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Liu X, Deng S, Li X, Liu H, Li Z, Wu Y, Luo P, Zhong X, Huang R, Liu R, Wu X, Huang B, Chen Z, Chen Z, Chen S. A Standardized Rat Model to Study Peri-implantitis of Transmucosal Osseointegrated Implants. Biomater Res 2024; 28:0021. [PMID: 38828365 PMCID: PMC11142924 DOI: 10.34133/bmr.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/19/2024] [Indexed: 06/05/2024] Open
Abstract
With the high incidence rate, distinctive implant characteristic and unique infection pattern, peri-implantitis (PI) requires a specially designed implant animal model for the researches on the pathogenesis and treatments. Previous small-animal PI models exhibit variability in implant site selection, design, and surgical procedures resulting in unnecessary tissue damage and less effectivity. Herein, a quantitative-analysis-based standardized rat model for transmucosal PI-related research was proposed. After dissecting the anatomic structures of the rat maxilla, we determined that placing the implant anterior to the molars in the rat maxilla streamlined the experimental period and enhanced animal welfare. We standardized the model by controlling the rat strain, gender, and size. The customized implant and a series of matched surgical instruments were appropriately designed. A clear, step-by-step surgical process was established. These designs ensured the success rate, stability, and replicability of the model. Each validation method confirmed the successful construction of the model. This study proposed a quantitative-analysis-based standardized transmucosal PI rat model with improved animal welfare and reliable procedures. This model could provide efficient in vivo insights to study the pathogenesis and treatments of PI and preliminary screening data for further large-animal and clinical trials.
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Affiliation(s)
- Xingchen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shudan Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiyan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
- Department of Stomatology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Zhixin Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - You Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Pu Luo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xinyi Zhong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Ruoxuan Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Runheng Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xiayi Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Baoxin Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shoucheng Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
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Zhang J, Tong Z, Chen L, Qian Y, Lu Y, Chen Q, Si M. Development and applications of peri-implantitis mouse models. Oral Dis 2024. [PMID: 38501334 DOI: 10.1111/odi.14929] [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: 01/07/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVE Peri-implantitis is one of the most common complications of implants. However, its pathogenesis has not been clarified. In recent years, mouse models are gradually being used in the study of peri-implantitis. This review aims to summarize the methods used to induce peri-implantitis in mice and their current applications. METHOD Articles of peri-implantitis mouse models were collected. We analyzed the various methods of inducing peri-implantitis and their application in different areas. RESULTS Most researchers have induced peri-implantitis by silk ligatures. Some others have induced peri-implantitis by Pg gavage and LPS injection. Current applications of peri-implantitis mouse models are in the following areas: investigation of pathogenesis and exploration of new interventions, comparison of peri-implantitis with periodontitis, the interaction between systemic diseases and peri-implantitis, etc. CONCLUSION: Silk ligature for 2-4 weeks, Pg gavage for 6 weeks, and LPS injection for 6 weeks all successfully induced peri-implantitis in mice. Mice have the advantages of mature gene editing technology, low cost, and short time to induce peri-implantitis. It has applications in the study of pathogenesis, non-surgical treatments, and interactions with other diseases. However, compared with large animals, mice also have a number of disadvantages that limit their application.
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Affiliation(s)
- Jianwei Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Zian Tong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Long Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yinjie Qian
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yifan Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
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Li Y, Li X, Guo D, Meng L, Feng X, Zhang Y, Pan S. Immune dysregulation and macrophage polarization in peri-implantitis. Front Bioeng Biotechnol 2024; 12:1291880. [PMID: 38347915 PMCID: PMC10859439 DOI: 10.3389/fbioe.2024.1291880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
The term "peri-implantitis" (peri-implantitis) refers to an inflammatory lesion of the mucosa surrounding an endosseous implant and a progressive loss of the peri-implant bone that supports the implant. Recently, it has been suggested that the increased sensitivity of implants to infection and the quick elimination of supporting tissue after infection may be caused by a dysregulated peri-implant mucosal immune response. Macrophages are polarized in response to environmental signals and play multiple roles in peri-implantitis. In peri-implantitis lesion samples, recent investigations have discovered a considerable increase in M1 type macrophages, with M1 type macrophages contributing to the pro-inflammatory response brought on by bacteria, whereas M2 type macrophages contribute to inflammation remission and tissue repair. In an effort to better understand the pathogenesis of peri-implantitis and suggest potential immunomodulatory treatments for peri-implantitis in the direction of macrophage polarization patterns, this review summarizes the research findings related to macrophage polarization in peri-implantitis and compares them with periodontitis.
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Affiliation(s)
- Yue Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xue Li
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Danni Guo
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Lingwei Meng
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yi Zhang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Shaoxia Pan
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
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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.
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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
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Hendrijantini N, Kuntjoro M, Agustono B, Maya Sitalaksmi R, Dimas Aditya Ari M, Theodora M, Effendi R, Setiawan Djuarsa I, Widjaja J, Sosiawan A, Hong G. Human umbilical cord mesenchymal stem cells induction in peri-implantitis Rattus norvegicus accelerates and enhances osteogenesis activity and implant osseointegration. Saudi Dent J 2023; 35:147-153. [PMID: 36942204 PMCID: PMC10024080 DOI: 10.1016/j.sdentj.2023.01.003] [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: 08/25/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023] Open
Abstract
Peri-implantitis additional treatment generally aims to repair damaged tissue through a regenerative approach. Human umbilical cord mesenchymal stem cells (hUCMSCs) produce a high osteogenic effect and are capable of modulating the immune system by suppressing inflammatory response, modulating bone resorption, and inducing endogenous osteogenesis. AIM This study was intended to discover the effect of hUCMSCs on an implant osseointegration process in peri-implantitis rat subjects as assessed by several markers including interleukin-10 (IL-10), transforming growth factor-β (TGF-β), receptor activator of nuclear factor kappa- β ligand (RANKL), bone morphogenic protein (BMP-2), osterix (Osx), and osteoprotegerin (OPG). MATERIAL AND METHODS The research design implemented during this study represented a true experimental design incorporating the use of Rattus norvegicus (Wistar strain) as subjects. RESULTS Data analysed by means of a Brown Forsythe test indicated differences between the increase in BMP-2 expression (p < 0.000) and Osx expression (p < 0.001) and between RANKL expression (p < 0.001, Tukey HSD) and OPG expression (p < 0.000, Games Howell). CONCLUSION According to the findings of this research, hUCMSCs induction is successful in accelerating and enhancing osteogenic activity and implant osseointegration in peri-implantitis rat subjects.
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Affiliation(s)
- Nike Hendrijantini
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Corresponding author.
| | - Mefina Kuntjoro
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Bambang Agustono
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ratri Maya Sitalaksmi
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Dimas Aditya Ari
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Marcella Theodora
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Rudy Effendi
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ivan Setiawan Djuarsa
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Jennifer Widjaja
- Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Agung Sosiawan
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Guang Hong
- Division for Globalization Initiative, Graduate School of Dentistry, Tohoku University, Sendai, Japan
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Heyman O, Horev Y, Mizraji G, Haviv Y, Shapira L, Wilensky A. Excessive inflammatory response to infection in experimental peri-implantitis: Resolution by Resolvin D2. J Clin Periodontol 2022; 49:1217-1228. [PMID: 35762068 PMCID: PMC9804794 DOI: 10.1111/jcpe.13631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/16/2022] [Accepted: 04/12/2022] [Indexed: 01/09/2023]
Abstract
AIM The aetiology and pathogenesis of peri-implantitis are currently under active research. This study aimed to dissect the pathogenesis of murine experimental peri-implantitis and assess Resolvin D2 (RvD2) as a new treatment modality. MATERIALS AND METHODS Four weeks following titanium implant insertion, mice were infected with Porphyromonas gingivalis using single or multiple oral lavages. RvD2 was administrated following infection, and tissues were analysed using flow cytometry, quantitative RT-PCR, taxonomic profiling, and micro-computed tomography. RESULTS Repeated infections with Pg resulted in microbial dysbiosis and a higher influx of innate and adaptive leukocytes to the peri-implant mucosa (PIM) than to gingiva surrounding the teeth. This was accompanied by increased expression levels of IFN-α, IL-1β, and RANKL\OPG ratio. Interestingly, whereas repetitive infections resulted in bone loss around implants and teeth, a single infection induced bone loss only around implants, suggesting a higher susceptibility of the implants to infection. Treatment with RvD2 prevented Pg-driven bone loss and reduced leukocyte infiltration to the PIM. CONCLUSIONS Murine dental implants are associated with dysregulated local immunity and increase susceptibility to pathogen-induced peri-implantitis. However, the disease can be prevented by RvD2 treatment, highlighting the promising therapeutic potential of this treatment modality.
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Affiliation(s)
- Oded Heyman
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
| | - Yael Horev
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
| | - Gabriel Mizraji
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
| | - Yaron Haviv
- Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
| | - Lior Shapira
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
| | - Asaf Wilensky
- Department of Periodontology, Hadassah Medical Center, Faculty of Dental MedicineHebrew University of JerusalemJerusalemIsrael
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Hasan J, Bright R, Hayles A, Palms D, Zilm P, Barker D, Vasilev K. Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants. ACS Biomater Sci Eng 2022; 8:4697-4737. [PMID: 36240391 DOI: 10.1021/acsbiomaterials.2c00540] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.
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Affiliation(s)
- Jafar Hasan
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Richard Bright
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Andrew Hayles
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Dennis Palms
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, 5005, South Australia, Australia
| | - Dan Barker
- ANISOP Holdings, Pty. Ltd., 101 Collins St, Melbourne VIC, 3000 Australia
| | - Krasimir Vasilev
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
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8
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Chew RJJ, Lu JX, Sim YF, Yeo ABK. Rodent peri-implantitis models: a systematic review and meta-analysis of morphological changes. J Periodontal Implant Sci 2022; 52:479-495. [PMID: 36468467 PMCID: PMC9807853 DOI: 10.5051/jpis.2200900045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/29/2022] [Accepted: 05/17/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Rodent models have emerged as an alternative to established larger animal models for peri-implantitis research. However, the construct validity of rodent models is controversial due to a lack of consensus regarding their histological, morphological, and biochemical characteristics. This systematic review sought to validate rodent models by characterizing their morphological changes, particularly marginal bone loss (MBL), a hallmark of peri-implantitis. METHODS This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed electronically using MEDLINE (PubMed), and Embase, identifying pre-clinical studies reporting MBL after experimental peri-implantitis induction in rodents. Each study's risk of bias was assessed using the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool. A meta-analysis was performed for the difference in MBL, comparing healthy implants to those with experimental peri-implantitis. RESULTS Of the 1,014 unique records retrieved, 23 studies that met the eligibility criteria were included. Peri-implantitis was induced using 4 methods: ligatures, lipopolysaccharide, microbial infection, and titanium particles. Studies presented high to unclear risks of bias. During the osseointegration phase, 11.6% and 6.4%-11.3% of implants inserted in mice and rats, respectively, had failed to osseointegrate. Twelve studies were included in the meta-analysis of the linear MBL measured using micro-computed tomography. Following experimental peri-implantitis, the MBL was estimated to be 0.25 mm (95% confidence interval [CI], 0.14-0.36 mm) in mice and 0.26 mm (95% CI, 0.19-0.34 mm) in rats. The resulting peri-implant MBL was circumferential, consisting of supra- and infrabony components. CONCLUSIONS Experimental peri-implantitis in rodent models results in circumferential MBL, with morphology consistent with the clinical presentation of peri-implantitis. While rodent models are promising, there is still a need to further characterize their healing potentials, standardize experiment protocols, and improve the reporting of results and methodology. TRIAL REGISTRATION PROSPERO Identifier: CRD42020209776.
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Affiliation(s)
| | | | - Yu Fan Sim
- Faculty of Dentistry, National University of Singapore, Singapore
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9
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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10
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Wu X, Qiao S, Wang W, Zhang Y, Shi J, Zhang X, Gu W, Zhang X, Li Y, Ding X, Wei J, Gu Y, Lai H. Melatonin prevents peri‑implantitis via suppression of TLR4/NF-κB. Acta Biomater 2021; 134:325-336. [PMID: 34271168 DOI: 10.1016/j.actbio.2021.07.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
Peri‑implantitis, which is characterized by peri‑implant mucositis and alveolar bone resorption, significantly shortens the service life of dental implants. Melatonin is well-known for its anti-inflammatory and osteoprotective activities. Nevertheless, the effects and mechanisms of melatonin to prevent peri‑implantitis remain unknown. In this study, the lipopolysaccharide-induced peri‑implantitis model was established after the titanium implants were osseointegrated, and the rats received daily administrations of melatonin. The gingival fibroblasts and osteoclasts/osteoblasts were also co-cultured to simulate the inflammatory environment in vitro. We found that prophylactic administration of melatonin decreased proinflammatory cytokine levels and osteoclast numbers, attenuated alveolar bone resorption, and reduced the incidence of peri‑implantitis in vivo. Furthermore, melatonin suppressed osteoclastic formation and function in the inflammatory co-culture environment, while melatonin promoted osteoblastic differentiation and function in the in vitro model. Mechanistically, melatonin reduced TLR4 protein levels, and inhibited activation of NF-κB to downregulate the levels of TNF, IL-1β, and IL-6. These data showed that melatonin was a potent agent to prevent peri‑implantitis through inhibiting TLR4/NF-κB signaling. Our findings provide a novel strategy to prevent peri‑implantitis, and expand the applications of melatonin. STATEMENT OF SIGNIFICANCE: Dental implants have become the first choice for restoring partial and full edentulism, but its service life is seriously affected by peri‑implantitis. Exploration of novel and effective approaches to prevent peri‑implantitis is an important and urgent need. In the present study, we have reported for the first time that prophylactic administration of melatonin delayed the occurrence and reduced the incidence of peri‑implantitis by decreasing proinflammatory cytokine levels, inhibiting osteoclastogenesis, and promoting osteogenesis. The study is expected to have an important significance on the prevention of peri‑implantitis.
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11
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Blank E, Grischke J, Winkel A, Eberhard J, Kommerein N, Doll K, Yang I, Stiesch M. Evaluation of biofilm colonization on multi-part dental implants in a rat model. BMC Oral Health 2021; 21:313. [PMID: 34144677 PMCID: PMC8212458 DOI: 10.1186/s12903-021-01665-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/02/2021] [Indexed: 01/15/2023] Open
Abstract
Background Peri-implant mucositis and peri-implantitis are highly prevalent biofilm-associated diseases affecting the tissues surrounding dental implants. As antibiotic treatment is ineffective to fully cure biofilm mediated infections, antimicrobial modifications of implants to reduce or prevent bacterial colonization are called for. Preclinical in vivo evaluation of the functionality of new or modified implant materials concerning bacterial colonization and peri-implant health is needed to allow progress in this research field. For this purpose reliable animal models are needed. Methods Custom made endosseous dental implants were installed in female Sprague Dawley rats following a newly established three-step implantation procedure. After healing of the bone and soft tissue, the animals were assigned to two groups. Group A received a continuous antibiotic treatment for 7 weeks, while group B was repeatedly orally inoculated with human-derived strains of Streptococcus oralis, Fusobacterium nucleatum and Porphyromonas gingivalis for six weeks, followed by 1 week without inoculation. At the end of the experiment, implantation sites were clinically assessed and biofilm colonization was quantified via confocal laser scanning microscopy. Biofilm samples were tested for presence of the administered bacteria via PCR analysis. Results The inner part of the custom made implant screw could be identified as a site of reliable biofilm formation in vivo. S. oralis and F. nucleatum were detectable only in the biofilm samples from group B animals. P. gingivalis was not detectable in samples from either group. Quantification of the biofilm volume on the implant material revealed no statistically significant differences between the treatment groups. Clinical inspection of implants in group B animals showed signs of mild to moderate peri-implant mucositis (4 out of 6) whereas the mucosa of group A animals appeared healthy (8/8). The difference in the mucosa health status between the treatment groups was statistically significant (p = 0.015). Conclusions We developed a new rodent model for the preclinical evaluation of dental implant materials with a special focus on the early biofilm colonization including human-derived oral bacteria. Reliable biofilm quantification on the implant surface and the symptoms of peri-implant mucositis of the bacterially inoculated animals will serve as a readout for experimental evaluation of biofilm-reducing modifications of implant materials.
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Affiliation(s)
- Eva Blank
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. .,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany.
| | - Jasmin Grischke
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Andreas Winkel
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Joerg Eberhard
- The University of Sydney Dental School & The Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nadine Kommerein
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Katharina Doll
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Ines Yang
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
| | - Meike Stiesch
- Department of Dental Prosthetics and Biomedical Materials Science, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Stadtfelddamm 34, 30625, Hannover, Germany
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12
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Deng S, Hu Y, Zhou J, Wang Y, Wang Y, Li S, Huang G, Peng C, Hu A, Yu Q, Han X. TLR4 mediates alveolar bone resorption in experimental peri-implantitis through regulation of CD45 + cell infiltration, RANKL/OPG ratio, and inflammatory cytokine production. J Periodontol 2020; 91:671-682. [PMID: 31489644 PMCID: PMC9930181 DOI: 10.1002/jper.18-0748] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/19/2019] [Accepted: 07/30/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND The present study was to determine the role of Toll-like receptor 4 (TLR4) signaling in inflammation and alveolar bone resorption using a murine model of Porphyromonas gingivalis-associated ligature-induced peri-implantitis. METHODS Smooth surface titanium implants were placed in the left maxilla alveolar bone 6 weeks after extraction of first and second molars in Wild-type (WT) and TLR4-/- (TLR4 KO) mice. Silk ligatures immersed with P. gingivalis were tied around the implants 4 weeks after the implant placement and confirmation of osteointegration. Two weeks after the ligation, bone resorption, osteoclastogenesis, cellular inflammatory responses, and gingival mRNA expression levels of cytokines were assessed by micro-computed tomography, tartrate-resistant acid phosphatase (TRAP) staining, immunobiological examination and Real-time quantitative polymerase chain reaction, respectively. RESULTS In both WT and TLR4 KO mice, the bone resorption around implants was significantly increased in the P. gingivalis/ligation group compared with control group. In P. gingivalis/ligation group, the levels of bone resorption, TRAP+ cell formation, and gingival CD3+ and CD45+ cell infiltration were significantly decreased in TLR4 KO mice compared with that in WT mice. Receptor activator of nuclear factor-kappa B ligand /osteoprotegerin (RANKL/OPG) ratio was significantly increased after P. gingivalis/ligation treatment in WT mice not in TLR4 KO mice. When comparing the P. gingivalis/ligation group with the respective control group, gingival mRNA expressions of IL-1β, IFN-γ, and 1L-17 were significantly increased in TLR4 KO mice. CONCLUSION This study suggests that TLR4 mediates alveolar bone resorption in P. gingivalis associated ligature-induced peri-implantitis through regulation of immune B cell infiltration, RANKL/OPG expression ratio, and differential inflammatory cytokine production.
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Affiliation(s)
- Shu Deng
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Department of Stomatology, The secondary Hospital of Tianjin Medical University, Tianjin, China
| | - Yang Hu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jing Zhou
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yufeng Wang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Department of Oral Mucosal Diseases, Ninth People’s Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine, Shanghai, China,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuguang Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Sicong Li
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Grace Huang
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Cheng Peng
- Department of Stomatology, The secondary Hospital of Tianjin Medical University, Tianjin, China
| | - Anka Hu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA
| | - Qing Yu
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Xiaozhe Han
- Department of Immunology and Infectious Diseases, The Forsyth Institute, Cambridge, Massachusetts, USA,Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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13
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Sun J, Eberhard J, Glage S, Held N, Voigt H, Schwabe K, Winkel A, Stiesch M. Development of a peri‐implantitis model in the rat. Clin Oral Implants Res 2019; 31:203-214. [DOI: 10.1111/clr.13556] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/18/2019] [Accepted: 10/19/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Jingqing Sun
- Affiliated Hospital of Stomatology School of Medicine Zhejiang University Hangzhou China
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Joerg Eberhard
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
- Faculty of Dentistry University of Sydney Sydney NSW Australia
| | - Silke Glage
- Institution for Laboratory Animal Science Hannover Medical School Hannover Germany
| | - Nadine Held
- Institution for Laboratory Animal Science Hannover Medical School Hannover Germany
| | - Henning Voigt
- Department of Otorhinolaryngology Hannover Medical School Hannover Germany
| | - Kerstin Schwabe
- Department of Neurosurgery Hannover Medical School Hannover Germany
| | - Andreas Winkel
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
| | - Meike Stiesch
- Department of Prosthetic Dentistry and Biomedical Materials Science Hannover Medical School Hannover Germany
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14
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Varon-Shahar E, Shusterman A, Piattelli A, Iezzi G, Weiss EI, Houri-Haddad Y. Peri-implant alveolar bone resorption in an innovative peri-implantitis murine model: Effect of implant surface and onset of infection. Clin Implant Dent Relat Res 2019; 21:723-733. [PMID: 31219661 DOI: 10.1111/cid.12800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To compare the difference in alveolar bone resorption around implants after immediate placement in a bacterial induced experimental periimplantitis murine model. The various conditions that were examined were: Effect of implant surface characteristics and the onset of the induced infection. MATERIALS AND METHODS Screw-shaped titanium implants, smooth-surface or sand-blasted large-grit acid-etched (SLA) coated, were inserted immediately after extraction of the first upper left molar, in 90 5-6-week-old BALB/c mice. The mice were infected with Porphyromonas gingivalis and Fusobacterium nucleatum 21 (early infection) or 42 days (delayed infection) after implantation. Six weeks post infection, bone volume around inserted implants was measured using micro-CT, and was compared to alveolar bone level around teeth. Histological analysis was also performed. RESULTS The level of bone loss was significantly higher around the implants compared to the teeth, for smooth surface implants the bone loss was higher than of the SLA surface in both control and infected groups with no statistical significance. The survival rate of the implants in immediate infection was 75% compared of the 100% survival of the delayed infection and control mice. There is no significant difference between the early and the delayed infection in alveolar bone loss level around the implants. CONCLUSIONS This model can assist in studying the differences in alveolar bone resorption in different implants and their effect on the development of the disease.
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Affiliation(s)
- Einat Varon-Shahar
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
| | - Ariel Shusterman
- Department of Prosthodontics, Faculty of Dentistry, The Hebrew University - Hadassah, Jerusalem, Israel
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Ervin I Weiss
- Dental School, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Yael Houri-Haddad
- Acting Head, Department of Prosthodontics, Faculty of Dentistry, The Hebrew University-Hadassah, Jerusalem, Israel
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15
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Wang X, Li Y, Feng Y, Cheng H, Li D. Macrophage polarization in aseptic bone resorption around dental implants induced by Ti particles in a murine model. J Periodontal Res 2019; 54:329-338. [PMID: 30635919 DOI: 10.1111/jre.12633] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/01/2018] [Accepted: 12/10/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Titanium particles/ions detected in peri-implant tissues have been considered as a potential etiologic factor for crestal bone loss around oral implants. However, the definite impact of titanium wear particles on the health of surrounding structures remains undetermined. The purpose of this study was to investigate the effects of titanium particles-induced foreign body reaction on peri-implant bone level and the related mechanism by using clodronate liposomes to deplete macrophages. MATERIAL AND METHODS Sprague Dawley rats with custom-made titanium screw implanted in bilateral maxillary first molar area for 4 weeks to obtain osseointegration were randomly divided into four groups. Twenty microgram titanium particles were introduced into the peri-implant tissue to induce aseptic foreign body reaction, and macrophages were depleted by the local injection of 100 μL clodronate liposome immediately and re-injection every 3 days until the sacrifice of the rats (Ti + LipClod group). Titanium-injected rats also treated with phosphate buffer solution (Ti + PBS) or empty liposome (Ti + Lip) as well as rats injected with PBS alone (Control) were included as controls. Eight weeks later, animals were sacrificed and samples containing implants were collected. Half of the samples were analyzed radiologically to measure bone level change, and macrophage markers (CD68, CCR7, CD163) was also characterized by immunofluorescence to evaluate macrophage number, density, and phenotype distribution (CCR7+M1/CD163+M2). The rest of the samples were used to determine the relative mRNA expression levels of TNF-α, IL-1β, IL-6, and RANKL with real-time PCR analysis. RESULTS No obvious bacterial contamination was found in all titanium-injected areas, and the implant survival rate was 100% with no implant loss. Compared with Ti + PBS and Ti + Lip group, macrophage density (1.64 ± 0.86%) infiltrated into peri-implant tissue and bone loss (0.17 ± 0.03 mm) around implant decreased significantly in the Ti + LipClod group. Immunofluorescence analysis showed that more macrophage infiltrated into peri-implant tissue in the Ti + PBS and Ti + Lip groups, predominantly with M1 phenotype. In contrast, the macrophage density was lower and M2 phenotype was dominant in the Control group, while macrophages density was significantly reduced and the M1 type macrophages were slightly more than M2 type in the Ti + LipClod group. Accordingly, TNF-α, IL-1β, IL6, and RANKL mRNA expression increased significantly in the Ti + PBS and Ti + Lip groups compared with Control and Ti + LipClod groups. CONCLUSIONS Titanium particles had a negative effect on peri-implant tissue by activating macrophages which induced an M1 macrophage phenotype promoting local secretion of inflammatory cytokines. It was found that clodronate liposome treatment attenuated the severity of inflammation and bone loss by depletion of macrophages. Therefore, the present study revealed the marked impact of macrophage polarization with respect to peri-implant bone loss caused by titanium particles.
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Affiliation(s)
- Xin Wang
- State Key Laboratory of Military Stomatology &National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China.,Department of Stomatology, the 901th Hospital, Hefei, China
| | - Yu Li
- State Key Laboratory of Military Stomatology &National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuan Feng
- State Key Laboratory of Military Stomatology &National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Haode Cheng
- State Key Laboratory of Military Stomatology &National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Dehua Li
- State Key Laboratory of Military Stomatology &National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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16
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Biguetti CC, Cavalla F, Silveira EM, Fonseca AC, Vieira AE, Tabanez AP, Rodrigues DC, Trombone APF, Garlet GP. Oral implant osseointegration model in C57Bl/6 mice: microtomographic, histological, histomorphometric and molecular characterization. J Appl Oral Sci 2018; 26:e20170601. [PMID: 29898187 PMCID: PMC5963915 DOI: 10.1590/1678-7757-2017-0601] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/25/2018] [Indexed: 12/14/2022] Open
Abstract
Despite the successful clinical application of titanium (Ti) as a biomaterial, the exact cellular and molecular mechanisms responsible for Ti osseointegration remains unclear, especially because of the limited methodological tools available in this field.
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Affiliation(s)
- Claudia Cristina Biguetti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil
| | - Franco Cavalla
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil.,Universidad de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Santiago, Chile
| | - Elcia M Silveira
- Universidade do Sagrado Coração, Departamento de Ciências Biológicas e da Saúde, Bauru, Brasil
| | - Angélica Cristina Fonseca
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil
| | - Andreia Espindola Vieira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil.,Universidade Federal de Alagoas, Instituto de Ciências Biológicas e da Saúde, Alagoas, Brasil
| | - Andre Petenuci Tabanez
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil
| | - Danieli C Rodrigues
- University of Texas at Dallas, Department of Bioengineering, Dallas, Texas, United States
| | | | - Gustavo Pompermaier Garlet
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, São Paulo, Brasil
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17
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Wong RL, Hiyari S, Yaghsezian A, Davar M, Casarin M, Lin YL, Tetradis S, Camargo PM, Pirih FQ. Early intervention of peri-implantitis and periodontitis using a mouse model. J Periodontol 2018; 89:669-679. [PMID: 29520950 PMCID: PMC8607848 DOI: 10.1002/jper.17-0541] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 11/07/2017] [Accepted: 11/16/2017] [Indexed: 11/09/2023]
Abstract
BACKGROUND Peri-implantitis is an inflammatory response to bacterial biofilm resulting in bone loss and can ultimately lead to implant failure. Because of the lack of predictable treatments available, a thorough understanding of peri-implantitis's pathogenesis is essential. The objective of this study is to evaluate and compare the response of acute induced peri-implantitis and periodontitis lesions after insult removal. METHODS Implants were placed in one-month-old C57BL/6J male mice eight weeks post extraction of their left maxillary molars. Once osseointegrated, ligatures were placed around the implants and contralateral second molars of the experimental groups. Controls did not receive ligatures. After one week, half of the ligatures were removed, creating the ligature-retained and ligature-removed groups. Mice were sacrificed at two time points, 5 and 14 days, from ligature removal. The specimens were analyzed via micro-computed tomography and histology. RESULTS By 5 and 14 days after ligature removal, the periodontitis group experienced significant bone gain, whereas the peri-implantitis group did not. Histologically, all implant groups exhibited higher levels of cellular infiltrate than any of the tooth groups. Osteoclast numbers increased in peri-implantitis and periodontitis ligature-retained groups and decreased following insult removal. Collagen was overall more disorganized in peri-implantitis than periodontitis for all groups. Peri-implantitis experimental groups revealed greater matrix metalloproteinase-8 and NF-kB levels than periodontitis. CONCLUSIONS Implants respond slower and less favorably to insult removal than teeth. Future research is needed to characterize detailed peri-implantitis disease pathophysiology.
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Affiliation(s)
- Ryan L. Wong
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
| | - Sarah Hiyari
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
| | - Aline Yaghsezian
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
| | - Mina Davar
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
| | - Maísa Casarin
- Federal University of Santa Maria, Department of Stomatology, Santa Maria, Rio Grande do Sul, Brazil
| | - Yi-Ling Lin
- University of California, Los Angeles, Section of Oral and Maxillofacial Pathology, Los Angeles, California
| | - Sotirios Tetradis
- University of California, Los Angeles, Section of Oral and Maxillofacial Radiology, Los Angeles, California
| | - Paulo M. Camargo
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
| | - Flavia Q. Pirih
- University of California, Los Angeles, Section of Periodontics, Los Angeles, California
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18
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Hiyari S, Wong RL, Yaghsezian A, Naghibi A, Tetradis S, Camargo PM, Pirih FQ. Ligature-induced peri-implantitis and periodontitis in mice. J Clin Periodontol 2017; 45:89-99. [PMID: 28921659 DOI: 10.1111/jcpe.12817] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 01/12/2023]
Abstract
AIM Peri-implantitis (PI), inflammation around dental implants, shares characteristics with periodontitis (PD). However, PI is more difficult to control and treat, and detailed pathophysiology is unclear. We aimed to compare PI and PD progression utilizing a murine model. MATERIALS AND METHODS Four-week-old male C57BL/6J mice had their left maxillary molars extracted. Implants were placed in healed extraction sockets and osseointegrated. Ligatures were tied around the implants and second molars. Controls did not receive ligatures. Mice were sacrificed 1 week, 1 and 3 months (n ≥ 5/group/time point) post-ligature placement. Bone loss analysis was performed. Histology was performed for: haematoxylin and eosin (H&E), tartrate-resistant acid phosphatase (TRAP), matrix metalloproteinase-8 (MMP-8), nuclear factor kappa-light-chain enhancer of activated B cells (NF-κB), toluidine blue and calcein. RESULTS PI showed statistically greater bone loss compared to PD at 1 and 3 months. At 3 months, 20% of implants in PI exfoliated; no natural teeth exfoliated in PD. H&E revealed that alveolar bone surrounding implants in PI appeared less dense compared to PD. PI presented with increased osteoclasts, MMP-8 and NF-κB, compared to PD. CONCLUSION PI exhibited greater tissue and bone destruction compared to PD. Future studies will characterize the pathophysiological differences between the two conditions.
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Affiliation(s)
- Sarah Hiyari
- Section of Periodontics, University of California, Los Angeles, CA, USA
| | - Ryan L Wong
- Section of Periodontics, University of California, Los Angeles, CA, USA
| | - Aline Yaghsezian
- Section of Periodontics, University of California, Los Angeles, CA, USA
| | - Azadi Naghibi
- Section of Periodontics, University of California, Los Angeles, CA, USA
| | - Sotirios Tetradis
- Section of Oral and Maxillofacial Radiology, University of California, Los Angeles, CA, USA
| | - Paulo M Camargo
- Section of Periodontics, University of California, Los Angeles, CA, USA
| | - Flavia Q Pirih
- Section of Periodontics, University of California, Los Angeles, CA, USA
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19
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Wong RL, Hiyari S, Yaghsezian A, Davar M, Lin YL, Galvan M, Tetradis S, Camargo PM, Pirih FQ. Comparing the Healing Potential of Late-Stage Periodontitis and Peri-Implantitis. J ORAL IMPLANTOL 2017; 43:437-445. [PMID: 29064761 DOI: 10.1563/aaid-joi-d-17-00157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Peri-implantitis is defined as an inflammatory disease affecting the tissues around osseointegrated functioning implants. Unfortunately, detailed peri-implantitis pathogenesis is not well understood and current treatments lack predictability. Compare the healing potential of late-stage ligature-induced periodontitis and peri-implantitis after ligature removal. Four-week-old C57BL/6J male mice had their left maxillary molars extracted. After 8 weeks, implants were placed in healed sockets and allowed to osseointegrate. Mice were separated into control (no ligature) and experimental (ligature) groups. In the experimental group, ligatures were placed around the implant and the contralateral second molar. Four weeks later, the ligature group was randomly divided into ligature-retained and ligature-removed groups. Mice were sacrificed at 2 time points: 1 and 2 weeks after ligature removal. The samples were analyzed by microcomputed tomography (micro-CT) and histology. Ligature-induced significant bone loss in peri-implantitis and periodontitis were compared with respective controls. At the 2-week time point, bone formation was observed in the ligature-removed groups compared with respective controls; however, more bone was regained in periodontitis ligature-removed compared with the peri-implantitis ligature-removed group. Histologically, the peri-implantitis ligature-retained group had higher inflammatory levels and a higher number of osteoclasts compared with the periodontitis ligature-retained group. Moreover, in the peri-implantitis ligature-retained group, collagen appeared less organized compared with the periodontitis ligature-retained group at both time points; although collagen tended to reorganize following ligature removal in both conditions. Peri-implantitis does not respond to treatment as well as periodontitis. Future work includes understanding peri-implantitis pathogenesis and developing predictable treatment protocols.
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Affiliation(s)
- Ryan L Wong
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Sarah Hiyari
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Aline Yaghsezian
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Mina Davar
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Yi-Ling Lin
- 2 Section of Oral and Maxillofacial Pathology, University of California, Los Angeles, Calif
| | - Maria Galvan
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Sotirios Tetradis
- 2 Section of Oral and Maxillofacial Pathology, University of California, Los Angeles, Calif
| | - Paulo M Camargo
- 1 Section of Periodontics, University of California, Los Angeles, Calif
| | - Flavia Q Pirih
- 1 Section of Periodontics, University of California, Los Angeles, Calif
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20
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Hiyari S, Naghibi A, Wong R, Sadreshkevary R, Yi-Ling L, Tetradis S, Camargo PM, Pirih FQ. Susceptibility of different mouse strains to peri-implantitis. J Periodontal Res 2017; 53:107-116. [PMID: 29044525 DOI: 10.1111/jre.12493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Peri-implantitis (PI) is an inflammatory condition that affects the tissues surrounding dental implants. Although the pathogenesis of PI is not fully understood, evidence suggests that the etiology is multifactorial and may include a genetic component. The aim of this study was to investigate the role of genetics in the development of peri-implantitis. MATERIAL AND METHODS Four-week-old C57BL/6J, C3H/HeJ and A/J male mice had their left maxillary molars extracted. Implants were placed in the healed extraction sockets. Upon osseointegration, ligatures were placed around the implant head for 1 or 4 weeks to induce PI. Micro-computed tomography scanning was used to measure volumetric bone loss. Histological analyses were also performed to evaluate collagen organization and the presence of neutrophils and osteoclasts. RESULTS Radiographically, comparing the ligature-treated mice, C57BL/6J displayed the greatest amount of bone loss, followed by C3H/HeJ and A/J mice at 1 and 4 weeks. Histologically, at 1 week, C57BL/6J mice presented with the highest numbers of neutrophils and osteoclasts. At 4 weeks, C57BL/6J mice presented with the most active bone remodeling compared with the other two strains. CONCLUSION There were significant differences in the severity of peri-implantitis among the different mouse strains, suggesting that the genetic framework can affect implant survival and success. Future work is needed to dissect the genetic contribution to the development of peri-implantitis.
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Affiliation(s)
- S Hiyari
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - A Naghibi
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - R Wong
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - R Sadreshkevary
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - L Yi-Ling
- Section of Oral Pathology, School of Dentistry, University of California, Los Angeles, CA, USA
| | - S Tetradis
- Section of Radiology, School of Dentistry, University of California, Los Angeles, CA, USA
| | - P M Camargo
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - F Q Pirih
- Section of Periodontics, School of Dentistry, University of California, Los Angeles, CA, USA
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21
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Tzach-Nahman R, Mizraji G, Shapira L, Nussbaum G, Wilensky A. Oral infection with Porphyromonas gingivalis
induces peri-implantitis in a murine model: Evaluation of bone loss and the local inflammatory response. J Clin Periodontol 2017; 44:739-748. [DOI: 10.1111/jcpe.12735] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Rinat Tzach-Nahman
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Gabriel Mizraji
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Lior Shapira
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Gabriel Nussbaum
- The Institute of Dental Sciences; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Asaf Wilensky
- Department of Periodontology; Faculty of Dental Medicine; The Hebrew University-Hadassah Medical Center; Jerusalem Israel
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22
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Nguyen Vo TN, Hao J, Chou J, Oshima M, Aoki K, Kuroda S, Kaboosaya B, Kasugai S. Ligature induced peri-implantitis: tissue destruction and inflammatory progression in a murine model. Clin Oral Implants Res 2016; 28:129-136. [DOI: 10.1111/clr.12770] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 01/27/2023]
Affiliation(s)
- Trang N. Nguyen Vo
- Department of Oral Implantology and Regenerative Dental Medicine; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Jia Hao
- Department of Oral Implantology and Regenerative Dental Medicine; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Josh Chou
- School of Life Sciences; Faculty of Science; University of Technology Sydney; Sydney NSW Australia
| | - Masamitsu Oshima
- Department of Oral Rehabilitation and Regenerative Medicine; Graduate School of Medicine; Dentistry and Pharmaceutical Sciences; Okayama University; Okayama Japan
| | - Kazuhiro Aoki
- Department of Bio-Matrix (Pharmacology); Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Shinji Kuroda
- Department of Oral Implantology and Regenerative Dental Medicine; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Boosana Kaboosaya
- Department of Oral Implantology and Regenerative Dental Medicine; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Shohei Kasugai
- Department of Oral Implantology and Regenerative Dental Medicine; Graduate School of Medical and Dental Sciences; Tokyo Medical and Dental University; Tokyo Japan
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