RESUMEN
The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers' expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones.
Asunto(s)
Pilares Dentales , Implantes Dentales , Encía/fisiología , Anciano , Adhesión Celular , Femenino , Encía/citología , Gingivitis/etiología , Gingivitis/metabolismo , Humanos , Molécula 1 de Adhesión Intercelular/metabolismo , Queratinas , Terapia por Láser/métodos , Masculino , Metaloproteinasa 9 de la Matriz/genética , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Nanoporos , Inhibidor Tisular de Metaloproteinasa-1/genética , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
Although, the high success rate of implant rehabilitation treatment, the biological complications such as bone loss and peri-implantitis are still present. The creation of a coronal biological seal between the implant and the oral tissues seems to be a crucial point on preserving dental implants. The objective of this study was to immunohistochemically analyze the behavior of peri-implant soft tissues around a new implant healing-abutment surface on humans. A total of 30 soft tissue biopsies were collected after a healing period of 30 (±7) days, to analyze the expression of inflammatory (cluster of differentiation 63 (CD63), human neutrophil peptides 1-3 (HPN1-3)) and junctional (E-cadherin, occludin, and ß-catenin) markers, on soft tissues around laser treated and machined alternated healing abutments. The evaluation demonstrated the whole area of the soft tissues adherent to the laser treated surface with a regular morphology. While several stress hallmarks in correspondence of machined surfaces were shown such as: a) An irregular, disrupted, and discontinued basal membrane with an increased inflammation evident both the epithelial and connective tissues; b) the absence or defective proper keratinization process of the external layer, and c) damages in the cell to cell interaction. In conclusion, the laser treated surface is preferable to maintain the integrity and functionality of the gingiva epithelium.
RESUMEN
Immediate dentin sealing (IDS) is an advantageous approach for realizing adhesive restorations, but it interferes with the polymerization of impression material due to the oxygen-inhibition layer (OIL), which leaves residues of impression material on the teeth. The aim of this study is to identify a clinical surface cleaning protocol after IDS in order to achieve defect-free impressions. Sixty extracted human teeth were cut to expose fresh dentin and the IDS protocol was performed. Samples were divided into six groups where different surface cleaning protocols were made before taking impressions: G1S and G1P groups, IDS and silicone (S) or polyether (P) impressions; G2S and G2P, treatment with prophy paste and impressions; G3S and G3P, final cleaning phase with surfactant agent and impressions. Teeth were evaluated with a scanning electron microscope to identify the areas (expressed in mm2) where residual impression material was present. The results demonstrate a reduction of residues in the G2 groups and the total disappearance in G3 groups with statistically significant differences between them. Superficial cleaning protocols with the prophy paste and surfactant agent lead to the elimination of the interaction with impression materials and OIL. These results suggest a safe clinical protocol for obtaining defect-free impressions after IDS.