Journal of long-term effects of medical implants最新文献

Background: Peri-implant disease pathogenesis results in production of pro-inflammatory mediators. These mediators alter the redox balance leading to decrease in antioxidants. The aim of the study was to compare the levels of interleukin-6 (IL-6) and superoxide dismutase (SOD) in peri-implant health and diseases.

Materials and methods: The present observational study was carried out from March 2023 to September 2023 in the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, India. A total of 60 patients with peri-implant health (n = 20), peri-implant mucositis (n = 20) and peri-implantitis (n = 20) were enrolled. Unstimulated salivary samples were collected and subjected to ELISA for IL-6 and SOD analysis. IL-6 and SOD levels were then compared between the groups using ANOVA.

Results: There was a statistically significant difference in IL-6 and SOD levels between the three groups with p value of 0.003 and 0.000 respectively.

Conclusion: The present study suggests that IL-6 level increases and SOD level decreases with severity of peri-implant diseases.

Temporomandibular joint (TMJ) disorders significantly impact orofacial health and quality of life, necessitating effective interventions. This study presents a comprehensive finite element analysis (FEA) focusing on the design and material modifications of temporomandibular joint implants, with the aim of improving their long-term stability and performance. Accurate mandible models extracted from Computational Tomography (CT) scans were used to create three variations of implants, each attached using varying screw configurations ranging from 2 to 5 for each analysis. The variations included implants without dimples, implants with 10% dimples, and implants with 20% dimples. The FEA considered material properties of Titanium and Ti-Nb-Zr alloy for the implants. The FEA results revealed that for 10% dimples models, equivalent stress was reduced by 6.25% with two screws fixation and further decreased by 14.28% with three screws, irrespective of the implant volume, reaffirming the significance of screw fixation. The model secured with three screws exhibited the least amount of stress for both titanium and zirconium alloys and dimple implants showed promise in reducing stress levels, particularly in low bone density conditions. These findings not only underscore the potential advantages of dimple implants in facilitating bone in growth and stability at the bone-implant interface but also highlight the pivotal role of implant dimples in modulating stress levels. The study contributes valuable insights for future advancements in TMJ implantology, offering potential optimizations for implant design and clinical outcomes.

The interdental papilla plays a critical role in both the function and esthetics of the anterior maxilla. In implant dentistry, maintaining this delicate soft tissue is often challenging, particularly when implants are adjacent to each other, due to anatomical and vascular limitations. To evaluate the mean height of the peri-implant papilla in the maxillary anterior region and investigate its association with the type of adjacent structure (natural tooth or implant) and implant location (central incisor, lateral incisor, canine). This cross-sectional study included 298 patients with 342 implants and 684 contact areas in the anterior maxilla, with at least 1 year of functional loading. Sites were categorized into implant-tooth (n = 401) and implant-implant (n = 283) groups. Papilla height was measured and statistical analysis was performed using independent t-tests and ANOVA. Mean papilla height was significantly greater in implant-tooth contacts than implant-implant contacts (P < 0.05). At central incisors, papilla height was 3.4 ± 0.4 mm (implant-tooth) vs. 3.0 ± 0.3 mm (implant-implant); at lateral incisors, 2.8 ± 0.3 mm vs. 2.6 ± 0.1 mm; and at canines, 3.0 ± 0.4 mm vs. 2.8 ± 0.2 mm. Central incisors consistently showed the highest papilla values. Peri-implant papilla height is significantly greater at implant-tooth contact sites compared with implant-implant sites in the anterior maxilla. Among all locations, central incisor regions demonstrated the highest papilla levels.

Postoperative infection of the instrumented spine carries serious morbidity, great cost, and even failure of the original objective. In the present review, we discuss the predisposing risk factors, analyze the effectiveness of preventive measures, and evaluate evidence-based treatment options for surgical site infections (SSIs) in spinal instrumentation procedures. Several risk factors are identified. Preoperative factors include concomitant infections, immunocompromised host conditions, advanced age, obesity, malnutrition, uncontrolled diabetes mellitus, tobacco use, and previous spinal surgery with instrumentation. Intraoperative factors include perioperative hypothermia, prolonged duration of surgery, posterior spinal approach, and violation of sterile conditions. Postoperative factors include paralytic patient and prolonged hospital bed rest. Distinct treatment options have been devised for the management of postoperative infection without the need of removing the instrumentation. Debridement is the initial approach and antibiotic therapy is an adjunctive step. Closure of the wound after infection may be accomplished by delayed primary, secondary intention closure or by other surgical methods such as continuing suction irrigation,VAC, and hyperbaric oxygen treatment. Infections with extensive soft tissue destruction and myonecrosis are best dealt with using muscle flaps after extensive debridement. Specific measures should be taken to minimize or eliminate the risk factors and optimize the patient's condition before spinal surgery with implants. However, if infection occurs despite prophylaxis, treatment should be instituted quickly and aggressively to prevent or reduce its consequences.

Osseointegration is related to the stability of the screw and influences the success rate of implant-supported prosthetic rehabilitation, as it promotes natural healing and effective bone formation, facilitating the preservation of the implant in the recipient site. Factors such as surgical technique, insertion torque, the type of recipient bone, and the macro- and microstructure of the implant can affect screw stability. The objective of this study is to analyze in vivo the influence of insertion torque, recipient bone type, and peri-implant bone loss on the implant stability quotient (ISQ) values of cylindrical implants with external hexagon (EH) and Morse taper (MT) connections, featuring a new surface treatment called referenced acid etching (RAE). A total of 40 implants were placed in edentulous areas following predefined inclusion and exclusion criteria. Immediately after implant placement (t0), insertion torque, resonance frequency, digital periapical radiographs, and peri-implant evaluation were recorded. Resonance frequency analysis, periapical radiographs, and peri-implant evaluations were repeated after osseointegration (t1) and 180 d after rehabilitation (t2). The data obtained were statistically analyzed using specific tests for each type of analysis, with a significance level of 5%. Regarding the ISQ value at t1, it resulted in a high value, with a significant reduction at t2, for both types of connection, there was bone resorption for the HE and bone gain for the MT. The installation of the implants up to 180 d of prosthesis functionality, stability, bone gain or loss and type of bone, presented clinically acceptable conditions for all connections studied.

The current study sought to assess the impact on quality of life in individuals with a single posterior tooth loss, as well as its improvement after a single-unit immediate implant loading in a 6-month follow-up. Forty patients with a single posterior tooth loss were evaluated for oral health-related quality of life using the OHIP-14 before and six months after rehabilitation, as well as anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). The Two-Way ANOVA was used to compare OHIP-14 scores at the tooth loss site and after rehabilitation. Descriptive statistics were computed for the HADS and OHIP-14 domains. Thirty-three patients that remained in the sample presented significantly reduced OHIP-14 scores after 6 months of rehabilitation, regardless the tooth loss site. Physical pain, psychological discomfort, psychological disability, and physical disability were the four most affected OHIP-14 domains and presented improvement after the rehabilitation. The individuals presented HADS scores for anxiety and depressive symptoms majorly within the normal range. Posterior single tooth loss has a detrimental impact on oral health-related quality of life. Either function or psychological domains appear to be impacted. The patients' rehabilitation was found to have a significant impact on quality-of-life improvement.

Biomarkers within peri-implant crevicular fluid (PICF) are emerging as pivotal diagnostic agents, promising heightened accuracy in identifying peri-implant diseases. The present study aimed to assess the impact of non-sur-gical therapy on PICF calprotectin levels in patients with peri-implantitis. A total of 40 individuals aged between 30 and 60 years were enrolled: Group I (n = 20 healthy peri-implant sites) and Group IIa (n = 20 peri-implantitis sites). Clinical parameters such as peri-implant probing depth (PPD) and clinical attachment level (CAL) were recorded. PICF samples were collected and assayed for calprotectin using enzyme-linked immunosorbent assay (ELISA). After clinical examination and PICF collection at baseline, mechanical debridement was done for peri-implantitis patients, and after 3 months, clinical examination and PICF collection was done (Group IIb). The results were statistically analyzed. The PICF calprotectin level was higher in Group IIa (43.76 ± 3.64 ng/mL) as compared with Group I (11.36 ±2.53 ng/mL). Between Groups IIa and IIb, there was a significant reduction in PPD, CAL, and calprotectin from baseline to 3 months (P < 0.05). Pearson correlation in Groups IIa and IIb revealed that the correlation between calprotectin and clinical parameters was strongly positive and statistically significant. The present study suggests that there was a significant reduction in PICF calprotectin levels among peri-implantitis patients after mechanical debridement. Also, there exists a positive correlation between PICF calprotectin and peri-implant health parameters.

Midface fractures constitute a severe medical challenge due to their intricacy, incidence, and socioeconomic implications. The orbit and the maxillary sinus are the most prominent parts of the face and form the most common site of fracture. Reconstruction of these frequently observed fractures is necessary. The uses of polypropylene (prolene) mesh are numerous in general surgery, so its use and effects in the maxillofacial region can be explored. The aim was to evaluate the efficacy of prolene mesh in treating defects in the midface due to trauma, especially the orbital floor and anterior wall of the maxillary sinus. This was an observational study of 15 patients with midface fractures who had undergone reconstruction with prolene mesh for orbital floor and anterior maxillary sinus wall defects. Data collected included gender, age, type of fracture, clinical parameters (e.g., postoperative tenderness at the surgical site, infraorbital paresthesia, diplopia, pus discharge, and extrusion of graft), and radiological assessment for sinus and/or orbital floor continuity and bone formation. Regular follow-ups were done at 1 week and 1, 3, and 6 months. Among the 15 patients studied, all were males with a mean age of 30 years. The clinical assessment revealed positive functional outcomes. Radiographic assessment with postoperative CT scans at 6 months showed sinus wall and/or orbital floor continuity and bone formation. The study concluded that, with proper case selection, prolene mesh is a safe and reliable option in the reconstruction of the anterior maxillary sinus wall and orbital floor.

Intertrochanteric hip fractures are commonly treated with cephalomedullary nailing. One time-consuming aspect of the procedure is intraoperatively measuring the helical blade length. This investigation sought to determine if preoperative imaging can be reliably used to predict helical blade length and therefore reduce operative time accurately. This was a single-center, single-surgeon retrospective chart review. All subjects were operated on by the senior author at a single urban level-1 trauma center. Each patient underwent cephalomedullary nailing using a helical blade. The medical records were reviewed for demographic, imaging, and operative data. Two raters preoperatively recorded head element length, subsequently estimated helical blade implant sizes, and actual implant length used intraoperatively. In total, 134 patients were analyzed. The results demonstrated that radiographs (R2 = 0.337, p < 0.001) and computed tomography (CT) imaging (R2 ≥ 0.435, p < 0.001) could not reliably predict helical blade length, and that radiographs were more accurate than CT scans in predicting actual implant size (p < 0.001). Preoperative imaging modalities predicted the exact size only 23.8% of the time using radiographs and 17.2% of the time using CT. Preoperative helical blade implant size was estimated accurately 24% of the time. However, raters were successful in estimating the length of the helical blade within three sizes. We demonstrate that preoperative imaging modalities are unable to accurately predict helical blade length.

This study aimed to evaluate the levels of alpha amylase in patients with healthy dental implants, peri-implant mucositis, and peri-implantitis. A cross-sectional study was conducted involving 75 implant sites, divided into three groups of 25: peri-implant health, peri-implant mucositis, and peri-implantitis. Peri-implant crevicular fluid was collected from each selected implant site and analyzed for alpha amylase levels using an ELISA kit. The resulting alpha amylase concentrations were statistically compared between the groups. The mean concentration of alpha amylase was lowest in healthy sites (9.57 ± 1.59 ng/mL), compared with peri-implant mucositis (14.90 ± 2.62 ng/mL) and peri-implantitis (20.67 ± 4.55 ng/mL), with the differences being statistically significant (P = 0.00). Furthermore, multiple comparisons revealed a statistically significant distinction between the groups (P = 0.000). Elevated levels of alpha amylase in peri-implant disease sites, as opposed to healthy sites, suggest its potential as a predictive marker for peri-implant diseases.