as an adjunct for bone regeneration: A systematic review of literature. Saudi Dent J 2023; 35:220-232. [PMID: 37091280 PMCID: PMC10114593 DOI: 10.1016/j.sdentj.2023.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
Background and objectives In spite of bone's healing capacity, critical-size bone defect regeneration and peri-implant osseointegration are challenging. Tissue engineering provides better outcomes, but requires expensive adjuncts like stem cells, growth factors and bone morphogenic proteins. Vitamin D (Vit.D) regulates calcium and phosphorus metabolism, and helps maintain bone health. Vit.D supplements in deficient patients, accentuates bone healing and regeneration. Therefore the aim of this systematic review was to evaluate the role of adjunctive Vit.D on bone defect regeneration. Methods Comprehensive database search of indexed literature, published between January 1990 and June 2022, was carried out. English language articles fulfilling inclusion criteria (clinical/in vivo studies evaluating bone regeneration including osseointegration and in vitro studies assessing osteogenic differentiation, with adjunct Vit.D) were identified and screened. Results Database search identified 384 titles. After sequential title, abstract and full-text screening, 23 studies (in vitro - 9/in vivo - 14) were selected for review. Vit.D as an adjunct with stem cells and osteoblasts resulted in enhanced osteogenic differentiation and upregulation of genes coding for bone matrix proteins and alkaline phosphatase. When used in vivo, Vit.D resulted in early and increased new bone formation and mineralization within osseous defects, and better bone implant contact and osseointegration, around implants. Adjunct Vit.D in animals with induced systemic illnesses resulted in bone defect regeneration and osseointegration comparable to healthy animals. While systemic and local administration of Vit.D resulted in enhanced bone defect healing, outcomes were superior with systemic route. Conclusions Based on this review, adjunct Vit.D enhances bone defect regeneration and osseointegration. In vitro application of Vit.D to stem cells and osteoblasts enhances osteogenic differentiation. Vit.D is a potentially non-invasive and inexpensive adjunct for clinical bone regeneration and osseointegration. Long term clinical trials are recommended to establish protocols relating to type, dosage, frequency, duration and route of administration.
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Szulc M, Świątkowska-Stodulska R, Pawłowska E, Derwich M. Vitamin D 3 Metabolism and Its Role in Temporomandibular Joint Osteoarthritis and Autoimmune Thyroid Diseases. Int J Mol Sci 2023; 24:ijms24044080. [PMID: 36835491 PMCID: PMC9964750 DOI: 10.3390/ijms24044080] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this review was to present the metabolism of vitamin D3, as well as to discuss the role of vitamin D3 in bone metabolism, temporomandibular joint osteoarthritis (TMJ OA), and autoimmune thyroid diseases (AITD) on the basis of the literature. Vitamin D3 plays a significant role in human health, as it affects the calcium-phosphate balance and regulates the bone metabolism. Calcitriol impresses the pleiotropic effect on human biology and metabolism. Its modulative function upon the immune system is based on the reduction of Th1 cell activity and increased immunotolerance. Vitamin D3 deficiency may lead to an imbalance in the relationship between Th1/Th17 and Th2, Th17/Th reg, and is considered by some authors as one of the possible backgrounds of autoimmune thyroid diseases (AITD), e.g., Hashimoto's thyroiditis or Graves' disease. Moreover, vitamin D3, through its direct and indirect influence on bones and joints, may also play an important role in the development and progression of degenerative joint diseases, including temporomandibular joint osteoarthritis. Further randomized, double blind studies are needed to unequivocally confirm the relationship between vitamin D3 and abovementioned diseases and to answer the question concerning whether vitamin D3 supplementation may be used in the prevention and/or treatment of either AITD or OA diseases.
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Affiliation(s)
- Michał Szulc
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Elżbieta Pawłowska
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
| | - Marcin Derwich
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
- Correspondence: ; Tel.: +48-660-723-164
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Landwehr VC, Fretwurst T, Heinen J, Vach K, Nelson K, Nahles S, Iglhaut G. Association of sex steroid hormones and new bone formation rate after iliac onlay grafting: a prospective clinical pilot study. Int J Implant Dent 2022; 8:53. [PMCID: PMC9663769 DOI: 10.1186/s40729-022-00447-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose
The present prospective study evaluates the association between new bone formation rate in the iliac onlay graft and sex steroid hormone serum levels.
Methods
A total of 15 partially or completely edentulous postmenopausal females and 9 males with less than 5 mm height of the remaining alveolar bone underwent iliac onlay grafting followed by dental implant placement using a two-stage approach. Sex hormone binding globulin and 17β-estradiol serum levels were investigated by electrochemiluminescence immunoassay, while total testosterone level was analyzed using radioimmunoassay. At the time of implant placement, 12 weeks after grafting, bone biopsies were obtained and analyzed histomorphometrically. Statistical analysis was performed using linear mixed models.
Results
Grafting procedure was successfully performed in all patients. The mean new bone formation rate was 32.5% (116 samples). In men the mean new bone formation rate (38.1%) was significantly higher (p < 0.01) than in women (27.6%). Independent of gender 17β-estradiol and testosterone were positively associated to overall new bone formation rate, albeit a significant influence was only seen for 17β-estradiol in men (p = 0.020). Sex hormone binding globulin had no influence on new bone formation rate (p = 0.897). There was no significant association between new bone formation rate and age (p = 0.353) or new bone formation rate and body mass index (p = 0.248).
Conclusion
Positive association of 17ß-estradiol as well as testosterone with new bone formation rate after iliac onlay grafting indicates a role of sex steroid hormones in alveolar bone regeneration, although the observed influence was only significant for 17ß-estradiol in men.
Graphical Abstract
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Bugălă NM, Carsote M, Stoica LE, Albulescu DM, Ţuculină MJ, Preda SA, Boicea AR, Alexandru DO. New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden. Diagnostics (Basel) 2022; 12:diagnostics12092080. [PMID: 36140482 PMCID: PMC9497746 DOI: 10.3390/diagnostics12092080] [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: 06/02/2022] [Revised: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
This review highlights oral anomalies with major clinical impact in Addison disease (AD), including dental health and dermatologic features, through a dual perspective: pigmentation issues and AD comorbidities with oral manifestations. Affecting 92% of AD patients, cutaneomucosal hyperpigmentation is synchronous with or precedes general manifestations by up to a decade, underlying melanocytic infiltration of the basal epidermal layer; melanophages in the superficial dermis; and, rarely, acanthosis, perivascular lymphocytic infiltrate, and hyperkeratosis. Intraoral pigmentation might be the only sign of AD; thus, early recognition is mandatory, and biopsy is helpful in selected cases. The buccal area is the most affected location; other sites are palatine arches, lips, gums, and tongue. Pigmented oral lesions are patchy or diffuse; mostly asymptomatic; and occasionally accompanied by pain, itchiness, and burn-like lesions. Pigmented lingual patches are isolated or multiple, located on dorsal and lateral areas; fungiform pigmented papillae are also reported in AD individuals. Dermoscopy examination is particularly indicated for fungal etiology; yet, it is not routinely performed. AD’s comorbidity burden includes the cluster of autoimmune polyglandular syndrome (APS) type 1 underlying AIRE gene malfunction. Chronic cutaneomucosal candidiasis (CMC), including oral CMC, represents the first sign of APS1 in 70–80% of cases, displaying autoantibodies against interleukin (IL)-17A, IL-17F ± IL-22, and probably a high mucosal concentration of interferon (IFN)-γ. CMC is prone to systemic candidiasis, representing a procarcinogenic status due to Th17 cell anomalies. In APS1, the first cause of mortality is infections (24%), followed by oral and esophageal cancers (15%). Autoimmune hypoparathyroidism (HyP) is the earliest endocrine element in APS1; a combination of CMC by the age of 5 years and dental enamel hypoplasia (the most frequent dental complication of pediatric HyP) by the age of 15 is an indication for HyP assessment. Children with HyP might experience short dental roots, enamel opacities, hypodontia, and eruption dysfunctions. Copresence of APS-related type 1 diabetes mellitus (DM) enhances the risk of CMC, as well as periodontal disease (PD). Anemia-related mucosal pallor is related to DM, hypothyroidism, hypogonadism, corresponding gastroenterological diseases (Crohn’s disease also presents oral ulceration (OU), mucogingivitis, and a 2–3 times higher risk of PD; Biermer anemia might cause hyperpigmentation by itself), and rheumatologic diseases (lupus induces OU, honeycomb plaques, keratotic plaques, angular cheilitis, buccal petechial lesions, and PD). In more than half of the patients, associated vitiligo involves depigmentation of oral mucosa at different levels (palatal, gingival, alveolar, buccal mucosa, and lips). Celiac disease may manifest xerostomia, dry lips, OU, sialadenitis, recurrent aphthous stomatitis and dental enamel defects in children, a higher prevalence of caries and dentin sensitivity, and gingival bleeding. Oral pigmented lesions might provide a useful index of suspicion for AD in apparently healthy individuals, and thus an adrenocorticotropic hormone (ACTH) stimulation is useful. The spectrum of autoimmune AD comorbidities massively complicates the overall picture of oral manifestations.
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Affiliation(s)
- Narcis Mihăiţă Bugălă
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- C.I. Parhon National Institute of Endocrinology, Aviatorilor Ave. 34–38, Sector 1, 011683 Bucharest, Romania
- Correspondence: ; Tel.: +40-744851934
| | - Loredana Elena Stoica
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dana Maria Albulescu
- Department of Anatomy, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Jana Ţuculină
- Department of Odontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Smaranda Adelina Preda
- Department of Odontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ancuta-Ramona Boicea
- Department of Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dragoș Ovidiu Alexandru
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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(Bio)Tribocorrosion in Dental Implants: Principles and Techniques of Investigation. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157421] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Tribocorrosion is a current and very discussed theme in tribology and medicine for its impact on industrial applications. Currently, the phenomena are mainly oriented to the biological environment and, in particular, to medical devices such as hip prostheses, dental implants, knee joints, etc. The term tribocorrosion underlines the simultaneous action of wear and corrosion in a tribocouple. It has a non-negligible effect on the total loss of contact materials and the potential failure of the bio-couplings. This overview aims to focus firstly on the basic principles of prosthesis tribocorrosion and subsequently to describe the techniques and the analytical models developed to quantify this phenomenon, reporting the most relevant results achieved in the last 20 years, proposed in chronological order, in order to discuss and to depict the future research developments and tendencies. Despite considerable research efforts, from this investigation come many issues worthy of further investigation, such as how to prevent or minimize tribocorrosion in biological tribopairs, the development of a consolidated protocol for tribological experiments in corrosive environments joined with new biomaterials and composites, the possibility to achieve more and more accurate theoretical models, and how to be able to ensure the success of new implant designs by supporting research and development for the management of implant complications. The above issues certainly constitute a scientific challenge for the next years in the fields of tribology and medicine.
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