Hyeon-Gyu Jo, Wonse Park, In-Ho Cha, Young-Soo Jung, Da Yun Lee, Jun-Young Kim
Introduction
This study aimed to analyze the factors affecting the occurrence of peri-implant medication-related osteonecrosis of the jaw (PI-MRONJ) in patients using anti-resorptive drugs (ARDs) on different implant position, inclinations, and types of prosthesis.
Methods
The data of 75 patients with bone necrosis that progressed around the implant between 2018 and 2022 were retrospectively examined to identify the factors influencing PI-MRONJ. Data, including patient demographics (age, sex, smoking status, concomitant disease, time of ARD therapy, dose of ARDs, and parafunctional habits) and implant-specific information (type of prosthesis, angle of insertion), were extracted from medical and dental records.
Results
Tilted implants with an angle ≥ 5.1° relative to the occlusal plane of the prosthesis had a stronger association with PI-MRONJ in comparison to non-tilted implants (inclination was < 5°). Additionally, the boundary of the area of osteonecrosis around the fixture was larger for the splinted implant-supported crowns than for the single implant supported crowns).
Conclusion
In patients taking anti-resorptive medications the inclination of the implant was associated with the occurrence of PI-MRONJ. Further studies are required to confirm the clinical findings.
{"title":"Clinical and Radiographic Features of Peri-Implant Medication-Related Osteonecrosis of the Jaw: A Retrospective Study","authors":"Hyeon-Gyu Jo, Wonse Park, In-Ho Cha, Young-Soo Jung, Da Yun Lee, Jun-Young Kim","doi":"10.1111/cid.13412","DOIUrl":"10.1111/cid.13412","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to analyze the factors affecting the occurrence of peri-implant medication-related osteonecrosis of the jaw (PI-MRONJ) in patients using anti-resorptive drugs (ARDs) on different implant position, inclinations, and types of prosthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of 75 patients with bone necrosis that progressed around the implant between 2018 and 2022 were retrospectively examined to identify the factors influencing PI-MRONJ. Data, including patient demographics (age, sex, smoking status, concomitant disease, time of ARD therapy, dose of ARDs, and parafunctional habits) and implant-specific information (type of prosthesis, angle of insertion), were extracted from medical and dental records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tilted implants with an angle ≥ 5.1° relative to the occlusal plane of the prosthesis had a stronger association with PI-MRONJ in comparison to non-tilted implants (inclination was < 5°). Additionally, the boundary of the area of osteonecrosis around the fixture was larger for the splinted implant-supported crowns than for the single implant supported crowns).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients taking anti-resorptive medications the inclination of the implant was associated with the occurrence of PI-MRONJ. Further studies are required to confirm the clinical findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jantien H. W. de Beus, Marco S. Cune, Henny J. A. Meijer, Gerry M. Raghoebar, Ulf Schepke
<div> <section> <h3> Background</h3> <p>Dental implants made of zirconia (ZrO<sub>2</sub>) are a potential alternative for titanium implants in dentistry because of their good biocompatibility, mechanical properties and excellent aesthetic results. However, solid long-term scientific data to prove clinical success of ZrO<sub>2</sub> implants are scarce.</p> </section> <section> <h3> Aim</h3> <p>The aim of this study was to describe and to examine the clinical performance of custom-made two-piece ZrO<sub>2</sub> implants, to identify possible influencing factors: a) manipulation of the implant after placement and b) the occlusal scheme on the survival rate, and to evaluate the performance of the implant-supported crown. This follow-up study collected and examined the 5-year data to answer the main question: What are the survival and the success rates of custom-made ZrO<sub>2</sub> implants in the maxillary premolar region after 5 years?</p> </section> <section> <h3> Material and Methods</h3> <p>Of the 31 included patients in this prospective 5-year follow-up single-arm clinical trial, 30 received a custom-made ZrO<sub>2</sub> implant to replace a missing single maxillary premolar, which was subsequently restored with a lithium disilicate crown. Parameters regarding clinical performance, marginal bone-level (MBL) changes, and patient-related outcome measures (PROMs) were assessed preoperatively, at the baseline, as well as 1 and 5 years after crown placement. Chances of survival and success of the implant were calculated and displayed using Kaplan–Meier statistics. Kaplan–Meier survival analysis was also performed with stratification based on the variables “manipulation of the implant prior to impression taking” and “occlusal scheme” and compared using log-rank tests. Bone-level moderation in time was compared using a paired samples <i>t</i>-test. Patient's expectations and satisfaction after 5 years were compared as a measure of fulfilled expectations, using a Wilcoxon signed-rank test. Performance of the implant-supported crowns was evaluated using validated criteria.</p> </section> <section> <h3> Results</h3> <p>Survival and success probabilities after 5 years were, respectively, 75.8% (95% CI [60.0%; 91.0%]) and 71.0% (95% CI [54.0%; 88.0%]) for the custom-made ZV3 implants. No significant differences in survival rate were found after stratification on “manipulation of the implant” and on “occlusal scheme.” Mean bone-level alteration between baseline and the first follow-up was +0.06 mm (95% CI [−0.23 mm; 0.12 mm]; SD = 0.42 mm) and between basel
背景：氧化锆（ZrO2）牙科种植体因其良好的生物相容性、机械性能和出色的美观效果，成为牙科领域钛种植体的潜在替代品。目的：本研究旨在描述和检查定制的两件式氧化锆种植体的临床表现，确定可能的影响因素：a）种植体植入后的操作；b）咬合方案对成活率的影响，并评估种植体支撑的牙冠的表现。这项跟踪研究收集并检查了 5 年的数据，以回答主要问题：上颌前磨牙区定制二氧化锆种植体5年后的存活率和成功率如何？在这项为期5年的前瞻性单臂随访临床试验的31名患者中，有30人接受了定制的ZrO2种植体，以替代缺失的单颗上颌前磨牙，随后用二硅酸锂冠进行修复。临床表现、边缘骨水平（MBL）变化和患者相关结果指标（PROMs）等参数在术前、基线、牙冠植入后 1 年和 5 年进行了评估。使用 Kaplan-Meier 统计法计算并显示种植体的存活率和成功率。卡普兰-梅耶生存率分析还根据 "取印模前对种植体的操作 "和 "咬合方案 "这两个变量进行分层，并使用对数秩检验进行比较。使用配对样本 t 检验比较了骨水平在时间上的调节作用。使用 Wilcoxon 符号秩检验比较了患者的期望值和 5 年后的满意度，以衡量期望值是否实现。种植体支撑牙冠的性能采用已验证的标准进行评估：结果：定制 ZV3 种植体 5 年后的存活率和成功率分别为 75.8%（95% CI [60.0%; 91.0%]）和 71.0%（95% CI [54.0%; 88.0%]）。根据 "种植体操作 "和 "咬合方案 "进行分层后，存活率没有发现明显差异。基线与第一次随访之间的平均骨水平变化为 +0.06 mm (95% CI [-0.23 mm; 0.12 mm]; SD = 0.42 mm)，基线与第二次随访之间的平均骨水平变化为 +0.04 mm (95% CI [-0.35 mm; 0.26 mm]; SD = 0.54 mm)。种植体在 5 年后仍能发挥作用的患者的满意度为 91.7%（IQR = [90.5%-97.3%]），表明患者对治疗感到满意。5 年后成功植入种植体的患者的总体满意度明显高于患者在治疗前表达的期望值。没有一个牙冠失败，也不需要任何干预措施：结论和临床意义：在我们的研究中，ZV3种植体的存活率低于预期，临床上无法接受。因此，本研究中应用的 ZV3 种植体不能推荐用于临床实践。强烈建议在进行更大规模的前瞻性随机临床试验以评估定制的二氧化锆种植体的治疗前，对二氧化锆种植体机械故障的不同表现形式进行进一步研究。
{"title":"Metal-Free Custom-Made Zirconia Implants—A Prospective 5-Year Follow-Up Single-Arm Clinical Trial","authors":"Jantien H. W. de Beus, Marco S. Cune, Henny J. A. Meijer, Gerry M. Raghoebar, Ulf Schepke","doi":"10.1111/cid.13404","DOIUrl":"10.1111/cid.13404","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dental implants made of zirconia (ZrO<sub>2</sub>) are a potential alternative for titanium implants in dentistry because of their good biocompatibility, mechanical properties and excellent aesthetic results. However, solid long-term scientific data to prove clinical success of ZrO<sub>2</sub> implants are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to describe and to examine the clinical performance of custom-made two-piece ZrO<sub>2</sub> implants, to identify possible influencing factors: a) manipulation of the implant after placement and b) the occlusal scheme on the survival rate, and to evaluate the performance of the implant-supported crown. This follow-up study collected and examined the 5-year data to answer the main question: What are the survival and the success rates of custom-made ZrO<sub>2</sub> implants in the maxillary premolar region after 5 years?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Of the 31 included patients in this prospective 5-year follow-up single-arm clinical trial, 30 received a custom-made ZrO<sub>2</sub> implant to replace a missing single maxillary premolar, which was subsequently restored with a lithium disilicate crown. Parameters regarding clinical performance, marginal bone-level (MBL) changes, and patient-related outcome measures (PROMs) were assessed preoperatively, at the baseline, as well as 1 and 5 years after crown placement. Chances of survival and success of the implant were calculated and displayed using Kaplan–Meier statistics. Kaplan–Meier survival analysis was also performed with stratification based on the variables “manipulation of the implant prior to impression taking” and “occlusal scheme” and compared using log-rank tests. Bone-level moderation in time was compared using a paired samples <i>t</i>-test. Patient's expectations and satisfaction after 5 years were compared as a measure of fulfilled expectations, using a Wilcoxon signed-rank test. Performance of the implant-supported crowns was evaluated using validated criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Survival and success probabilities after 5 years were, respectively, 75.8% (95% CI [60.0%; 91.0%]) and 71.0% (95% CI [54.0%; 88.0%]) for the custom-made ZV3 implants. No significant differences in survival rate were found after stratification on “manipulation of the implant” and on “occlusal scheme.” Mean bone-level alteration between baseline and the first follow-up was +0.06 mm (95% CI [−0.23 mm; 0.12 mm]; SD = 0.42 mm) and between basel","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Bagnasco, Maria Menini, Paolo Pesce, Umberto Gibello, Massimo Carossa, Francesco Pera
Background
Full-arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium- and long-term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant-abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment.
Purpose
The aim of the present multicenter split-mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri-implant parameters in immediate-load full-arch rehabilitations.
Materials and Methods
Twenty patients were rehabilitated with immediately loaded fixed full-arch rehabilitations. All the implants presented the same macro- and micro-topography but different implant-abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri-implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72-month post-loading. Technical and biological complications were recorded.
Results
In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow-up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow-up.
Conclusions
After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes.
{"title":"Evaluation of Internal and External Hexagon Connections in Immediately Loaded Full-Arch Rehabilitations: A Multicenter Randomized Split-Mouth Controlled Trial With a 6-Year Follow-Up","authors":"Francesco Bagnasco, Maria Menini, Paolo Pesce, Umberto Gibello, Massimo Carossa, Francesco Pera","doi":"10.1111/cid.13416","DOIUrl":"10.1111/cid.13416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Full-arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium- and long-term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant-abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of the present multicenter split-mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri-implant parameters in immediate-load full-arch rehabilitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty patients were rehabilitated with immediately loaded fixed full-arch rehabilitations. All the implants presented the same macro- and micro-topography but different implant-abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri-implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72-month post-loading. Technical and biological complications were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow-up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ting Wang, Gaoli Xu, Chuankai Zhang, Tymour Forouzanfar, Junwei Liang, Yulei Pan, Chenxi Shen, Gang Wu, Haiyan Lin
Objective
To evaluate the efficacy of 3D-printed scaffolds that were osteoinductively functionalized with a bone morphogenetic protein 2 (BMP-2)-incorporated biomimetic calcium phosphate particles (BMP-2-inc. BpNcCaP)/hyaluronic acid (HA) composite gel in vertical bone augmentation in beagle dogs.
Materials and Methods
Four Beagle dogs were used in this study. Three months after the extraction of 1st, 2nd, 3rd, and 4th premolars at both sides of the lower jaws of Beagle dogs, one or two critical-size vertical bone defects (4 mm vertical bone defect without buccal and lingual bone) on each side were surgically created. The defects were randomly subjected to the following groups: (1) Control (without bone-defect-filling materials); (2) 3D scaffold; (3) BMP2-inc. BpNcCaP/HA-functionalized 3D scaffold. Six weeks post-surgery, samples were harvested and subjected to micro-CT and histomorphometric analyses.
Results
The struts of the BMP2-inc. BpNcCaP/HA-func. 3D scaffold were covered by a thick layer of cemented irregular particles with an average pore size at 327 ± 27 μm. The BpNcCaP/HA-func. 3D scaffold group bore significantly higher bone volume, bone volume fraction, trabecular number, trabecular thickness, bone mineral density, connectivity density, and bone volumes in three directions (mesiodistal, buccolingual, and apicocoronal) when compared with the groups of Control and 3D scaffold. Moreover, the BMP2-inc. BpNcCaP/HA-func. 3D scaffold group bore significantly lower trabecular separation and exhibited significantly higher bone-to-scaffold contact percentage and newly formed bone area percentage within pores in comparison with 3D scaffold.
Conclusions
BMP2-inc. BpNcCaP/HA-func. 3D scaffold dramatically enhanced vertical alveolar bone augmentation, which suggests a promising application potential of BMP2-inc. BpNcCaP/HA-func. 3D scaffold in dental clinic.
{"title":"Osteoinductively Functionalized 3D-Printed Scaffold for Vertical Bone Augmentation in Beagle Dogs","authors":"Ting Wang, Gaoli Xu, Chuankai Zhang, Tymour Forouzanfar, Junwei Liang, Yulei Pan, Chenxi Shen, Gang Wu, Haiyan Lin","doi":"10.1111/cid.13408","DOIUrl":"10.1111/cid.13408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy of 3D-printed scaffolds that were osteoinductively functionalized with a bone morphogenetic protein 2 (BMP-2)-incorporated biomimetic calcium phosphate particles (BMP-2-inc. BpNcCaP)/hyaluronic acid (HA) composite gel in vertical bone augmentation in beagle dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Four Beagle dogs were used in this study. Three months after the extraction of 1st, 2nd, 3rd, and 4th premolars at both sides of the lower jaws of Beagle dogs, one or two critical-size vertical bone defects (4 mm vertical bone defect without buccal and lingual bone) on each side were surgically created. The defects were randomly subjected to the following groups: (1) Control (without bone-defect-filling materials); (2) 3D scaffold; (3) BMP2-inc. BpNcCaP/HA-functionalized 3D scaffold. Six weeks post-surgery, samples were harvested and subjected to micro-CT and histomorphometric analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The struts of the BMP2-inc. BpNcCaP/HA-func. 3D scaffold were covered by a thick layer of cemented irregular particles with an average pore size at 327 ± 27 μm. The BpNcCaP/HA-func. 3D scaffold group bore significantly higher bone volume, bone volume fraction, trabecular number, trabecular thickness, bone mineral density, connectivity density, and bone volumes in three directions (mesiodistal, buccolingual, and apicocoronal) when compared with the groups of Control and 3D scaffold. Moreover, the BMP2-inc. BpNcCaP/HA-func. 3D scaffold group bore significantly lower trabecular separation and exhibited significantly higher bone-to-scaffold contact percentage and newly formed bone area percentage within pores in comparison with 3D scaffold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BMP2-inc. BpNcCaP/HA-func. 3D scaffold dramatically enhanced vertical alveolar bone augmentation, which suggests a promising application potential of BMP2-inc. BpNcCaP/HA-func. 3D scaffold in dental clinic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahmoud Nour, Mohamed Shawky, Rofaida A. Abaas, Maha Hakam, Mohammed Atef
Background
Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation.
Methodology
Twenty-four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy-apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively.
Results
Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (p > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (p > 0.05).
Conclusion
The two-stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended.
{"title":"Two Stage Sinus Lifting Using Nanohydroxyapatite Particles Versus Deproteinized Bovine Bone: Randomized Clinical Trial","authors":"Mahmoud Nour, Mohamed Shawky, Rofaida A. Abaas, Maha Hakam, Mohammed Atef","doi":"10.1111/cid.13410","DOIUrl":"10.1111/cid.13410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Twenty-four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy-apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (<i>p</i> > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The two-stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT03184857.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA).
Materials and Methods
Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements.
Results
A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (n = 15) did not report the incidence of sinus membrane perforation.
Conclusion
Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA.
{"title":"Minimally Invasive Sinus Augmentation: A Systematic Review","authors":"Benyapha Sirinirund, Amanda B. Rodriguez Betancourt, Riccardo Scaini, Yu-Chang Wu, Hsun-Liang Chan","doi":"10.1111/cid.13403","DOIUrl":"10.1111/cid.13403","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Technology improvement and a better understanding of sinus anatomy and wound healing in the past decade have allowed the development of minimally invasive surgical techniques. This systematic review focused on identifying and describing these techniques for vertical and lateral sinus augmentation (VSA and LSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Electronic and hand search were conducted to screen the literature published from January 2003 to May 2024. The selected studies had to include detailed techniques for minimally invasive SA. Data extraction included the study types, sample size, technique/instrument details, and outcome measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 36 articles (27 VSA, 8 LSA with an additional 1 article included both procedures) with 2732 sinus augmentation met the inclusion criteria. Minimally invasive VSA includes the use of modified rotary instruments with stopper, balloon, hydraulic pressure, digital planning, endoscope, and operating microscope. These techniques aim for conservative flap reflection, precise sinus window preparation, and/or controlled sinus membrane elevation. Most of the selected studies (<i>n</i> = 15) did not report the incidence of sinus membrane perforation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Within the limitations of this review, minimally invasive VSA and LSA achieved sufficient sinus augmentation and implant success with the potential advantages of reduced surgical complications and morbidity. Comparative studies with defined outcomes are encouraged to further validate these useful minimally invasive techniques for SA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chang-Hoon Kim, Ji-Youn Hong, SeungIl Shin, Seung-Yun Shin, Jong-Hyuk Chung, Daniel S. Thoma, Hyun-Chang Lim
Objectives
The objective of this study is to investigate the effect of collagen matrix with polydeoxyribonucleotide (PDRN) at two concentrations on keratinized tissue (KT) regeneration for buccally positioned implants in canines.
Methods
Four implants were placed in the edentulous mandible of five dogs simultaneously with KT removal. The implants were positioned buccally with respect to the ridge crest. After 2 months, KT augmentation was performed applying the following treatment modalities:(1) free gingival graft (FGG), (2) xenogeneic collagen matrix (XCM), (3) XCM loaded with 2 mg/mL PDRN (PDRN2), and (4) XCM loaded with 4 mg/mL PDRN (PDRN4). All animals were sacrificed 3 months later. Outcomes included clinical (KT height) and histomorphometric measurements (KT height/length, level of the mucosa, mucosal thickness, supracrestal soft tissue height).
Results
Clinical and histomorphometric KT formation at 3 months was greatest in groups with FGG (4.70 ± 1.00/3.94 ± 0.93 mm) and PDRN2 (4.85 ± 1.43/3.95 ± 0.87 mm). Group PDRN2 (1.87 ± 1.50 mm) showed a higher marginal mucosal level with respect to the implant platform compared to other groups (range: 0.57 ± 0.97–0.69 ± 1.14 mm). All groups presented a soft tissue thickness of < 2 mm on the buccal aspect of the implants.
Conclusions
Based on the limitations of this pilot preclinical study, XCM with 2 mg/mL of PDRN demonstrated a potential for KT augmentation.
{"title":"Preclinical Investigation on the Effect of Collagen Matrix With Polydeoxyribonucleotide at Buccally Positioned Implants","authors":"Chang-Hoon Kim, Ji-Youn Hong, SeungIl Shin, Seung-Yun Shin, Jong-Hyuk Chung, Daniel S. Thoma, Hyun-Chang Lim","doi":"10.1111/cid.13411","DOIUrl":"10.1111/cid.13411","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study is to investigate the effect of collagen matrix with polydeoxyribonucleotide (PDRN) at two concentrations on keratinized tissue (KT) regeneration for buccally positioned implants in canines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four implants were placed in the edentulous mandible of five dogs simultaneously with KT removal. The implants were positioned buccally with respect to the ridge crest. After 2 months, KT augmentation was performed applying the following treatment modalities:(1) free gingival graft (FGG), (2) xenogeneic collagen matrix (XCM), (3) XCM loaded with 2 mg/mL PDRN (PDRN2), and (4) XCM loaded with 4 mg/mL PDRN (PDRN4). All animals were sacrificed 3 months later. Outcomes included clinical (KT height) and histomorphometric measurements (KT height/length, level of the mucosa, mucosal thickness, supracrestal soft tissue height).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinical and histomorphometric KT formation at 3 months was greatest in groups with FGG (4.70 ± 1.00/3.94 ± 0.93 mm) and PDRN2 (4.85 ± 1.43/3.95 ± 0.87 mm). Group PDRN2 (1.87 ± 1.50 mm) showed a higher marginal mucosal level with respect to the implant platform compared to other groups (range: 0.57 ± 0.97–0.69 ± 1.14 mm). All groups presented a soft tissue thickness of < 2 mm on the buccal aspect of the implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on the limitations of this pilot preclinical study, XCM with 2 mg/mL of PDRN demonstrated a potential for KT augmentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liza Lima Ramenzoni, Jothi Varghese, Patrick Roger Schmidlin, Shubhankar Mehrotra
Objective
The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs.
Material and Methods
Rough and smooth Ti surfaces were contaminated with a multispecies biofilm and cleaned with a chitosan brush. Discs were treated either with injectable-platelet-rich fibrin (i-PRF), advanced platelet-rich fibrin (A-PRF+), or enamel matrix derivatives (EMDs) before osteoblast seeding.
Results
Biocompatibility, adhesion, migration, and gene expression of runt-related transcription factor 2 (RUNX2), collagen Type I Alpha 2 (COL1a2), alkaline phosphatase (ALP), osteocalcin (OC), and osteonectin (ON) were performed. All the tested biologic agents similarly increased cell viability. Specifically, osteoblasts seeded over i-PRF and EMD-treated surfaces showed improvement in adhesion and migration and significantly increased ALP, OC, ON, RUNX-2, and COL1a2 mRNA levels up to 2.8 fold (p < 0.05) with no differences between Ti surfaces.
Conclusions
i-PRF and EMD possess beneficial bioactive properties that enhance tissue healing and promote regeneration on thoroughly sterilized surfaces. Biologically active materials may hold the potential to influence the process of implant re-osseointegration, which warrants more research since sterilization of the affected surfaces under clinical conditions is still not reliably possible and remains one of the greatest challenges.
{"title":"Effects of i-PRF, A-PRF+, and EMD on Osteogenic Potential of Osteoblasts on Titanium","authors":"Liza Lima Ramenzoni, Jothi Varghese, Patrick Roger Schmidlin, Shubhankar Mehrotra","doi":"10.1111/cid.13406","DOIUrl":"10.1111/cid.13406","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Rough and smooth Ti surfaces were contaminated with a multispecies biofilm and cleaned with a chitosan brush. Discs were treated either with injectable-platelet-rich fibrin (i-PRF), advanced platelet-rich fibrin (A-PRF+), or enamel matrix derivatives (EMDs) before osteoblast seeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Biocompatibility, adhesion, migration, and gene expression of <i>runt-related transcription factor 2</i> (<i>RUNX2</i>), <i>collagen Type I Alpha 2</i> (<i>COL1a2</i>), <i>alkaline phosphatase</i> (<i>ALP</i>), <i>osteocalcin</i> (<i>OC</i>), and <i>osteonectin</i> (<i>ON</i>) were performed. All the tested biologic agents similarly increased cell viability. Specifically, osteoblasts seeded over i-PRF and EMD-treated surfaces showed improvement in adhesion and migration and significantly increased <i>ALP, OC, ON, RUNX-2</i>, and <i>COL1a2</i> mRNA levels up to 2.8 fold (<i>p</i> < 0.05) with no differences between Ti surfaces.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>i-PRF and EMD possess beneficial bioactive properties that enhance tissue healing and promote regeneration on thoroughly sterilized surfaces. Biologically active materials may hold the potential to influence the process of implant re-osseointegration, which warrants more research since sterilization of the affected surfaces under clinical conditions is still not reliably possible and remains one of the greatest challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad H. A. Saleh, Hamoun Sabri, Natalia Di Pietro, Luca Comuzzi, Nicolas C. Geurs, Layal Bou Semaan, Adriano Piattelli
<p>Tooth loss, resulting from various causes such as periodontal disease or dental caries, can lead to the subsequent resorption of the alveolar bone process [<span>1</span>]. This fundamentally complicates implant-based rehabilitation, especially in the posterior maxilla. Crestal migration of the maxillary sinus floor due to pneumatization, combined with resorption of the alveolar bone, can result in inadequate residual bone height. This situation may require pre-implant interventions like sinus floor elevation (SFE) to ensure enough bone for implant placement [<span>2, 3</span>].</p><p>Several strategies have been introduced to increase the bone height in the posterior maxilla [<span>3-5</span>]. SFE has been shown to have relatively high success in augmenting the posterior maxilla with a deficient bone height. Two main techniques have been introduced: (1) The transalveolar (vertical, closed) SFE, and (2) The lateral window approach (open). It should be noted that several modifications of these techniques have also been introduced [<span>6-8</span>].</p><p>Given that this regenerative intervention aims to enhance bone height and width to facilitate proper implant placement, dental implants can be placed simultaneously with the sinus augmentation procedure (referred to as the “one-stage” technique). Alternatively, a staged approach may be employed, where bone augmentation occurs during the initial surgical intervention, followed by the placement of dental implants once adequate bone volume has been established (known as the “two-stage” technique) [<span>9, 10</span>].</p><p>The classical sinus lift procedure, introduced by Tatum in the 1970s, involves a lateral window approach [<span>11, 12</span>]. This technique involves creating incisions to expose the sinus wall, followed by a trapdoor osteotomy to access the sinus membrane and cavity. Careful dissection and membrane elevation are performed to create space for graft material. If sufficient basal bone is present, implants may be placed simultaneously, protruding through the sinus cavity and protected by the sinus membrane. The remaining space is typically filled with bone replacement grafts, and the window opening is closed with a barrier membrane. However, a two-stage approach is required if the basal bone is inadequate, and implants are placed only after sufficient bone regeneration [<span>9</span>].</p><p>In contrast, an alternative, less-invasive technique introduced by Tatum and modified by Summers is the crestal approach [<span>13</span>]. When indicated, this approach involves elevating the sinus floor through the alveolar crest using osteotomes. Summers' modification utilizes concave-tipped tapered osteotomes to fracture the maxillary floor and elevate the sinus membrane. This technique is less invasive, less time-consuming, and allows for better bone density and implant stability due to lateral compression exerted by the osteotomes. After membrane elevation, various bone grafting mat
{"title":"Clinical Indications and Outcomes of Sinus Floor Augmentation With Bone Substitutes: An Evidence-Based Review","authors":"Muhammad H. A. Saleh, Hamoun Sabri, Natalia Di Pietro, Luca Comuzzi, Nicolas C. Geurs, Layal Bou Semaan, Adriano Piattelli","doi":"10.1111/cid.13400","DOIUrl":"10.1111/cid.13400","url":null,"abstract":"<p>Tooth loss, resulting from various causes such as periodontal disease or dental caries, can lead to the subsequent resorption of the alveolar bone process [<span>1</span>]. This fundamentally complicates implant-based rehabilitation, especially in the posterior maxilla. Crestal migration of the maxillary sinus floor due to pneumatization, combined with resorption of the alveolar bone, can result in inadequate residual bone height. This situation may require pre-implant interventions like sinus floor elevation (SFE) to ensure enough bone for implant placement [<span>2, 3</span>].</p><p>Several strategies have been introduced to increase the bone height in the posterior maxilla [<span>3-5</span>]. SFE has been shown to have relatively high success in augmenting the posterior maxilla with a deficient bone height. Two main techniques have been introduced: (1) The transalveolar (vertical, closed) SFE, and (2) The lateral window approach (open). It should be noted that several modifications of these techniques have also been introduced [<span>6-8</span>].</p><p>Given that this regenerative intervention aims to enhance bone height and width to facilitate proper implant placement, dental implants can be placed simultaneously with the sinus augmentation procedure (referred to as the “one-stage” technique). Alternatively, a staged approach may be employed, where bone augmentation occurs during the initial surgical intervention, followed by the placement of dental implants once adequate bone volume has been established (known as the “two-stage” technique) [<span>9, 10</span>].</p><p>The classical sinus lift procedure, introduced by Tatum in the 1970s, involves a lateral window approach [<span>11, 12</span>]. This technique involves creating incisions to expose the sinus wall, followed by a trapdoor osteotomy to access the sinus membrane and cavity. Careful dissection and membrane elevation are performed to create space for graft material. If sufficient basal bone is present, implants may be placed simultaneously, protruding through the sinus cavity and protected by the sinus membrane. The remaining space is typically filled with bone replacement grafts, and the window opening is closed with a barrier membrane. However, a two-stage approach is required if the basal bone is inadequate, and implants are placed only after sufficient bone regeneration [<span>9</span>].</p><p>In contrast, an alternative, less-invasive technique introduced by Tatum and modified by Summers is the crestal approach [<span>13</span>]. When indicated, this approach involves elevating the sinus floor through the alveolar crest using osteotomes. Summers' modification utilizes concave-tipped tapered osteotomes to fracture the maxillary floor and elevate the sinus membrane. This technique is less invasive, less time-consuming, and allows for better bone density and implant stability due to lateral compression exerted by the osteotomes. After membrane elevation, various bone grafting mat","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cid.13400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dalia Yossri, Nevine H. Kheir El Din, Nermeen Sami Afifi, Doaa Adel-Khattab
<div> <section> <h3> Objective</h3> <p>Soft tissue seal around implants ensures stable osseointegration and a long-term survival of dental implants. Different surface modification and decontamination for implant abutments were endorsed in order to improve peri-implant soft tissue healing, such as laser, plasma spray, acid etching, and steaming. The aim of this study was to evaluate the response of peri-implant soft tissue to titanium abutments treated with Erbium-doped: Yttrium-Aluminum-Garnet (Er:YAG) laser versus plasma spray.</p> </section> <section> <h3> Methods</h3> <p>Twenty-four patients who required implant placement in the maxillary arch participated in this study. Patients were divided into three groups, abutments treated with Er:YAG laser versus cold plasma spray and untreated abutments. Fourteen days following the implant abutment insertion, soft tissue peri-implant biopsies were taken for histological, histochemical, and immunohistochemical evaluation. Scanning electron microscopy was done for the abutments; plaque index (PI) and gingival index (GI) were assessed 14 days and 3 months following final restoration.</p> </section> <section> <h3> Results</h3> <p>Regarding the histological results, the least mean inflammatory cell count was in the plasma group (174.09 ± 40.67), followed by the laser group (654.27 ± 85.95) and the control group (852.00 ± 117.98), with statistically significant differences between them. The mean area fraction of collagen fibers showed the highest value in the plasma group (9.73 ± 1.91), followed by the laser group (3.25 ± 0.49), while the lowest value was found in the control group (1.17 ± 0.51). The immunohistochemical expression of E-cadherin was significantly higher and uniformly distributed in the plasma group (42.4 ± 11.2%) followed by the laser group (15.4 ± 4.07%) and the control group (6.8 ± 1.7%). SEM analysis of healing abutments showed fibroblast-like cells, which were more developed with dense fibers in the plasma group; laser group fibers showed fewer and more delicate fibers than the plasma group, while no fibers were detected in the control group.</p> </section> <section> <h3> Conclusion</h3> <p>Within the limitations of this feasibility study, the present data concluded that plasma spray and Erbium: YAG laser can be used for abutment surface treatment to achieve better peri-implant soft tissue healing. Clinically and histologically, plasma spray showed a better effect on the peri-implant soft tissues by reducing the inflammatory reaction, promoting collagen fiber formation, higher fibroblast-like cell attachment, and upregulating E-cadherin expression than Erbium: YAG laser an
{"title":"Soft tissue response to titanium healing abutments treated by Er: YAG laser or plasma spray: A randomized controlled feasibility clinical study with SEM and histological analysis","authors":"Dalia Yossri, Nevine H. Kheir El Din, Nermeen Sami Afifi, Doaa Adel-Khattab","doi":"10.1111/cid.13373","DOIUrl":"10.1111/cid.13373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Soft tissue seal around implants ensures stable osseointegration and a long-term survival of dental implants. Different surface modification and decontamination for implant abutments were endorsed in order to improve peri-implant soft tissue healing, such as laser, plasma spray, acid etching, and steaming. The aim of this study was to evaluate the response of peri-implant soft tissue to titanium abutments treated with Erbium-doped: Yttrium-Aluminum-Garnet (Er:YAG) laser versus plasma spray.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four patients who required implant placement in the maxillary arch participated in this study. Patients were divided into three groups, abutments treated with Er:YAG laser versus cold plasma spray and untreated abutments. Fourteen days following the implant abutment insertion, soft tissue peri-implant biopsies were taken for histological, histochemical, and immunohistochemical evaluation. Scanning electron microscopy was done for the abutments; plaque index (PI) and gingival index (GI) were assessed 14 days and 3 months following final restoration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding the histological results, the least mean inflammatory cell count was in the plasma group (174.09 ± 40.67), followed by the laser group (654.27 ± 85.95) and the control group (852.00 ± 117.98), with statistically significant differences between them. The mean area fraction of collagen fibers showed the highest value in the plasma group (9.73 ± 1.91), followed by the laser group (3.25 ± 0.49), while the lowest value was found in the control group (1.17 ± 0.51). The immunohistochemical expression of E-cadherin was significantly higher and uniformly distributed in the plasma group (42.4 ± 11.2%) followed by the laser group (15.4 ± 4.07%) and the control group (6.8 ± 1.7%). SEM analysis of healing abutments showed fibroblast-like cells, which were more developed with dense fibers in the plasma group; laser group fibers showed fewer and more delicate fibers than the plasma group, while no fibers were detected in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Within the limitations of this feasibility study, the present data concluded that plasma spray and Erbium: YAG laser can be used for abutment surface treatment to achieve better peri-implant soft tissue healing. Clinically and histologically, plasma spray showed a better effect on the peri-implant soft tissues by reducing the inflammatory reaction, promoting collagen fiber formation, higher fibroblast-like cell attachment, and upregulating E-cadherin expression than Erbium: YAG laser an","PeriodicalId":50679,"journal":{"name":"Clinical Implant Dentistry and Related Research","volume":"27 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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