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1.
Artículo en Inglés | MEDLINE | ID: mdl-34076631

RESUMEN

This case control study measured early crestal bone changes around subcrestally placed platform-switched implants surrounded by thin soft tissue and compared them with regular, matching-platform implants placed in a supracrestal position and surrounded by thick soft tissue. Sixty-six patients received two-piece internal hex dental implants. Control group patients (n = 33) received implants that had a horizontally matching implant-abutment connection and were placed approximately 0.5 to 1 mm supracrestally. Test group patients (n = 33) received platform-switched implants that were placed about 1.5 mm subcrestally. Clinical examinations were conducted, intraoral radiographs were taken, and statistical analysis was performed. After 2 months, the mean bone loss was 0.2 mm (SD: 0.22 mm; range: 0.1 to 1.2 mm) in the control group and -0.69 mm (SD: 0.65 mm; range: 0 to 2.6 mm) in the test group; this difference was found to be statistically significant (P < .05). After 1 year, mean bone loss was 0.28 mm (SD: 0.36 mm; range: 0.1 to 1.63 mm) in the control group and -0.6 mm (SD: 0.55 mm; range: 0.05 to 1.8 mm) in the test group. Platform-switched implants placed in a subcrestal position in vertically thin soft tissues showed statistically significantly more bone loss than non-platform-switched implants placed supracrestally with vertically thick tissues.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Huesos , Estudios de Casos y Controles , Implantación Dental Endoósea , Humanos
2.
BMC Oral Health ; 21(1): 171, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794841

RESUMEN

BACKGROUND: This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). METHODS: This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. RESULTS: A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient's age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). CONCLUSIONS: Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
3.
BMC Oral Health ; 21(1): 214, 2021 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-33906655

RESUMEN

BACKGROUND: The influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents. METHODS: In this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal-Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons. RESULTS: After a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P < 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P < 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P < 0.05) and GLP-1 group (P < 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P > 0.05). CONCLUSIONS: The radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone. Clinical trial registration number ChiCTR2000034211 (retrospectively registered).


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Diabetes Mellitus Tipo 2 , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Estudios de Seguimiento , Humanos , Hipoglucemiantes/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento
4.
Int J Oral Maxillofac Implants ; 36(2): 355-360, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909727

RESUMEN

PURPOSE: The objective of this study was to report implant survival rates, marginal bone loss, and the impact of prosthesis type among patients with type 2 diabetes mellitus (DMT2), with high hemoglobin A1C (HbA1c) values. MATERIALS AND METHODS: This retrospective study utilized patient medical records from an oral surgeon's office. Patients who had moderately or poorly controlled DMT2 with HbA1c values up to 10% were reviewed. Inclusion criteria were partially or fully edentulous patients diagnosed with DMT2 who were subsequently treated with implant-supported prosthetic restorations. Patients were at least 18 years of age. Exclusion criteria were patients who did not present for annual follow-up visits, patient records with incomplete surgical or restorative data, or nondiagnostic radiographs. All the fixed restorations were cement-retained, and the removable restorations were supported by two to six implants. Marginal bone loss and the consequences of prosthetic type were assessed from the last available radiograph compared with the one taken after the surgical procedure. RESULTS: Data of 357 implants were extracted from the records of 38 patients with HbA1c values (6.9% to 10.0%). The mean follow-up was 7.3 years, with a minimum of 5 years. Six implants failed, yielding a 98.4% overall implant survival rate. The patients were divided into two groups according to the HbA1c values before implant placement. The moderately controlled group included 25 patients with DMT2, with HbA1c values of 6.9% to 8.0%, and the poorly controlled group included 13 patients, with HbA1c values of 8.1% to 10.0%. The overall mean bone loss was 2.02 ± 2.43 mm. In both groups, the maxilla demonstrated more bone loss than the mandible (P < .05). Marginal bone loss in moderately controlled and poorly controlled groups was 1.86 (± 2.21) mm and 2.33 (± 2.85) mm, respectively (P < .05). Removable prostheses also revealed greater bone loss rates compared with fixed prostheses in both groups (P < .05). CONCLUSION: Patients with high HbA1c values (8.1% to 10.0%) had more marginal bone loss than those with lower HbA1c values. Removable dentures should be reconsidered as a standard treatment option in these patients.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Diabetes Mellitus Tipo 2 , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Diabetes Mellitus Tipo 2/complicaciones , Estudios de Seguimiento , Hemoglobina A Glucada , Humanos , Estudios Retrospectivos
5.
Clin Oral Implants Res ; 32(5): 651-656, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33686723

RESUMEN

OBJECTIVES: To analyse whether there is a difference in marginal bone levels (MBL) and the respective changes between cemented and screw-retained reconstructions at 3 and 5 years of loading. METHODS: Radiographic data from 14 prospective multicentre clinical trials following implant loading with fixed cemented (CEM) or screw-retained (SCREW) reconstructions with a 3- to 5-year follow-up were retrieved from a database. MBL and MBL changes were assessed at initiation of implant loading (BL), at 3 (FU-3) and 5 years (FU-5) thereafter. The presence of peri-implantitis was also determined. RESULTS: Data from 1,672 implants at BL, 1,565 implants at FU-3 and 1,109 implants at FU-5 were available. The mean MBL amounted to 0.57 mm (SD 0.87) at BL, 0.55 mm (SD 0.86) at FU-3 and 0.65 mm (SD 1.18) at FU-5. At FU-3, the mean MBL was 0.44 mm (SD 0.65) in group CEM and 0.63 mm (SD 0.99) in group SCREW showing a significant difference between the groups (intergroup <0.05). At FU-5, the mean MBL was 0.42 mm (SD 0.77) in CEM and 0.80 mm (SD 1.37) in SCREW, again with significant differences between both groups (p < .05). MBL changes between BL and FU-3 amounted to 0.11 mm (SD 1.02) (bone loss) in SCREW and -0.17 mm (SD 1.03) (bone gain) in CEM. Similarly, mean MBL changes from BL to FU-5 amounted to 0.23 mm (SD 1.31) (bone loss) in SCREW and -0.26 mm (SD 1.27) (bone gain) in CEM. The prevalence of peri-implantitis amounted to 6.9% in CEM and 5.6% in group SCREW (intergroup p = .29063) at FU-3. At FU-5, peri-implantitis amounted to 4.6% in CEM and 6.2% in group SCREW (intergroup p = .28242). CONCLUSION: Cemented implant reconstructions compared with screw-retained reconstructions revealed higher marginal bone levels and similar rates of peri-implantitis during 5 years. The difference in MBL and the respective changes between the two groups, however, appear to be clinically negligible.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Tornillos Óseos , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Humanos , Periimplantitis/etiología , Estudios Prospectivos
6.
J Oral Sci ; 63(2): 152-156, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33597334

RESUMEN

PURPOSE: To determine the impact of experimentally preformed peri-implant crater-shaped bone defects on the evolution of in situ microbiota and development of bone defects compared to those induced over time by ligature placement only. METHODS: Implants were installed in the mandibles of eight dogs. Standardized bone defects were preformed in four test animals but not in the other four control animals, prior to implant (3.3 mm × 8 mm) installation. After 2 months of healing, peri-implantitis was induced with silk ligatures in both groups for 2 months. Microbial samples were obtained from implants and teeth for analysis at three time points (qPCR), and the average depths of the bone defects were measured. RESULTS: At the baseline, the total marker load of periodontal-pathogenic bacteria (TML) for teeth accounted for 5.2% (0-17.4%). After implant healing, TMLs for implants and teeth were comparable (7.1% [0.3-17.4%]). The TML of both groups was 3.5%, 2 months after ligature placement. Bone defects had a mean depth of 1.84 mm at preformed defects and 1.64 mm at control sites (P > 0.05). CONCLUSION: Preformed defects in the test group showed comparable results to the control group in terms of TML, the incidence of periodontal-pathogenic bacteria, and bone defect depth.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Pérdida de Hueso Alveolar/etiología , Animales , Implantes Dentales/efectos adversos , Ligadura , Mandíbula
7.
Int J Oral Maxillofac Implants ; 36(1): 165-176, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600538

RESUMEN

PURPOSE: This study sought to define the tissue responses at different implant-abutment interfaces by studying bone and peri-implant mucosal changes using a 5-year prospective randomized clinical trial design study. The conus interface was compared with the flat-to-flat interface and platform-switched implant-abutment systems. MATERIALS AND METHODS: One hundred forty-one subjects were recruited and randomized to the three treatment groups according to defined inclusion and exclusion criteria. Following implant placement and immediate provisionalization in healed alveolar ridges, clinical, photographic, and radiographic parameters were measured at 6 months and annually for 5 years. The calculated changes in marginal bone levels, peri-implant mucosal zenith location, papillae lengths, and peri-implant Plaque Index and bleeding on probing were statistically compared. RESULTS: Forty-eight conus interface implants, 49 flat-to-flat interface implants, and 44 platform-switched implants were placed in 141 subjects. Six platform-switched interface and eight flatto- flat interface implants failed, most of them within 3 months. After 5 years, 33 conical interface, 28 flat-to-flat interface, and 27 platform-switched interface implants remained for evaluation. Calculation of marginal bone level change showed a mean marginal bone loss of -0.16 ± 0.45 (-1.55 to 0.65), -0.92 ± 0.70 (-2.90 to 0.20), and -0.81 ± 1.06 (-3.35 to 1.35) mm for conical interface, flat-to-flat interface, and platform-switched interface implants, respectively (P < .0005). The peri-implant mucosal zenith changes were minimal for all three interface designs (0.10 mm and +0.08 mm, P > .60). Only 16% to 19% of the surfaces had presence of bleeding on probing, with no significant differences (P > .81) between groups. Interproximal tissue changes were positive and similar among the implant interface designs. CONCLUSION: Over 5 years, the immediate provisionalization protocol resulted in stable peri-implant mucosal responses for all three interfaces. Compared with the flat-to-flat and platform-switched interfaces, the conical interface implants demonstrated significantly less early marginal bone loss. The relationship of marginal bone responses and mucosal responses requires further experimental consideration.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Estética Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Prospectivos
8.
Clin Implant Dent Relat Res ; 23(2): 259-269, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33527729

RESUMEN

BACKGROUND: The relation between implant abutment disconnection (AD) and increased crestal bone loss is still debated. PURPOSE: To compare bone changes below implant-abutment junction of subcrestally placed implants between: (1) implant level restorations, that underwent four ADs and (2) implants with immediate tissue level abutment with no AD, 1 month (T2) and 1-year (T3) after final restoration delivery. MATERIALS AND METHODS: Sixty-four patients received 64 bone level implants with platform-switching and conical connection in edentulous sites of posterior mandible and maxilla. All implants were placed 1.5 mm subcrestally and distributed among: (1) control group, that received a regular healing abutment and (2) test group with immediate tissue level (ITL) abutment, which was torqued to implants during surgery, transforming bone level implant to tissue level type. After 2-3 months of healing and a 1-month temporization, final zirconia-based screw-retained crowns were delivered to both groups. Crestal bone levels were calculated after final crown delivery (T2); after 1-year follow-up (T3) and compared using Mann-Whitney U test (p ≤ .05). RESULTS: Early bone loss of the test and control groups was 0.14 ± 0.27 mm and 0.64 ± 0.64 mm, respectively; the 0.5 mm difference was statistically significant (p = .0001). Late bone loss was 0.06 ± 0.16 mm and 0.21 ± 0.56 mm for the test and control group, respectively; the 0.15 mm difference between the groups was no more statistically significant (p = .22). Both groups displayed bone gain, 0.08 and 0.43 mm, respectively, and the overall crestal bone loss was reduced. CONCLUSIONS: Immediate tissue level abutments can significantly reduce early bone loss when measured 1 month after final prosthesis delivery, however, after 1-year follow-up, difference between the groups was no more statistically significant.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/etiología , Coronas , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea , Restauración Dental Provisional , Estudios de Seguimiento , Humanos
9.
Odontology ; 109(3): 649-660, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33496913

RESUMEN

To evaluate implant loss (IL) and marginal bone loss (MBL); follow-up period of up to 10 years after prosthetic loading. Retrospective multi-centre cross-sectional cohort study. Double analysis: (1) all the implants (n = 456) were analysed; (2) to allow for possible cluster error, one implant per patient (n = 143) was selected randomly. Statistical analysis: Spearman's correlation coefficient; Kruskal-Wallis (post-hoc U-Mann-Whitney); Chi-square (post-hoc Haberman). (1) Analysing all the implants (456): IL was observed in patients with past periodontitis (6 vs. 2.2%, p < 0.05), short implants (12 vs. 2.8%, p < 0.001) and when using regenerative surgery (11.3 vs. 2.9%, p < 0.001); greater MBL was observed among smokers (0.39 ± 0.52 vs. 0.2 ± 0.29, p < 0.01), maxillary implants (0.28 ± 0.37 vs. 0.1 ± 0.17, p < 0.0001), anterior region implants (0.32 ± 0.36 vs. 0.21 ± 0.33, p < 0.001), external connection implants (0.2 ± 0.29 vs. 0.63 ± 0.59, p < 0.0001), and 2-3 years after loading (p < 0.0001). (2) analysing the cluster (143): IL was observed in smokers (18.8 vs. 3.5%, p < 0.05), splinted fixed crowns (12.9%, p < 0.01), short implants (22.2 vs. 4.0%, p < 0.01) and when using regenerative surgery (19.2 vs. 3.4%, p < 0.01); greater MBL was observed in maxillary implants (0.25 ± 0.35 vs. 0.11 ± 0.18, p < 0.05), in the anterior region (p < 0.05), in the first 3 years (p < 0.01), in external connection implants (0.72 ± 0.71 vs. 0.19 ± 0.26, p < 0.01) and in short implants (0.38 ± 0.31 vs. 0.2 ± 0.32, p < 0.05). There is greater risk in smokers, patients with past periodontal disease, external connection implants, the use of short implants and when regenerative techniques are used. To prevent MBL and IL, implantologists should be very meticulous in indicating implants in patients affected by these host factors.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/etiología , Estudios de Cohortes , Estudios Transversales , Implantes Dentales/efectos adversos , Humanos , Estudios Retrospectivos
10.
Clin Implant Dent Relat Res ; 23(1): 61-72, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33438320

RESUMEN

BACKGROUND: Customized sealing socket abutment (SSA) has been claimed to optimize the peri-implant hard and soft tissues in type 1 implant placement. However, the evidence to claim the benefits of this technique over the use a conventional healing abutment remains weak. PURPOSE: The aim of this retrospective study was to provide a 3D-radiographic evaluation of hard tissues changes following immediate implant placement in molar sites combined to ARP technique and installation of SSA. MATERIALS AND METHODS: Baseline and follow-up (FU) CBCTs (from 1 to 5 years) of 26 patients were collected and included in the study. Baseline and FU CBCTs were superimposed and horizontal and vertical bone changes were assessed. RESULTS: A total of 26 patients and 27 implants were included. Horizontal bone remodeling was not significant in any of the measured areas except in the most cervical level, where a mean bone remodeling of 0.73 mm was found. Proximal and buccal vertical bone changes were not significant. CONCLUSIONS: Within the limits of a retrospective study, dimensional alveolar ridge changes 1 to 5 years after immediate implant placement in molar sites with simultaneous ARP technique and installation of SSA seem to be very limited.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Humanos , Estudios Retrospectivos , Extracción Dental/efectos adversos , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
12.
Clin Implant Dent Relat Res ; 23(2): 159-169, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33463007

RESUMEN

BACKGROUND: Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant, despite the fact that their significance for the long-term survival of the implant has never been properly assessed. PURPOSE: To challenge the assumption that the natural course of peri-implant bone loss is the loss of the implant. MATERIALS AND METHODS: This article is a narrative review on reasons and interpretations of marginal bone level changes around dental implants. RESULTS AND CONCLUSIONS: Different views regarding the pattern and progression of marginal bone loss depending on dental specialties have been identified. However, the present finding of a negative correlation between an increasing cumulative marginal bone loss and a decreasing risk of implant failures over time indicates that peri-implant marginal bone loss does not necessarily represent a condition of disease. Reduction of marginal bone levels may be observed in a majority of patients during follow-up time, with only a minority of those patients losing implants and implant-supported prostheses in the long term. Bone level changes seem often to occur as a consequence of physiological processes and/or as an adaptation to altered external as well as host response factors. Periodical radiological assessments of implant-restorations remain a valid diagnostic tool for the detection of potential implant fractures, loss of osseointegration, screws working loose and for the detection of the few cases with advanced, continuously progressing marginal bone loss during time. The detection of peri-implant marginal bone loss at one time point should not be immediately considered as a sign of ongoing pathology and of an increased risk of future loss of the implant in question.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Oseointegración
13.
Clin Implant Dent Relat Res ; 23(2): 170-177, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33463079

RESUMEN

BACKGROUND: Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant. Reduction of marginal bone levels in association with bleeding on probing have been claimed to be a sign of pathology and an indication of treatment needs. PURPOSE: To assess the available evidence that peri-implant bone loss is caused by infection. MATERIALS AND METHODS: This article is a narrative review on the interpretation of marginal bone level changes around dental implants as a consequence of infection. RESULTS AND CONCLUSIONS: There is evidence that plaque accumulation induces an inflammatory reaction in the peri-implant soft tissues and that resumption of plaque control measures results in the reduction of the inflammation. Since plaque is always present in the oral cavity, a cause-effect relationship between plaque accumulation and peri-implantitis, defined as inflammation of the peri-implant soft tissues associated with marginal bone loss has been difficult to validate and has not been proven so far. There is no evidence of the mechanisms involved in the tissue reactions resulting in the conversion from a state of an inevitable inflammation contained in the soft tissues to a state of inflammation involving the loss of peri-implant marginal bone. There is today no consensus whether implants should be expected to be surrounded by tissues which are completely free from inflammation, or that an "immune-driven", chronic, subclinical inflammation should be expected at the foreign body implant. The infectious origin theory appears to be mainly supported by ligature-induced experimental peri-implantitis investigations in animal models that suffer of several methodological problems, and therefore, provide misleading information with regards to human clinical applications in large, routine populations.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Placa Dental , Periimplantitis , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Animales , Implantes Dentales/efectos adversos , Humanos , Inflamación , Periimplantitis/etiología
14.
Life Sci ; 269: 119073, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33460666

RESUMEN

AIMS: Coagulation is a common event that play a double-edged role in physiological and pathological process. Anti-coagulation methods were applied in joint surgery or scaffolds implantation to encourage new vascular formation and avoid coagulation block. However, whether anti-coagulation drug perform regulatory roles in bone structure is unknown. This study aims to explore a direct thrombin inhibitor, argatroban, effects on bone marrow stromal cells (BMSCs) and decipher the underlying mechanisms. MATERIALS AND METHODS: Argatroban effects on BMSCs were investigated in vivo and in vitro. The drug was applied in periodontal disease model mice and bone loss was evaluated by µCT and histology. BMSCs were treated with different doses argatroban or vehicle. Cellular reactions were analyzed using wound healing assay, qRT-PCR, Alizarin Red S staining and western blotting. KEY FINDINGS: We demonstrated that local injection of argatroban can rescue bone loss in periodontal disease in vivo. To explore the underlying mechanism, we examined that cell proliferation and differentiation capability. Proliferation and migration of BMSCs were both inhibited by applying lower dose of argatroban. Interestingly, without affecting osteoclastogenesis, osteogenic differentiation was significantly induced by argatroban, which were shown by extracellular mineralization and upregulation of early osteoblastic differentiation markers, alkaline phosphatase, Osteocalcin, transcription factors RUNX2 and Osterix. In addition, molecular analysis revealed that argatroban promoted ß-catenin nuclear translocation and led to an increase of osteogenesis through activating canonical Wnt signaling. SIGNIFICANCE: Taken together, our results show the novel application of the anti-coagulation compound argatroban in the commitment of BMSCs-based alveolar bone regeneration and remodeling.


Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Arginina/análogos & derivados , Células Madre Mesenquimatosas/citología , Osteogénesis , Periodontitis/complicaciones , Ácidos Pipecólicos/farmacología , Sulfonamidas/farmacología , Trombina/antagonistas & inhibidores , Vía de Señalización Wnt/efectos de los fármacos , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/metabolismo , Pérdida de Hueso Alveolar/patología , Animales , Antitrombinas/farmacología , Arginina/farmacología , Diferenciación Celular , Proliferación Celular , Células Cultivadas , Masculino , Células Madre Mesenquimatosas/efectos de los fármacos , Células Madre Mesenquimatosas/metabolismo , Ratones , Ratones Endogámicos C57BL
15.
Clin Oral Implants Res ; 32(3): 285-296, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33314332

RESUMEN

OBJECTIVES: Evaluate the effects of two different machined-collar lengths and designs on peri-implant healing. MATERIAL AND METHODS: An implant with a microtextured surface and 3.6mm-long internal-connection machined collar was compared to two implants that had an identical 1.2mm-long external-connection machined collar, but one had the microtextured surface while the other's was machined. Participants received the three implants, with microgap at the crest, alternately at five sites between mental foramen, and a full-arch prosthesis. Peri-implant bone levels were measured after 23 to 26 years of function. Keratinized tissue height, plaque, probing depth, bleeding, and purulence were also evaluated. Descriptive and mixed models for repeated\measures analyses were used, with Bonferroni correction for pairwise comparisons. RESULTS: Twenty-two participants (110 implants) were evaluated at the 25-year examination. Microtextured implants with the longer machined collar had significantly greater mean marginal bone loss (-1.77mm ± 0.18, mean ± SE) than machined (-0.85mm ± 0.18, p < .001) and microtextured (-1.00 ± 0.18mm, p < .001) implants with the shorter machined collar. Keratinized tissue height was greater for internal-connection (0.74mm ± 0.10) versus external-connection (0.51 ± 0.08, p =  0.01) microtextured implants. No differences were observed for plaque (p = 0.78), probing depth (p = 0.42), bleeding (p  = 0.07), and purulence (p = 1.00). Implant survival rate was 99%. CONCLUSIONS: Implants with the 1.2mm machined collar limited bone loss to 1mm, while those with the longer machined collar showed > 1.5mm loss after 25 years of function with microgap at the crest. Internal-connection design and fixture surface microtexturing did not result in greater bone preservation. ClinicalTrials.gov Identifier: NCT03862482.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/prevención & control , Implantación Dental Endoósea , Diseño de Prótesis Dental , Humanos , Oseointegración , Estudios Prospectivos , Propiedades de Superficie
16.
Rev. Fundac. Juan Jose Carraro ; 24(44): 20-25, 2021.
Artículo en Español | LILACS | ID: biblio-1223204

RESUMEN

La enfermedad periodontal (EP) es una patología que afecta principalmente los tejidos que rodean a la pieza dentaria (PD) y se caracteriza, en la mayoría de los casos, por una exposición bacteriana que favorece una respuesta destructiva e inflamatoria del huésped, que conduce a la pérdida de inserción periodontal de la PD, provocando una marcada reabsorción ósea y la posible pérdida de las PD. El diagnóstico de EP implica evaluaciones clínicas y radiográficas, en la actualidad se están realizando diversas investigaciones para evaluar posibles compuestos en los fluidos orales a través de lo cual puede ser posible evaluar la presencia y gravedad de estas enfermedades, como así también el riesgo en los pacientes. Hay evidencias de la interacción de macromoléculas salivales, como las mucinas, con microorganismos específicos. De esta manera las mucinas, junto con otros productos de la saliva, ayudan a modular tanto el número como el tipo de proliferación de ciertos organismos y provocar la disminución de otros. La revisión de la literatura actual concluye que las mucinas salivales pueden servir como un parámetro bioquímico de la inflamación del periodonto (AU)


Periodontal disease (PD) is a pathology that mainly affects the tissues surrounding the tooth (PD) and is characterized, in most cases, by a bacterial exposure that favors a destructive and inflammatory response of the host, which leads to the loss of periodontal insertion of the PD, causing a marked bone resorption and the possible loss of the PD. The diagnosis of PD involves clinical and radiographic evaluations, at present several investigations are being carried out to evaluate possible compounds in oral fluids through which it may be possible to evaluate the presence and severity of these diseases, as well as the risk in patients. There is evidence of the interaction of salivary macromolecules, such as mucins, with specific microorganisms. In this way, mucins, together with other saliva products, help modulate both the number and type of proliferation of certain organisms and cause the decrease of others. The review of the current literature concludes that salivary mucins can serve as a biochemical parameter of inflammation of the periodontium (AU)


Asunto(s)
Humanos , Enfermedades Periodontales , Biomarcadores , Mucinas/fisiología , Saliva/inmunología , Proteínas y Péptidos Salivales/fisiología , Periodoncio/fisiopatología , Pérdida de Hueso Alveolar/etiología , Mediadores de Inflamación/fisiología
17.
Angle Orthod ; 90(3): 321-329, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378432

RESUMEN

OBJECTIVES: To test the null hypothesis that there is no difference in bone dehiscence formation before and after orthodontic tooth movement through an atrophic alveolar ridge. MATERIAL AND METHODS: This longitudinal retrospective study evaluated pretreatment and posttreatment cone-beam computed tomography imaging of 15 adult patients. Twenty-five teeth were moved through the atrophic alveolar bone, whereas 25 teeth not subjected to translational movement were considered controls. The distances between the cementoenamel junction and the alveolar bone crest were assessed at the mesial, distal, buccal, and lingual surfaces of all of these teeth. Data were compared using the Wilcoxon test. The Spearman correlation test and multivariate linear regression analysis were also performed. RESULTS: In general, crestal bone height was reduced around 0.5 mm in all groups in every direction. Median buccal dehiscence increased significantly (+2.25 mm) (P < .05) in teeth moved through the atrophic ridge. Control teeth also had buccal crest loss (+0.83 mm), but this was not statistically different from that of the experimental teeth. Lingual dehiscence increased significantly for the experimental (+0.17 mm) and control (+0.65 mm) groups. Mesial bone height decreased more in the control group (-0.44mm) than in the experimental group (-0.14mm). There was moderate correlation between amount of tooth movement and alveolar bone loss. CONCLUSIONS: The null hypothesis was rejected as dehiscence increased after tooth movement through an atrophic alveolar ridge, mainly in the buccal plate.


Asunto(s)
Pérdida de Hueso Alveolar , Técnicas de Movimiento Dental , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Proceso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Humanos , Estudios Retrospectivos , Técnicas de Movimiento Dental/efectos adversos
18.
Molecules ; 25(24)2020 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-33321702

RESUMEN

The aim of this study was to assess the effect of local application of essential oil of Pistacia atlantica kurdica (EOK) gel in treatment of experimentally induced periodontitis in rats and its effect on osteoclastogenic bone markers. Twenty-four male Wistar rats of 250 to 350 g were used in this study and were allocated into four groups. Control negative (without induced periodontitis), control positive (induced experimental periodontitis left without treatment), treatment control (induced experimental periodontitis and treated with Chlorhexidine gel) and EOK treated group (induced experimental periodontitis treated with EOK gel). The animals were sacrificed after 30 days, and the mandibular central incisor and surrounding tissue were dissected from the mandible and further processed for preparing H&E slides. Inflammatory cells, osteoclast cells, and periodontal ligament (PDL) were examined and measured histologically. Finally, the mean concentrations of both markers, receptor activator of nuclear factor kappa-Β ligand (RANKL) and (Interleukin-1ß) IL-1ß, were analyzed by ELISA. A significant reduction of inflammatory reaction and osteoclast numbers with improvement of PDL and low mean concentrations of RANKL and IL-1ß were seen in the EOK treated group in comparison to the control group and the chlorhexidine group as well. The extract showed a protective effect in the healing of periodontitis that had been induced in rats and decreased bone resorption by down regulation of serum RANKL and IL-1ß markers.


Asunto(s)
Antiinflamatorios no Esteroideos/química , Antiinflamatorios no Esteroideos/farmacología , Biomarcadores , Osteoclastos/metabolismo , Periodontitis/metabolismo , Pistacia/química , Gomas de Plantas/química , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/metabolismo , Pérdida de Hueso Alveolar/patología , Animales , Huesos/efectos de los fármacos , Huesos/metabolismo , Huesos/patología , Cromatografía de Gases y Espectrometría de Masas , Inmunohistoquímica , Aceites Volátiles/química , Aceites Volátiles/farmacología , Osteoclastos/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Ligamento Periodontal/metabolismo , Ligamento Periodontal/patología , Periodontitis/tratamiento farmacológico , Periodontitis/etiología , Ratas
19.
Artículo en Inglés | MEDLINE | ID: mdl-33327506

RESUMEN

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.


Asunto(s)
Pérdida de Hueso Alveolar , Coronas , Implantes Dentales de Diente Único , Enfermedades Periodontales , Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/etiología , Coronas/normas , Coronas/estadística & datos numéricos , Implantes Dentales de Diente Único/efectos adversos , Implantes Dentales de Diente Único/normas , Implantes Dentales de Diente Único/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Periodontales/complicaciones , Prevalencia , Estudios Retrospectivos
20.
PLoS One ; 15(8): e0237660, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32841254

RESUMEN

This study evaluated the influence of type 2 diabetes mellitus on bone loss, bone repair and cytokine production in hyperglycemic rats, treated or not with metformin. The animals were distributed as follow: Non-Hyperglycemic (NH), Non Hyperglycemic with Ligature (NH-L), Treated Non Hyperglycemic (TNH), Treated Non Hyperglycemic with Ligature Treated (TNH-L), Hyperglycemic (H), Treated Hyperglycemic (TH), Hyperglycemic with Ligature (H-L), Treated Hyperglycemic with Ligature (TH-L). At 40th day after induction of hyperglycemia, the groups NH-L, TNH-L, H-L, TH-L received a ligature to induce periodontitis. On the 69th, the TNH, TNH-L, TH, TH-L groups received metformin until the end of the study. Bone repair was evaluated at histometric and the expression levels of Sox9, RunX2 and Osterix. Analysis of the ex-vivo expression of TNF-α, IFN-γ, IL-12, IL-4, TGF-ß, IL-10, IL-6 and IL-17 were also evaluated. Metformin partially reverse induced bone loss in NH and H animals. Lower OPG/RANKL, increased OCN and TRAP expression were observed in hyperglycemic animals, and treatment with metformin partially reversed hyperglycemia on the OPG/RANKL, OPN and TRAP expression in the periodontitis. The expression of SOX9 and RunX2 were also decreased by hyperglycemia and metformin treatment. Increased ex vivo levels of TNF-α, IL-6, IL-4, IL-10 and IL-17 was observed. Hyperglycemia promoted increased IL-10 levels compared to non-hyperglycemic ones. Treatment of NH with metformin was able to mediate increased levels of TNF-α, IL-10 and IL-17, whereas for H an increase of TNF-α and IL-17 was detected in the 24- or 48-hour after stimulation with LPS. Ligature was able to induce increased levels of TNF-α and IL-17 in both NH and H. This study revealed the negative impact of hyperglycemia and/or treatment with metformin in the bone repair via inhibition of transcription factors associated with osteoblastic differentiation.


Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Hiperglucemia/complicaciones , Metformina/administración & dosificación , Periodontitis/prevención & control , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/metabolismo , Proceso Alveolar/citología , Proceso Alveolar/efectos de los fármacos , Proceso Alveolar/metabolismo , Proceso Alveolar/patología , Animales , Regeneración Ósea/efectos de los fármacos , Regeneración Ósea/genética , Diferenciación Celular/efectos de los fármacos , Citocinas/metabolismo , Diabetes Mellitus Experimental/inducido químicamente , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/inducido químicamente , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/metabolismo , Humanos , Hiperglucemia/inducido químicamente , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/metabolismo , Osteoblastos/fisiología , Periodontitis/etiología , Periodontitis/metabolismo , Ratas , Estreptozocina/toxicidad , Factores de Transcripción/metabolismo
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