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The Effect of Implantoplasty on Fracture Resistance and Implant Surface Changes: An In Vitro and Finite Element Analysis Study. 种植体成形术对抗折性和种植体表面变化的影响:体外和有限元分析研究。
Pub Date : 2024-11-06 DOI: 10.1111/cid.13409
Rayner Goh, Kai Chun Li, Momen A Atieh, Sunyoung Ma, Abigail Oliver, Diana Giraldo, Andrew Tawse-Smith

Introduction: Implantoplasty can be performed on implants diagnosed with peri-implantitis to facilitate implant decontamination and improve access for oral home care. However, its effect on the mechanical strength of the implant is still uncertain. This study aimed to evaluate the effect of implantoplasty on the fracture resistance of dental implants with various degrees of bone loss, as well as its surface changes.

Methods: Eighty 4.2 × 13 mm conical connection dental implants were allocated evenly into four groups based on the bone defect morphology: circumferential or semi-circumferential, and 3 or 5 mm vertical height. Half of the implants underwent implantoplasty with tungsten carbide finishing burs. Weight, volume, and surface roughness of the implants were recorded prior to and after instrumentation. All implants were subjected to static loading to failure or fracture and the implant surfaces were then analyzed using optical microscopy. Finite element analysis was carried out to assess the stress pattern on dental implants after implantoplasty.

Results: Implantoplasty significantly reduced the fracture resistance of implants with all defect morphologies, aside from those with 3 mm of circumferential bone loss. Implants with 5 mm of peri-implant bone loss also experienced significantly reduced fracture resistance compared to the 3 mm group. Significant decrease in fracture resistance was only observed between the circumferential and semi-circumferential groups with 5 mm of bone loss. Surface roughness was also significantly reduced following implantoplasty. The results from finite element analysis revealed a change in pattern of stress concentration in the implant after implantoplasty.

Conclusion: Implantoplasty negatively impacted the fracture resistance of standard diameter dental implants in most scenarios. The increase in exposed implant length resulted in a decrease in fracture resistance. This increase in fracture risk should be considered prior to implantoplasty, especially in implants with more advanced bone loss.

导言:种植体植入术可用于诊断为种植体周围炎的种植体,以促进种植体净化,改善口腔家庭护理的可及性。然而,其对种植体机械强度的影响仍不确定。本研究旨在评估种植体成形术对不同程度骨质流失的牙科种植体的抗折性及其表面变化的影响:方法:根据骨缺损形态将 80 颗 4.2 × 13 毫米的锥形连接种植体平均分为四组:环形或半环形,垂直高度为 3 毫米或 5 毫米。半数种植体使用碳化钨精加工车针进行种植整形。在植入前和植入后,对种植体的重量、体积和表面粗糙度进行了记录。对所有种植体进行静态加载,直至失效或断裂,然后使用光学显微镜对种植体表面进行分析。此外,还进行了有限元分析,以评估种植整形术后牙科种植体的应力模式:结果:种植体植入术明显降低了所有缺损形态种植体的抗折性,只有周缘骨缺失 3 毫米的种植体除外。与 3 毫米组相比,种植体周围骨质流失 5 毫米的种植体的抗折性也明显降低。只有周缘骨质缺失 5 毫米组和半周缘骨质缺失 5 毫米组之间的抗折性才会显著降低。种植体植入后,表面粗糙度也明显降低。有限元分析的结果表明,种植体植入术后种植体的应力集中模式发生了变化:结论:在大多数情况下,种植体植入术对标准直径牙科种植体的抗折性产生了负面影响。种植体暴露长度的增加导致抗折性降低。在进行种植手术前应考虑到骨折风险的增加,尤其是骨质流失较严重的种植体。
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引用次数: 0
Clinical and Radiographic Features of Peri-Implant Medication-Related Osteonecrosis of the Jaw: A Retrospective Study. 植入前药物相关性颌骨骨坏死的临床和放射学特征:一项回顾性研究
Pub Date : 2024-11-06 DOI: 10.1111/cid.13412
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.

导言:该研究旨在分析在不同种植体位置、倾斜度和修复体类型上使用抗吸收药物(ARDs)的患者发生种植体周围药物相关性颌骨坏死(PI-MRONJ)的影响因素:回顾性研究了2018年至2022年间75例种植体周围骨坏死进展患者的数据,以确定影响PI-MRONJ的因素。数据包括患者人口统计学特征(年龄、性别、吸烟状况、伴随疾病、ARD治疗时间、ARD剂量和副功能习惯)和种植体特定信息(修复体类型、插入角度),均从医疗和牙科记录中提取:结果:与非倾斜种植体相比,相对于修复体咬合面角度≥5.1°的倾斜种植体与PI-MRONJ的关系更为密切(倾斜度为5.1°):在服用抗骨质吸收药物的患者中,种植体的倾斜度与 PI-MRONJ 的发生有关。需要进一步的研究来证实临床发现。
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引用次数: 0
Metal-Free Custom-Made Zirconia Implants-A Prospective 5-Year Follow-Up Single-Arm Clinical Trial. 无金属定制氧化锆假体--一项为期 5 年的前瞻性单臂随访临床试验。
Pub Date : 2024-11-06 DOI: 10.1111/cid.13404
Jantien H W de Beus, Marco S Cune, Henny J A Meijer, Gerry M Raghoebar, Ulf Schepke
<p><strong>Background: </strong>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><p><strong>Aim: </strong>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><p><strong>Material and methods: </strong>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 t-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><p><strong>Results: </strong>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 baseline and the second follow-up was +0.04 mm (95% CI [-0.35 mm; 0.26 mm]; SD = 0.54 mm). Patients' satisfaction for patients with implants still in function after 5 years was 91.7% (IQR = [90.5%-97.3%]), indicating satisfaction with the treatment. Pooled satisfaction in patients with successful implants after 5 years was significantly higher than patients' expressed expectations before treatment. None of the crowns failed, and no interventions were required.</p>
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。
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引用次数: 0
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. 立即加载全髋关节康复中的内外六边形连接评估:随访 6 年的多中心随机分口对照试验。
Pub Date : 2024-11-06 DOI: 10.1111/cid.13416
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.

背景:全弓即刻加载康复是目前广泛使用的一种康复方法,它能保证可预测的中长期效果。影响中长期效果和稳定性的因素有很多。目的:本多中心分口对照试验的目的是评估外六方连接(EHC)和内六角连接(IHC)是否会影响即刻加载全牙弓修复的成功率、骨吸收和种植体周围参数:对 20 名患者进行了即刻加载固定全牙弓修复。所有种植体的宏观和微观形态相同,但种植体与基台的连接方式不同。随机选择一侧下颌使用 IHC,另一侧下颌使用 EHC。结果测量指标包括种植体成活率、种植体周围边缘骨缺损(MBL)、牙菌斑指数(PI)、探诊深度(PD)和探诊出血量(BoP),分别在种植体植入后 3、6、12、36 和 72 个月进行评估。记录了技术和生物学并发症:在20名患者中,植入了43颗EHC种植体和40颗IHC种植体。在 32 到 72 个月的随访期间,两名患者退出(死亡),没有种植体丢失。EHC 种植体的累积存活率为 97.44%,IHC 种植体的累积存活率为 97.22%。EHC 组的 MBL 吸收了 2 毫米,IHC 组的 MBL 吸收了 1.9 毫米。两组在任何时间的任何参数上都没有发现明显的统计学差异。在随访的第36个月至第72个月期间,未发现生物学或技术上的并发症:经过72个月的功能锻炼后,内六角和外六角连接都能提供良好的临床效果,并且在临床效果方面没有任何明显差异。
{"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":"<p><strong>Background: </strong>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><p><strong>Purpose: </strong>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><p><strong>Materials and methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>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>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Osteoinductively Functionalized 3D-Printed Scaffold for Vertical Bone Augmentation in Beagle Dogs. 用于比格犬垂直骨增量的骨诱导功能化三维打印支架
Pub Date : 2024-10-31 DOI: 10.1111/cid.13408
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.

目的评估骨形态发生蛋白 2(BMP-2)-纳入生物仿生磷酸钙颗粒(BMP-2-inc. BpNcCaP)/透明质酸(HA)复合凝胶的骨诱导功能化三维打印支架在比格犬垂直骨增量中的疗效:本研究使用了四只比格犬。在比格犬下颌两侧的第 1、2、3 和 4 颗前臼齿拔除三个月后,通过手术在两侧各创建一个或两个临界大小的垂直骨缺损(4 毫米垂直骨缺损,不含颊舌骨)。缺陷随机分为以下几组:(1)对照组(无骨缺陷填充材料);(2)三维支架;(3)BMP2-inc. BpNcCaP/HA 功能化三维支架。手术后六周,采集样本并进行显微 CT 和组织形态学分析:结果:BMP2-inc.结果:BMP2-inc.BpNcCaP/HA-func.三维支架的支柱被一层厚厚的胶结不规则颗粒覆盖,平均孔径为 327 ± 27 μm。BpNcCaP/HA-func.与对照组和三维支架组相比,BpNcCaP/HA-func.三维支架组的骨量、骨量分数、骨小梁数、骨小梁厚度、骨矿物质密度、连接密度和三个方向(中轴、颊舌和心尖)的骨量均明显增加。此外,BMP2-inc. BpNcCaP/HA-func.此外,与三维支架相比,BMP2-inc. BpNcCaP/HA-func:结论:BMP2-inc.结论:BMP2-inc. BpNcCaP/HA-func.三维支架在牙科临床中的应用潜力。
{"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":"https://doi.org/10.1111/cid.13408","url":null,"abstract":"<p><strong>Objective: </strong>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><p><strong>Materials and methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>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>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Stage Sinus Lifting Using Nanohydroxyapatite Particles Versus Deproteinized Bovine Bone: Randomized Clinical Trial. 使用纳米羟基磷灰石颗粒与去蛋白牛骨的两阶段窦提升术:随机临床试验。
Pub Date : 2024-10-31 DOI: 10.1111/cid.13410
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.

Trial registration: ClinicalTrials.gov identifier: NCT03184857.

背景:上颌窦底抬高术是一种可预测的上颌后牙槽脊垂直缺损增高技术。据报道,有几种生物材料可成功用于上颌窦增高,包括异种移植物和羟基磷灰石。本研究旨在比较在上颌窦增量术中使用异种移植物和纳米羟基磷灰石生成骨的质量和数量:将 24 名患者/窦随机分为两组:对照组患者使用去蛋白牛骨(DBB)进行窦底抬高和增量,而研究组患者使用纳米羟基磷灰石骨(NHA)进行窦增量。对每位患者的术前、术后即刻和术后 6 个月的骨高度进行了评估。此外,术后 6 个月后,还通过组织学和组织形态计量学分析评估了新形成骨的质量:结果:两种生物材料都显示出良好的巩固性。研究组 6 个月后的平均骨高为(11.72 ± 1.24)毫米,对照组为(12.01 ± 1.16)毫米,差异无统计学意义(P > 0.05)。新形成骨的平均骨面积百分比,NHA 组为 29.84% ± 6.7%,DBB 组为 34.73 ± 7.9%。此外,NHA 组残留移植材料的平均百分比为 32.43% ± 11.53%,而 DBB 组为 30.43% ± 8.27%。从组织学角度看,两组在不同参数上无明显差异(P > 0.05):结论:使用 NHA 和 DBB 进行的两阶段窦底增量术在再生骨的质量和数量方面均无统计学意义上的显著差异。建议进行样本更大、随访时间更长的研究:试验注册:ClinicalTrials.gov identifier:NCT03184857.
{"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":"https://doi.org/10.1111/cid.13410","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methodology: </strong>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><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03184857.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minimally Invasive Sinus Augmentation: A Systematic Review. 微创鼻窦增生:系统回顾
Pub Date : 2024-10-30 DOI: 10.1111/cid.13403
Benyapha Sirinirund, Amanda B Rodriguez Betancourt, Riccardo Scaini, Yu-Chang Wu, Hsun-Liang Chan

Aim: 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.

目的:过去十年中,随着技术的进步以及对鼻窦解剖和伤口愈合的深入了解,微创手术技术得以发展。本系统性综述的重点是识别和描述这些用于垂直和侧向鼻窦增大术(VSA 和 LSA)的技术:材料和方法:通过电子和手工检索筛选了 2003 年 1 月至 2024 年 5 月期间发表的文献。所选研究必须包含微创鼻窦增容的详细技术。数据提取包括研究类型、样本大小、技术/器械细节和结果测量:共有 36 篇文章(27 篇 VSA,8 篇 LSA,另有 1 篇文章同时包含两种手术),2732 个鼻窦增大术符合纳入标准。微创 VSA 包括使用带有塞子、球囊、液压、数字规划、内窥镜和手术显微镜的改良旋转器械。这些技术旨在实现保守的皮瓣反射、精确的窦窗准备和/或可控的窦膜抬高。大多数所选研究(n = 15)未报告窦膜穿孔的发生率:在本综述的局限性范围内,微创 VSA 和 LSA 达到了足够的窦增量和植入成功率,并具有减少手术并发症和发病率的潜在优势。我们鼓励开展具有明确结果的比较研究,以进一步验证这些有用的微创技术。
{"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":"https://doi.org/10.1111/cid.13403","url":null,"abstract":"<p><strong>Aim: </strong>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><p><strong>Materials and methods: </strong>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><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preclinical Investigation on the Effect of Collagen Matrix With Polydeoxyribonucleotide at Buccally Positioned Implants. 胶原蛋白基质与聚脱氧核苷酸对颊部植入物影响的临床前研究
Pub Date : 2024-10-27 DOI: 10.1111/cid.13411
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.

研究目的本研究旨在探讨两种浓度的聚脱氧核苷酸(PDRN)胶原基质对犬颊侧种植体角化组织(KT)再生的影响:在切除 KT 的同时,在五只犬的无牙下颌植入了四个种植体。种植体的颊侧位置与牙脊嵴相关。2 个月后,采用以下治疗方式进行 KT 增量:(1) 游离牙龈移植 (FGG);(2) 异种胶原基质 (XCM);(3) 含有 2 毫克/毫升 PDRN 的 XCM (PDRN2);(4) 含有 4 毫克/毫升 PDRN 的 XCM (PDRN4)。所有动物均在 3 个月后处死。结果包括临床(KT 高度)和组织形态测量(KT 高度/长度、粘膜水平、粘膜厚度、上软组织高度):3个月时,临床和组织形态测量的KT形成在FGG组(4.70 ± 1.00/3.94 ± 0.93 mm)和PDRN2组(4.85 ± 1.43/3.95 ± 0.87 mm)最大。与其他组相比,PDRN2 组(1.87 ± 1.50 mm)与种植体平台的边缘粘膜水平更高(范围:0.57 ± 0.97-0.69 ± 1.14 mm)。所有组的软组织厚度均符合结论:基于这项临床前试验研究的局限性,含有 2 毫克/毫升 PDRN 的 XCM 显示出了 KT 增量的潜力。
{"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":"https://doi.org/10.1111/cid.13411","url":null,"abstract":"<p><strong>Objectives: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>Based on the limitations of this pilot preclinical study, XCM with 2 mg/mL of PDRN demonstrated a potential for KT augmentation.</p>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of i-PRF, A-PRF+, and EMD on Osteogenic Potential of Osteoblasts on Titanium. i-PRF、A-PRF+ 和 EMD 对钛上成骨细胞成骨潜能的影响
Pub Date : 2024-10-22 DOI: 10.1111/cid.13406
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.

研究目的本研究评估了三种已知具有骨诱导潜能的生物活性物质在先前净化过的钛盘(Ti)上的作用:粗糙和光滑的钛表面被多菌种生物膜污染,并用壳聚糖刷进行清洁。在成骨细胞播种前,用可注射的富血小板纤维蛋白(i-PRF)、高级富血小板纤维蛋白(A-PRF+)或釉基质衍生物(EMDs)处理钛盘:结果:对生物相容性、粘附性、迁移性以及runt相关转录因子2(RUNX2)、Ⅰ型胶原蛋白α2(COL1a2)、碱性磷酸酶(ALP)、骨钙素(OC)和骨连蛋白(ON)的基因表达进行了研究。所有测试的生物制剂都同样提高了细胞活力。具体而言,在 i-PRF 和 EMD 处理过的表面上播种的成骨细胞显示出粘附性和迁移性的改善,ALP、OC、ON、RUNX-2 和 COL1a2 mRNA 水平显著增加达 2.8 倍(p 结论:i-PRF 和 EMD 具有有益的生物活性特性,可增强组织愈合并促进彻底灭菌表面的再生。生物活性材料可能会影响种植体的再骨结合过程,这需要进行更多的研究,因为在临床条件下对受影响表面进行消毒仍然是不可靠的,也是最大的挑战之一。
{"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":"https://doi.org/10.1111/cid.13406","url":null,"abstract":"<p><strong>Objective: </strong>The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs.</p><p><strong>Material and methods: </strong>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><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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>","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Indications and Outcomes of Sinus Floor Augmentation With Bone Substitutes: An Evidence-Based Review. 使用骨替代物进行窦底增高术的临床适应症和疗效:基于证据的综述
Pub Date : 2024-10-17 DOI: 10.1111/cid.13400
Muhammad H A Saleh, Hamoun Sabri, Natalia Di Pietro, Luca Comuzzi, Nicolas C Geurs, Layal Bou Semaan, Adriano Piattelli
{"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":"https://doi.org/10.1111/cid.13400","url":null,"abstract":"","PeriodicalId":93944,"journal":{"name":"Clinical implant dentistry and related research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Clinical implant dentistry and related research
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