International Journal of Implant Dentistry最新文献

Purpose: Diminished bone levels or the lack of osseointegration can lead to higher rates of failure of dental implants. The present study is aimed to evaluate the correlation between hypertension, diabetes mellitus and hyperlipidemia, on the marginal bone loss (MBL) surrounding dental implants among patients attending the University of Nevada, Las Vegas dental clinics.

Methods: Clinical notes from patients at the University of Nevada, Las Vegas (UNLV) dental clinics were analyzed using AxiUm™ software. The study included patients with dental implants diagnosed with hypertension, diabetes mellitus, and hyperlipidemia who attended the UNLV School of Dental Medicine clinics from 2012 to 2022. Exclusions were made for patients with acquired immune deficiency syndrome and those with a limited number of radiographs. A search was conducted using keywords such as 'systemic disease,' 'marginal bone loss,' 'dental implant,' 'high cholesterol,' 'hypertension,' and 'diabetes' within the system.

Results: Out of 1,310 potentially eligible patients, 57 fulfilled the inclusion criteria. The total number of evaluated implants was 165. 18% of the sample patients were 55 to 64 years of age, and 79% were 65 or above. 45.6% of patients reported having more than four systemic diseases and 67% of patients had four or more prescription medications. Patients diagnosed with hypertension (78.95%) or hyperlipidemia (73.68%) had the highest presence of marginal bone loss surrounding the dental implant(s) while those with diabetes (40.35%) had the least amount of MBL. Patients diagnosed with both hypertension and hyperlipidemia (29.82%) experienced the highest incidence of MBL around implants. The medications prescribed to combat these health issues, such as statins and antihypertensive, also showed the same trends and corresponded with a higher prevalence of MBL.

Conclusions: Within the limitations of the present investigation, patients diagnosed with hyperlipidemia and hypertension were more likely to exhibit MBL surrounding dental implants.

Objective: This research endeavors to scrutinize the influence of attachment systems and denture cleaning methodologies on microbial biomass and composition within the realm of implant-supported overdentures, a crucial consideration for patients with dentition defects necessitating such prosthetic solutions.

Subjects and methods: Employing five polymethyl methacrylate specimens designed to emulate the fitting surfaces of traditional dentures and implant-supported overdentures. Following the polishing of each specimen and the quantification of its roughness, co-cultivation with three distinct microbial strains ensued, culminating in ultrasonic cleaning in water. The bar-clip group, differentiated by the depth of attachment, underwent cleaning employing four diverse methods. Biomass quantities were meticulously recorded both pre and post cleaning interventions, with subsequent data analysis via t-testing and one-way ANOVA, maintaining a significance level of α = 0.05.

Results: The bar-clip groups demonstrated an elevated degree of microbial adhesion, with the deeper locator group exhibiting heightened biomass residue post-cleaning, indicative of increased cleaning complexity. Ultrasonic cleaning predominantly targeted biofilm and deceased bacteria, whereas chemical cleaners primarily reduced the quantity of viable bacteria. The synergistic application of ultrasonics and chemical cleaning treatments yielded the minimal biomass residue.

Conclusion: In contemplating the utilization of dentures milled by dental computer-aided design/manufacturing systems, meticulous pre-use surface polishing is imperative. The extent of biofilm adhesion correlates with the chosen attachment system. This study advocates for the incorporation of ultrasonic cleaning in conjunction with chemical cleaning solutions to optimize the removal of biofilm and live cellular entities in the context of implant-supported overdentures.

Purpose: To demonstrate the viability of a coordinate-measuring machine (CMM) for the geometric analysis of 3D printed surgical templates.

Methods: The template was designed and modified by adding 18 cylindrical landmarks for CMM test and then classified into five groups according to the slicing software and resins (opaque and transparent): Streamflow-O, Streamflow-T, Shapeware-T, Rayware-T and Polydevs-T (N = 3). Three standing times (0 w, 1 w, and 2 w) were included to observe possible deformation. All the measurements were performed automatically by the CMM through a preset program. The Euclidian distance (dxyz) was regarded as the representation of global dimension accuracy, and displacements in the x-, y-, and z-axes were also calculated.

Results: The average dxyz values of Streamflow-O, Streamflow-T, Shapeware-T, Rayware-T and Polydev-T are 32.6 μm, 31.3 μm, 56.4 μm, 96.4 μm, and 55.3 μm, respectively. Deviations were mainly induced by the upward bending of the free end region (positive direction of the z-axis). Different resins did not have a significant influence on the dimensional accuracy. Moreover, deformation appeared to be negligible after 2 weeks of storage, and the z-axis displacements were only approximately 30 μm at week 1 and 10 μm at week 2.

Conclusions: The deviations of the DLP-printed template are induced mainly by z-axis displacements and are determined by the processing accuracy. After 2 weeks, the dimensional stabilities of these templates are reliable, which is encouraging for clinicians. Moreover, the CMM is preliminarily demonstrated to be a feasible tool for achieving automated geometric analysis of surgical templates.

Objectives: 8-hydroxydeoxyguanosine (8-OHdG) and Malondialdehyde (MDA) are commonly used as markers to evaluate oxidative DNA and Lipid damage in disorders including chronic inflammatory diseases. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) protect tissues against oxidative injury from free oxygen radicals generated by various metabolic processes. The aim of this study was to evaluate 8-OHdG and MDA levels, and SOD and GPx activities in whole saliva of patients with peri-implant diseases.

Materials and methods: A cross-sectional study was conducted on a sum of 60 age gender balanced; peri-implantitis (n = 20), peri-mucositis (n = 20) and healthy (n = 20) individuals. Unstimulated whole saliva samples were collected and to determine the clinical condition of each subject; the plaque index (PI), gingival index (GI), peri-implant probing pocket depth (PIPD), peri-implant presence of bleeding on probing (BOP) (with/without suppuration) and radiographic signs of crestal bone loss (BL) were measured. The salivary 8-OHdG level was measured using the ELISA method. SOD, GPx activities and MDA levels were determined spectrophotometrically.

Results: A total of 60 individuals had evaluations of 318 implants. In comparison to the peri-mucositis and peri-implantitis groups, the healthy group had significantly lower PI and GI scores (p < 0.001). The PIPD value differed amongst the groups, with the peri-implantitis group having the highest value (p < 0.001). Compared to the peri-mucositis and control groups, the peri-implantitis group had a significantly higher BL score (p < 0.001 and p < 0.001, respectively). The peri-implantitis group showed a significantly higher 8-OHdG level (p < 0.001; p < 0.001 respectively) than the peri-mucositis and control groups. Compared to the peri-mucositis and control groups, the peri-implantitis group had a significantly higher MDA level (p < 0.001 and p < 0.001, respectively). The peri-implantitis group had a significantly higher SOD level (p < 0.001 and p < 0.001, respectively) in comparison to the peri-mucositis and control groups. There was no significant difference in GPx levels between the peri-mucositis and control groups (p > 0.05), while the peri-implantitis group had significantly lower GPx levels than the peri-mucositis and control groups (p < 0.001 and p < 0.001, respectively).

Conclusions: Elevated levels of oxidative stress in saliva may indicate the onset of pathological bone loss surrounding the implant and may be an indication of peri-implantitis.

Clinical relevance: In peri-implant diseases, changes may occur in the levels of 8-OHdG, MDA, SOD and GPx in saliva, which may lead to a deterioration in the oxidant/antioxidant balance.

Purpose: Ridge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition.

Methods: In this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (Allo), 21 received allogeneic bone substitutes with hyaluronic acid (AlloHya). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation.

Results: Vertical height loss after 4 months was significantly greater in the Allo group (-0.82 ± 0.95 mm) compared to the AlloHya group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (Allo) and 10.3 ± 7.7% (AlloHya) (p = 0.038). After four months, average bone density was significantly higher in the AlloHya compared to the Allo group (p = 0.004). Nearly all implants (39 out of 40) were classified as "Success" according to the ICOI scheme, with no differences in implant quality between the two study groups.

Conclusions: Improved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation.

Purpose: The present study evaluated osteopenia (OPN) and osteoporosis (OP) as risk factors for dental implant failure and repeat failure.

Methods: We performed a retrospective study on over 100 randomly selected patients per analysis to determine the effect of health status, smoking status, sex, implant location and operative conditions on first and second (re-implantation) implant survival. Analyses were conducted first using chi-squared test, followed by multiple logistic regression for significant variables.

Results: In the cohort examining the effect of myriad risk factors on second implant survival, it was found that OPN and OP greatly impacted implant survival, wherein patients with osteoporosis or osteopenia had significantly more implant failures (p = 0.0353). Sex and operative conditions had no effect on implant survival, while implant location showed a notable effect wherein significantly more failures occurred in the maxilla vs mandible (p = 0.0299). Upon finding that OPN and OP have a significant effect on second implant survival, we conducted an additional study focusing on the impact of health status. Based on the multiple logistical regression analysis, we found that OPN and OP are the most significant factor in first implant survival (p = 0.0065), followed by diabetes (p = 0.0297). Importantly, it was observed that early implant failure is also significantly correlated with osteoporosis (p = 0.0044).

Conclusion: We show here a marked relationship in which the risk of first and second implant failure are significantly higher in patients with osteoporosis and osteopenia.

Purpose: The aim of this long-term cohort study in periodontally compromised patients with implants was to analyze the correlation between gingival phenotype and peri-implant crestal bone loss, and between clinical measures and gingival phenotype.

Methods: Implant-supported single crowns and bridges were used to rehabilitate 162 implants in 57 patients. Patients were examined over a 2 to 20-year period on a recall schedule of 3 to 6 months. In addition to recording clinical parameters, intraoral radiographs were taken at baseline (immediately after superstructure insertion) and at 1, 3, 5, 10, 15, and 20 years. Patients were differentiated into phenotype 1 with thin, scalloped gingiva and narrow attached gingiva (n = 19), phenotype 2 with thick, flat gingiva and wide attached gingiva (n = 23), or phenotyp 3 with thick, scalloped gingiva and narrow attached gingiva (n = 15).

Results: The mean peri-implant crestal bone loss during the first 12 months was 1.3 ± 0.7 mm. Patients with gingival phenotype 1 had a significantly greater rate of increased crestal bone loss at implants (p = 0.016). No significant differences were present in subsequent years. The prevalence of mucositis at all implants was 27.2%, and the prevalence of peri-implantitis 9.3%. Univariate analyses indicated a significantly higher peri-implantitis risk in patients with gingival phenotype 2 (p-OR = 0.001; p-OR = 0.020). The implants of patients with phenotype 2 had significantly greater probing depths (1st year p < 0.001; 3rd year p = 0.016; 10th year p = 0.027; 15th year p < 0.001). Patients with gingival phenotype 3 showed no significantly increased probing depths, signs of inflammation and crestal bone loss.

Conclusions: Patients with a gingival phenotype 1 have greater crestal bone loss at implants during the first year of functional loading. Patients with gingival phenotype 2 had significantly greater probing depth at implants and risk of peri-implantitis.

Purpose: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants.

Methods: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35-50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss.

Results: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average.

Conclusions: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants.

Background: In older patients with progressive neurodegeneration, replacing fixed implant-supported prostheses (FIP) with implant overdentures (IOD) has been proposed to prevent future mucosal injury and create an oral environment that is easier for caregivers to clean. However, there have been no reports on the progress after replacing FIP with IOD. In this report, we present the progress of an older patient with Parkinson's disease in whom FIP was replaced with IOD.

Case presentation: An 81-year-old male patient with Parkinson's disease presented to our outpatient clinic with bruxism and crossbites. FIPs, with five Brånemark system implants, were placed in the bilateral lower molars. The FIP was replaced with an IOD with two locator attachments to create an oral environment that was easier for caregivers to clean and allow easy recovery of masticatory function if residual teeth were fractured in the care environment. As his systemic condition deteriorated, treatment was changed from outpatient to in-home visits. During dental care visits, professional oral cleaning and denture repair were continued, and good nutritional status was maintained. However, the patient developed cholecystitis and was hospitalized. During hospitalization, gastrostomy was performed because he developed aspiration pneumonia. After discharge from the hospital, the patient remained in bed all day and could not wear an IOD, resulting in buccal mucosa ulceration due to abrasion of the locator abutment. We decided to replace the abutment with cover screws; however, not all the implants could sleep submucosally. Although regular oral cleaning was resumed, new ulcers developed even when cover screws were installed. Additionally, swelling and drainage were observed at the peri-implant mucosal site where peri-implantitis had once occurred during an outpatient visit. The patient was readmitted to the hospital for a urinary tract infection, and subsequent visits were abandoned.

Conclusions: By replacing FIP with IOD in an older patient with Parkinson's disease, we addressed a barrier to caregiver-provided oral management. The removable prosthesis facilitated smooth oral care by caregivers and functional recovery in the event of trouble with residual teeth. However, it could not completely avoid the recurrence of buccal mucosal ulcers or peri-implantitis.