Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors.

BACKGROUND: The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS: This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS: A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION: The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.

Efeito de superfícies de implantes nano-estruturadas na expressão de genes de osteoblastos e no contato osso-implante in vivo / Effect of nanostructured implant surfaces on osteoblast related gene expression and bone-implant contact in vivo

As tendências atuais na terapia com implantes odontológicostêm incluído o uso de implantes com superfícies modificadasutilizando nanotecnologia. Ciência que permite a construçãode novos materiais e dispositivos pela manipulação de átomosindividuais e moléculas (escala menor do que 100nm). O objetivodeste trabalho foi avaliar o papel das modificações em escalananométrica de superfícies de implantes osseointegradospara melhorar o processo de osseointegração. Nanotecnologiaoferece a engenheiros e profissionais da área de biologia e saúdenovos meios para entender e otimizar funções e respostasespecíficas de células. As várias técnicas utilizadas para adicionarcaracterísticas nanométricas às superfícies de implantesosseointegrados são descritas neste trabalho. Vários trabalhostem apresentado os efeitos da nanotecnologia na modulaçãode etapas fundamentais do processo de osseointegração. Asvantagens e desvantagens da utilização da nanotecnologia nasuperfície de implantes também são discutidas nesse trabalho.Posteriormente, em uma série de experimentos in vitro e in vivo,foi possível avaliar o efeito específico destas modificações emdois diferentes modelos. Como efeitos observados da aplicaçãode nanoestruturas à superfície dos implantes osseointegradosfoi possível verificar-se uma melhor e mais rápida resposta deosseointegração destes materiais, atuando efetivamente na cascatade diferenciação de osteoblastos.

Current trends in clinical dental implant therapy include useof endosseous dental implant surfaces embellished with nanoscaletopographies. Nanotechnology deals with materials withat least one significant dimension less than 100nm. The goal ofthis study was to consider the role of nanoscale topographic modificationof titanium substrates for the purpose of improvingosseointegration. Nanotechnology offers engineers and biologistsnew ways of interacting with relevant biological processes.Moreover, nanotechnology has provided means of understandingand achieving cell specific functions. The various techniquesthat can impart nanoscale topographic features to titaniumendosseous implants are described. Existing data supportingthe role of nanotopography suggests that critical steps in osseointegrationcan be modulated by nanoscale modification ofthe implant surface. Important distinctions between nanoscaleand micron-scale modification of the implant surface are presentlyconsidered. The advantages and disadvantages of nanoscalemodification of the dental implant surface are discussed.Finally, available data concerning the current dental implantsurfaces that utilize nanotopography in clinical dentistry aredescribed. Nanoscale modification of titanium endosseous implantsurfaces can alter cellular and tissue responses that maybenefit osseointegration and dental implant therapy. In a seriesof in vitro and in vivo experiments it was possible to evaluatethe effect of this modifications in different study designs. Theadvantages of the use of nanocues added to the surface of theosseointegrated dental implants allowed to a better and fasterosseointegration response of these materials, by acting on thedifferentiation of the osteoblasts.

The effects of implant surface nanoscale features on osteoblast-specific gene expression.

This study investigated the influence of nanoscale implant surface features on osteoblast differentiation. Titanium disks (20.0 x 1.0 mm) with different nanoscale materials were prepared using sol-gel-derived coatings and characterized by scanning electron microscopy, atomic force microscopy and analyzed by X-ray Photoelectron Spectrometer. Human Mesenchymal Stem Cells (hMSCs) were cultured on the disks for 3-28 days. The levels of ALP, BSP, Runx2, OCN, OPG, and OSX mRNA and a panel of 76 genes related to osteogenesis were evaluated. Topographical and chemical evaluation confirmed nanoscale features present on the coated surfaces only. Bone-specific mRNAs were increased on surfaces with superimposed nanoscale features compared to Machined (M) and Acid etched (Ac). At day 14, OSX mRNA levels were increased by 2-, 3.5-, 4- and 3-fold for Anatase (An), Rutile (Ru), Alumina (Al), and Zirconia (Zr), respectively. OSX expression levels for M and Ac approximated baseline levels. At days 14 and 28 the BSP relative mRNA expression was significantly up-regulated for all surfaces with nanoscale coated features (up to 45-fold increase for Al). The PCR array showed an up-regulation on Al coated implants when compared to M. An improved response of cells adhered to nanostructured-coated implant surfaces was represented by increased OSX and BSP expressions. Furthermore, nanostructured surfaces produced using aluminum oxide significantly enhanced the hMSC gene expression representative of osteoblast differentiation. Nanoscale features on Ti implant substrates may improve the osseointegration response by altering adherent cell response.