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Belloni A, Argentieri G, Orilisi G, Notarstefano V, Giorgini E, D'Addazio G, Orsini G, Caputi S, Sinjari B. New insights on collagen structural organization and spatial distribution around dental implants: a comparison between machined and laser-treated surfaces. J Transl Med 2024; 22:120. [PMID: 38297308 PMCID: PMC10829267 DOI: 10.1186/s12967-024-04906-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND One of the main factors for the osseointegration of dental implants is the development of an adequate soft tissue barrier, mainly composed by collagen, which protects the implant from bacterial development. The structural features of the peri-implant collagen are influenced by the implant components and, in particular, by the type of the surface. In the clinical practice, healing abutments are characterized by smooth surfaces, named machined. Recently, a new laser technique, Synthegra, has been developed to obtain a topography-controlled surface with micrometric regular pores that seems reducing the risk of peri-implantitis. Based on this background, this study aims investigating the structural organization and spatial distribution of collagen surrounding healing abutments characterized by laser-treated and machined surfaces. METHODS Gingiva portions surrounding custom-made healing abutments (HA), characterized by alternated laser-treated and machined surfaces, were collected and analyzed by combining Fourier Transform InfraRed Imaging (FTIRI) spectroscopy, a non-invasive and high-resolution bidimensional analytical technique, with histological and multivariate analyses. RESULTS Masson's trichrome staining, specific for collagen, highlighted a massive presence of collagen in all the analyzed samples, evidencing a surface-related spatial distribution. The nature of collagen, investigated by the FTIRI spectroscopy, appeared more abundant close to the laser-treated surface, with a perpendicular disposition of the bundles respect to the HA; conversely, a parallel distribution was observed around the machined surface. A different secondary structure was also found, with a higher amount of triple helices and a lower quantity of random coils in collagen close to the laser treated surfaces. CONCLUSIONS FTIRI spectroscopy demonstrates that the use of a laser treated transmucosal surface can improve the morphological organization of the peri-implant collagen, which presents a distribution more similar to that of natural teeth. TRIAL REGISTRATION This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970). Registered 06/03/2023, retrospectively registered, https://clinicaltrials.gov/show/NCT05754970 .
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Affiliation(s)
- Alessia Belloni
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Giulio Argentieri
- Electron Microscopy Laboratory, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Giulia Orilisi
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Valentina Notarstefano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Elisabetta Giorgini
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria D'Addazio
- Electron Microscopy Laboratory, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy.
| | - Sergio Caputi
- Electron Microscopy Laboratory, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Bruna Sinjari
- Electron Microscopy Laboratory, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
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Windra Sari A, Widyaningrum R, Setiawan A, Mitrayana. Recent development of photoacoustic imaging in dentistry: A review on studies over the last decade. Saudi Dent J 2023; 35:423-436. [PMID: 37520594 PMCID: PMC10373091 DOI: 10.1016/j.sdentj.2023.05.013] [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: 01/03/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 08/01/2023] Open
Abstract
Background This work performs a literature review of photoacoustic imaging (PAI) in dentistry and discusses the development of PAI in relation to oral health. Methods A search method was used to locate papers published between 2011 and 2023 in Google Scholar and PubMed databases, and 25 studies were selected. Reports on PAI in dentistry were included. Articles not written in English or whose full text could not be accessed were excluded. The remaining publications were checked and evaluated to determine whether they contain supportive materials for PAI in dentistry. Results The majority of articles about PAI in dentistry are associated with caries studies. Photoacoustic microscopy is the most commonly utilized PAI system. PAI studies generally focus on ex-vivo investigations using extracted human teeth. The acoustic signal obtained from carious teeth is greater than that obtained from normal teeth. In addition to imaging oral soft tissues from animal models and the periodontal pocket depth in human volunteers, PAI is applied to evaluate dental implants and oral biofilms. Conclusion There have been numerous investigation on PAI in dentistry, but it is not yet applicable in dental practice. In the future, PAI studies are expected to contribute to the invention of an alternative non-ionizing imaging technology that is comfortable for patients, user friendly, and capable of providing reliable information at a reasonable cost.
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Affiliation(s)
- Atika Windra Sari
- Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, Indonesia
| | - Rini Widyaningrum
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andreas Setiawan
- Department of Physics, Faculty of Science and Mathematics, Satya Wacana Christian University, Jl. Diponegoro 52-60, Salatiga, Indonesia
| | - Mitrayana
- Department of Physics, Faculty of Mathematics and Natural Sciences, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, Indonesia
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Gaggi G, Di Credico A, D'Addazio G, Ghinassi B, Argentieri G, Caputi S, Di Baldassarre A, Sinjari B. Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials. BMC Oral Health 2023; 23:425. [PMID: 37370064 DOI: 10.1186/s12903-023-03148-y] [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: 03/27/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Dental implant is the principal treatment for edentulism and the healthiness of the peri-implant tissue has a pivotal role for its longterm success. In addition, it has been shown that also the topography of the healing abutment can influence the outcome of the restoration. The objective of this human clinical trial was to assess the impact of a novel laser-treated healing abutment on peri-implant connective tissue and extracellular matrix proteins compared to the conventional machined surface, which served as the control group. METHODS During second surgical stage a customized healing abutment were inserted on 30 single dental implants. Healing abutments were realized with two alternated different surface (two side laser-treated surfaces and two side machined surfaces) in order to be considered both as test and control on the same implant and reduce positioning bias. Following the soft tissue healing period (30 ± 7 days) a 5 mm circular biopsy was retrieved. Immuno-histochemical and quantitative real-time PCR (qPCR) analyses were performed on Collagen, Tenascin C, Fibrillin I, Metalloproteinases (MMPs) and their inhibitor (TIMPs). 15 were processed for qPCR, while the other 15 were processed for immunohistochemical analysis. Paired t-test between the two groups were performed. A value of p < 0.05 was considered statistically significant. RESULTS Results revealed that the connective tissue facing the laser-treated surface expressed statistically significant lower amount of MMPs (p < 0.05) and higher level of TIMPs 3 (p < 0.05), compared to the tissue surrounding the machined implant, which, in turn expressed also altered level of extracellular matrix protein (Tenascin C, Fibrillin I (p < 0.05)) and Collagen V, that are known to be altered also in peri-implantitis. CONCLUSIONS In conclusion, the laser-treated surface holds promise in positively influencing wound healing of peri-implant connective tissue. Results demonstrated that topographic nature of the healing abutments can positively influence mucosal wound healing and molecular expression. Previous studies have been demonstrated how laser treatment can rightly influence integrity and functionality of the gingiva epithelium and cell adhesion. Regarding connective tissue different molecular expression demonstrated a different inflammatory pattern between laser treated or machined surfaces where laser treated showed better response. Targeted interventions and preventive measures on peri- implant topography could effectively minimize the risk of peri-implant diseases contributing to the long-term success and durability of restoration. However, new studies are mandatory to better understand this phenomenon and the role of this surface in the peri-implantitis process. TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970 ). Registered 06/03/2023, retrospectively registered.
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Affiliation(s)
- Giulia Gaggi
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Andrea Di Credico
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Gianmaria D'Addazio
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Barbara Ghinassi
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Giulio Argentieri
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Sergio Caputi
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
| | - Angela Di Baldassarre
- Human Anatomy and Cell Differentiation Lab, Department of Medicine and Aging Sciences, University "G.d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy.
| | - Bruna Sinjari
- Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
- Electron Microscopy Laboratory, University "G. d'Annunzio" of Chieti-Pescara, 66100, Chieti, Italy
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Canullo L, Rakic M, Corvino E, Burton M, Krumbeck JA, Chittoor Prem A, Ravidà A, Ignjatović N, Sculean A, Menini M, Pesce P. Effect of argon plasma pre-treatment of healing abutments on peri-implant microbiome and soft tissue integration: a proof-of-concept randomized study. BMC Oral Health 2023; 23:27. [PMID: 36650477 PMCID: PMC9843976 DOI: 10.1186/s12903-023-02729-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Biofilm-free implant surface is ultimate prerequisite for successful soft and bone tissue integration. Objective of the study was to estimate the effects of argon plasma healing abutment pre-treatment (PT) on peri-implant soft-tissue phenotype (PiSP), inflammation, plaque accumulation and the microbiome (PiM) between non-treated (NPT) and treated (PT) abutments following 3-months healing period. The hypothesis was that cell-conductive and antimicrobial properties of PT would yield optimal conditions for soft tissue integration. MATERIAL AND METHODS Two months following second-phase surgery, microbiological and clinical parameters were assessed around thirty-six healing abutments with two types of microtopography, smooth surface (MACHINED) and ultrathin threaded microsurface (ROUGH). A two level randomization schema was used to achieve equal distribution and abutments were randomly divided into rough and machined groups, and then divided into PT and NPT groups. PiM was assessed using next-generation DNA sequencing. RESULTS PiM bacterial composition was highly diverse already two months post-implantation, consisting of key-stone pathogens, early and late colonizers, while the mycobiome was less diverse. PT was associated with lower plaque accumulation and inflammation without significant impact on PiSP, while in NPT clinical parameters were increased and associated with periopathogens. NPT mostly harbored late colonizers, while PT exerted higher abundance of early colonizers suggesting less advanced plaque formation. Interaction analysis in PT demonstrated S. mitis co-occurrence with pro-healthy Rothia dentocariosa and co-exclusion with Parvimonas micra, Porphyromonas endodontalis and Prevotella oris. PiSP parameters were generally similar between the groups, but significant association between PiM and keratinized mucosa width was observed in both groups, with remarkably more expressed diversity in NPT compared to PT. PT resulted in significantly lower BOP and PI around rough and machined abutments, respectively, without specific effect on PiM and PiSP. CONCLUSIONS PT contributed to significantly the less advanced biofilm accumulation and inflammation without specific effects on PiSP.
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Affiliation(s)
- Luigi Canullo
- grid.5734.50000 0001 0726 5157Department of Periodontology, University of Bern, Bern, Switzerland ,grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Mia Rakic
- grid.4795.f0000 0001 2157 7667ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Emilio Corvino
- grid.8404.80000 0004 1757 2304University of Florence, Florence, Italy
| | - Maria Burton
- Zymo Research Corporation, 17062 Murphy Ave, Irvine, CA 92614 USA
| | - Janina A. Krumbeck
- Zymo Research Corporation, 17062 Murphy Ave, Irvine, CA 92614 USA ,Pangea Laboratory, 14762 Bentley Cir., Tustin, CA 92780 USA
| | | | | | - Nenad Ignjatović
- grid.419857.60000 0001 2221 9722Institute of Technical Science of the Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia
| | - Anton Sculean
- grid.5734.50000 0001 0726 5157Department of Periodontology, University of Bern, Bern, Switzerland
| | - Maria Menini
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Paolo Pesce
- grid.5606.50000 0001 2151 3065Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
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Genova T, Chinigò G, Munaron L, Rivolo P, Luganini A, Gribaudo G, Cavagnetto D, Mandracci P, Mussano F. Bacterial and Cellular Response to Yellow-Shaded Surface Modifications for Dental Implant Abutments. Biomolecules 2022; 12:biom12111718. [PMID: 36421732 PMCID: PMC9687512 DOI: 10.3390/biom12111718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Dental implants have dramatically changed the rehabilitation procedures in dental prostheses but are hindered by the possible onset of peri-implantitis. This paper aims to assess whether an anodization process applied to clinically used surfaces could enhance the adhesion of fibroblasts and reduce bacterial adhesion using as a reference the untreated machined surface. To this purpose, four different surfaces were prepared: (i) machined (MAC), (ii) machined and anodized (Y-MAC), (iii) anodized after sand-blasting and acid etching treatment (Y-SL), and (iv) anodized after double acid etching (Y-DM). All specimens were characterized by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Moreover, the mean contact angle in both water and diiodomethane as well as surface free energy calculation was assessed. To evaluate changes in terms of biological responses, we investigated the adhesion of Streptococcus sanguinis (S. sanguinis) and Enterococcus faecalis (E. faecalis), fetal bovine serum (FBS) adsorption, and the early response of fibroblasts in terms of cell adhesion and viability. We found that the anodization reduced bacterial adhesion, while roughened surfaces outperformed the machined ones for protein adsorption, fibroblast adhesion, and viability independently of the treatment. It can be concluded that surface modification techniques such as anodization are valuable options to enhance the performance of dental implants.
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Affiliation(s)
- Tullio Genova
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy
| | - Giorgia Chinigò
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy
| | - Luca Munaron
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy
| | - Paola Rivolo
- Department of Applied Science and Technology, Materials and Microsoystems Laboratory (ChiLab), Politecnico di Torino, 10129 Torino, Italy
| | - Anna Luganini
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy
| | - Giorgio Gribaudo
- Department of Life Sciences and Systems Biology, University of Turin, 10123 Turin, Italy
| | - Davide Cavagnetto
- Department of Surgical Sciences, CIR Dental School, University of Turin, 10126 Turin, Italy
- Politecnico di Torino, 10129 Torino, Italy
- Correspondence:
| | - Pietro Mandracci
- Department of Applied Science and Technology, Materials and Microsoystems Laboratory (ChiLab), Politecnico di Torino, 10129 Torino, Italy
| | - Federico Mussano
- Department of Surgical Sciences, CIR Dental School, University of Turin, 10126 Turin, Italy
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Rapp L, Madden S, Rode AV, Walsh LJ, Spallek H, Nguyen Q, Dau V, Woodfield P, Dao D, Zuaiter O, Habeb A, Hirst TR. Anesthetic-, irrigation- and pain-free dentistry? The case for a femtosecond laser enabled intraoral robotic device. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.976097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
By leveraging ultrashort pulse laser and micro-electromechanical systems (MEMS) technologies, we are developing a miniaturized intraoral dental robotic device that clamps onto teeth, is remotely controlled, and equipped with a focusing and scanning system to perform efficient, fast, and ultra-precise laser treatments of teeth and dental restorative materials. The device will be supported by a real-time monitoring system for visualization and diagnostic analysis with appropriate digital controls. It will liberate dentists from repetitive manual operations, physical strain and proximity to the patient's oro-pharyngal area that potentially contains infectious agents. The technology will provide patients with high-accuracy, minimally invasive and pain-free treatment. Unlike conventional lasers, femtosecond lasers can ablate all materials without generating heat, thus negating the need for water irrigation, allowing for a clear field of view, and lowering cross-infection hazards. Additionally, dentists can check, analyze, and perform precise cutting of tooth structure with automatic correction, reducing human error. Performing early-stage diagnosis and intervention remotely will be possible through units installed at schools, rural health centers and aged care facilities. Not only can the combination of femtosecond lasers, robotics and MEMS provide practical solutions to dentistry's enduring issues by allowing more precise, efficient, and predictable treatment, but it will also lead to improving the overall access to oral healthcare for communities at large.
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Kim JC, Lee M, Yeo ISL. Three interfaces of the dental implant system and their clinical effects on hard and soft tissues. MATERIALS HORIZONS 2022; 9:1387-1411. [PMID: 35293401 DOI: 10.1039/d1mh01621k] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Anatomically, the human tooth has structures both embedded within and forming part of the exterior surface of the human body. When a tooth is lost, it is often replaced by a dental implant, to facilitate the chewing of food and for esthetic purposes. For successful substitution of the lost tooth, hard tissue should be integrated into the implant surface. The microtopography and chemistry of the implant surface have been explored with the aim of enhancing osseointegration. Additionally, clinical implant success is dependent on ensuring that a barrier, comprising strong gingival attachment to an abutment, does not allow the infiltration of oral bacteria into the bone-integrated surface. Epithelial and connective tissue cells respond to the abutment surface, depending on its surface characteristics and the materials from which it is made. In particular, the biomechanics of the implant-abutment connection structure (i.e., the biomechanics of the interface between implant and abutment surfaces, and the screw mechanics of the implant-abutment assembly) are critical for both the soft tissue seal and hard tissue integration. Herein, we discuss the clinical importance of these three interfaces: bone-implant, gingiva-abutment, and implant-abutment.
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Affiliation(s)
- Jeong Chan Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea
| | - Min Lee
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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