Impact of osteoporosis in dental implants:A systematic review

AIM: To assess the failure and bone-to-implant contact rate of dental implants placed on osteoporotic subjects. METHODS: Extensive examination strategies were created to classify studies for this systematic review. MEDLINE(via Pub Med) and EMBASE database were examined for studies in English up to and including May 2014. The examination presented a combination of the MeS H words described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration". Assessment of clinical and/or histological peri-implant conditions in osteoporosis subjects treated with titanium dental implants. The examination included a combination of the MeS H terms described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration".RESULTS: Of 943 potentially eligible articles, 12 were included in the study. A total of 133 subjects with osteoporosis, 73 subjects diagnosed with osteopenia and 708 healthy subjects were assessed in this systematic review. In these subjects were installed 367, 205, 2981 dental implants in osteoporotic, osteopenic and healthy subjects, respectively. The failure rate of dental implant was 10.9% in osteoporotic subjects, 8.29% in osteopenic and 11.43% in healthy ones. Bone-to-implant contact obtained from retrieved implants ranged between 49.96% to 47.84%, for osteoporosis and non-osteoporotic subjects. CONCLUSION: Osteoporotic subjects presented higher rates of implant loss, however, there is a lower evidence to strengthen or refute the hypothesis that osteoporosis may have detrimental effects on bone healing. Consequently, final conclusions regarding the effect of osteoporosis in dental implant therapy cannot be made at this time. There are no randomized clinical trial accessible for evaluation and the retrospectivenature of the evaluated studies shall be taken in account when interpreting this study.

Investigation of a new design for zirconia dental implants

Objective:To assess the biomechanical properties of a new design configuration for zirconia dental implants. Methods: The new design has a cylindrical shape that is partially hollow and porous in the bottom, which permits the implants to be locked into the alveolar bone over time. It also utilizes bioactive glass coatings to increase adhesion to surrounding bone structure. Samples of the new design were fabricated in the laboratory and their material strength, hardness, and fracture toughness were evaluated. In addition, biocompatibility of the new design was evaluated through testing in dogs. Results: Results of mechanical tests indicate that structural properties of the new design exceed the usual requirements for implants. Moreover, animal tests suggest that there is appreciable improvement in lock-in strength and osteointegration. Conclusion: The new design configuration is biomechanically feasible and further research is warranted to improve the design for human use.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

AIM: To discuss important characteristics of the useof dental implants in posterior quadrants and the rehabilitation planning. METHODS: An electronic search of English articles was conducted on MEDLINE(PubM ed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. RESULTS: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations(bone quantity and density), radiographic techniques, implant selection(number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. CONCLUSION: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

Actual Practical Attitude and Knowledge of Dental Implants among Senior Dental Students and General Dentists Graduated from Some Saudi and Non-Saudi Dental Schools

Objective: To assess the actual practical attitude and knowledge of dental implants among senior dental students and general dentists graduated from some Saudi and Non-Saudi dental schools. Methods: A total of 300 senior dental students and general dentists participated in the study. Hard copies of the self-designed, multiple-choice questionnaires were distributed to all participants. The questionnaire consisted of 31 questions in five parts. Data were collected and analyzed using Chi-square test and t-test, where p Results: There is a statistically significant relationship between the participants’ answers, and their dental schools. Participants’ general knowledge, training, and teaching of dental implants, as well as information about restorations retained for the dental implants, were higher among participants from Saudi dental schools than participants from non-Saudi dental schools, while the information about dental implants was higher among participants from non-Saudi dental schools than participants from Saudi dental schools. Conclusion: We conclude that the actual practical attitude and knowledge of dental implants among participants in the current study was insufficient. Therefore, dental implant education in the undergraduate curricula of dental schools surveyed should be updated to include teaching, laboratory training, and preclinical and clinical training.

I Do Biotech Dental Implants: Prospective Multicentric Study after 5 Years of Functional Loading

Introduction: I Do Biotech’s implants were developed starting in 2014. Since then, they obtained GMP and KFDA licenses for distribution in 2015. The main objective of this paper is to determine the survival rate of I Do Biotech implants five years after the first surgery. Material and Methods: 1000 implants were used on 480 prostheses across 10 clinics on 320 healthy, non-smoker and non-diabetic patients, chosen at random, of which 160 are male and 160 female, all in the age range of 30 to 50 years old. The failure rate was studied related to the patient’s gender, the length and diameter of the implant, anatomical location, the percentage of peri-implantitis, prosthodontic failures and the patient’s quality of life. Discussion: The results obtained are similar to those of Van Steenberghe D. Dieter-Busenlechner, E. Serrano Catauria and far superior to those of Sáenz Guzmán. Failure rates vary greatly from study to study due to the heterogeneity of the samples in the other research papers. Conclusion: The overall implant failure rate at 5 years is 1.7%. The factors affecting significantly the survival rate are: the implant diameter, its length and the anatomic area. Failure ratios increase significantly when the diameter or the length of the implant decreases, and when they are placed in the posterior maxilla (up to 4.3%). The rate of peri-implantitis is 5.1%. The prosthodontic failure rate is 2.91%. The improvement in quality of life and satisfaction increases with the years.

GUIDED TISSUE REGENERATION AROUND DENTAL IMPLANTS IN IMMEDIATE EXTRACTION SOCKETS:COMPARISON OF RESORBABLE ANDNONRESORBABLE MEMBRANES

This study was per formed to compare the efficacy of guided tissue regeneration (GTR) around dentalimplants immediately placed into extraction sockets by resorbable of nonresorbable membranes. Mandibular. P2, P3, and P4 of four aduIt beagle dogs were extracted bilaterally, and buccal standard defects were cre-ated and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into thefresh extraction sockets. Four implants were untreated controls, four implants received polytetrafluoro-ethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes (ParaGuide), andfive implants received polyglactin 910 mesh (Vicryl). After l4 weeks, clinical measurements were takenand the dogs were sacrificed and all specimens retrieved for histologic and histomorphometric evaluation.The average gain in bone height was 2. 1mm for untreated control sites, 3. 3mm for Gore-Tex sites,3. 8mm for collagen sites, and 1. 3mm for polyglactin 910 sites. The greatest gain in bone height and volume was seen for two sites that received Gore-Tex membranes and remained covered for the entire evalua-tion interval. The results of this study indicate that Gore-Tex and collagen membrane preduced gdri re-sults for GTR around Implants immediately placed into extraction sockets. Since collagen membrane doesnot cause obvious infection and does not need the surgical reentry for membrane removal, it can be a validalternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin910 mesh seems not suitable to be used as GTR membrane in immediate implantation for its hIgh infectionrate.

Maxillo-mandibular rehabilitations with very early osteointegrated dental implants for severe hypodontia and anodontia related to ectodermal dysplasia

The ectodermal dysplasias are rare diseases with hypodontia, hypotrichosis and hypohidrosis. The subject's life is considerably constrained and this from an early age, with major difficulties for the integration and acceptance of conventional prosthetic occlusal rehabilitation. The use of implants is an integral part of early treatment, in the regions of stable growth, that is to say symphysis. In two childs of 5 and 6 years we have made implant-borne prosthetic rehabilitation in the maxilla and the mandible. Aesthetic and social evaluation were positive. We have restored the normal oro-facial functions for the correct development of skeletal bases. They acted as an external fixator intraoral, stimulating the growth by the function. Our question was: can we leave a child throughout his childhood and adolescence with a not suitable removable prosthesis, under the pretext of growth unfinished?

Survival of dental implants in patients with bone dysplasia:A systematic review

Objective:This study used published studies to assess the survival rate of dental implants placed in patients with bone dysplasia of the maxillofacial region.Material and methods:An electronic search without a specified date range was performed using the MEDLINE,PubMed,EMBASE,Web of Science,and Cochrane databases.No gender or age restrictions were applied.Results:Eighteen publications were found that met the study’s criteria,reporting data on 18 patients with bone dysplasia including cleidocranial dysplasia(CDD),fibrous dysplasia(FD),florid cemento-osseous dysplasia(FCOD),and odonto-maxillary segmental dysplasia(SOMD),who received a total of 130 implants,an average of 7.2 implants/patient(range 1 to 16).The mean age of the patients was 36.7 years(range 15 to 70 years).For implants placed in bone dysplasia,the survival rates were 100% for patients with CDD(n=8),FD(n=5),SOMD(n=2),FCOD with implants inserted far from the lesions(n=2)and 0% for dental implants inserted within FCOD(n=1).The mean follow-up was 38.2 months(min 6,max 60).Conclusions:Dental implants placed in patients with dysplastic bone lesions show high survival rates,similar to those in the general population for CDD,FD,and SOMD.For FCOD,the failure rate was 100%.

Development of Niobium Oxide Coatings on Sand-Blasted Titanium Alloy Dental Implants

The purpose of this study was to use scanning electron microscopy (SEM) evaluation to determine the optimal anodizetion conditions needed to generate niobium oxide coatings on titanium alloy dental implant screws. Sand-blasted titanium alloy dental implants were anodized in dilute hydrofluoric acid (HF(aq)) solution using a Sorensen DLM 300-2 power supply. The HF concentration and anodization time were varied and the resulting implant surfaces were evaluated using a Jeol JSM-5310LV Scanning Electron Microscope to determine the ideal anodization conditions. While HF is necessary to facilitate oxide growth, increasing concentrations resulted in proportionate increases in coating delamination. In a similar manner, a minimum anodization time of 1 hour was necessary for oxide growth but longer times produced more delamination especially at higher HF(aq) concentrations. SEM imaging showed that implants anodized for 1 hour in a 0.1% HF(aq) aqueous solution had the best results. Anodization can be used to generate niobium oxide coatings on sand-blasted Ti alloy dental implants by balancing the competing factors of oxide growth and coating delamination. It is believed that these oxide coatings have the potential to improve osseointegration relative to untreated dental implants when evaluated in an in vivo study.

Study of Tissue Engineered Dental Implants of human alveolar Bone-Evaluations on their osteogenic activities invitro

The development of the activated cellular bony implant, in light of the principle on tissue engineering, has brought about a new era to the fields of dental maxillofacial implantation. The present study separated the osteoblast like cells from human alveolar bone and seeded them into 3 types of biodegradable scaffold to form the complexes and then evaluated their osteogenic activities in vitro, in order to acquire experimental data that are essential to future clinical practice of this new type of therapeutical procedure in oral and maxillofacial surgery. Material and methods: Human alveolar bone origin cells were separated from alveolar bone around the third impacted teeth of 3 patients by enzyme digestion and went on cultures with α MEM containing β glycerophosphate and Dexamethasone at 5% CO2 ,37℃ for 21 28 days. Confirmed osteoblasts like cells were then seeded onto 3 types of degradable biomaterials of polyglycolic acid scaffold, collagen sponge, and L lactic acid/ε caprolactone to form cell matrices complexes. The 3 types of complex were continued to culture for 21 28 days in vitro at the same conditions with the single layer cultured cells. The cell proliferation, morphological changes, ALPase activity and mineral nodules formation on scaffolds were measured and observed at 3 days intervals to evaluate the affinities & the osteogenic activities of the human alveolar osteoblast like cells in the 3 different complexes. Result and discussion: The results indicated that the cultured human alveolar bone origin cells from 3 patients could successfully express the osteoblasts phenotype in single layered culturing in vitro after stimulated by β glycerophosphate and Dexamethasone. It has been shown that the cultured osteoblast like cells seeded on PGAS matrix had the highest attachmental, proliferative and osteogenic activities, suggesting a good bio affinity between the human alveolar osteoblast like cells and the PGAS matrix. The statistical analysis (ANOVA) showed that there were significant differences between PGAS osteoblasts complex and CLGS or LACT complexes on osteogenic activities. (P<0.05). It was also noticed that cultured human alveolar osteoblasts seeded in biodegradable materials had a delayed peak period on cell proliferation and PLAase production ,suggesting the osteoblasts seeded on scaffolds need a period of time to adjust themselves before they can normally proliferate and expres their phenotypes. Conclusion: PGAS osteoblasts complex is worth to be further developed into a tissue engineered cellular artificial bony implant for reconstructing the oral maxillofacial bony defects in a more effective way in the future.

Mechanical Experiment for 3D Printing of Titanium Bone Bionic Dental Implants

[Objectives] To explore the flexural strength of 3D printed titanium bone bionic dental implants and provide a scientific basis for the clinical application of 3D printed porous bionic bone dental implants. [Methods] The cone-beam CT( CBCT) image information of 20 premolars extracted by orthodontic requirement was collected,and a new porous bone bionic dental implant was produced using modeling software and 3D printer. The premolars were divided into two groups( A and B). The universal testing machine was used to test the flexural strength of the two groups and the difference in flexural strength between the two groups was compared through statistics. [Results]Twenty 3D printed porous titanium bone bionic implants were accurately produced; the morphology of group A and group B were extremely similar to each other; the average flexural strength of group A was 2 767. 92 N,while the average flexural strength of group B was 778. 77 N,showing that the average flexural strength of group A was significantly higher than that of group B,and the difference was statistically significant( P < 0. 05).[Conclusions]The personalized porous structure root implants produced by 3D printing technology are very similar to the target tooth morphology,and show high accuracy and small error of production. Besides,the flexural strength of 3D printed personalized porous structure root implants can fully meet the requirements of the maximum occlusal force for dental implant restoration. It is expected to provide a scientific basis for clinical application of 3 D printed porous bionic bone tooth implants.

Awareness of Patients toward Dental Implants as an Alternative Treatment to Replace Missing Teeth in Kinshasa, D. R. Congo

Background: Dental implant is an artificial root inserted in the jawbone, which restores a lost tooth so that it looks, feels, and is fit like a natural tooth. It is considered to be the best treatment option for single or multiple missing teeth. The aim of this study was to assess the awareness of patients about dental implants as an alternative treatment in Congolese patients. Materials and Methods: A cross-sectional study was conducted in two institutions namely, CBCO Bandal and Ngaliema Clinic, from August to December 2017. A total of 450 respondents have participated in the survey. A printed questionnaire comprised of 20 questions in order to evaluate patients dental awareness was used. Gender, level of education, awareness of dental implant and dental implants therapy, sources of information and the expectation about the sources of information were assessed. The collected data were entered in Microsoft Excel 2010 and analyzed by SPSS (IBM SPSS 20.0, Chicago, IL, USA) software. Results: Out of 450 participants, 14.4% were aware of dental implants. The main disadvantage of dental implant was the high cost. When asked about the anchorage, 86% didn’t know where the dental implant was anchored. Ninety-two percent didn’t know for how long an implant last, 6% thought that dental implant last for a lifetime. When patients were asked about the sources of information, the dentist (5%) and media (5.5%) were the main sources of information. The majority of patients (88.4%) would like to get information about dental implants from their dentist. Conclusion: Dentists should be more involved in the promotion of information about dental implants as a treatment modality to replace missing teeth.

Evaluation of titanium dental implants after early failure of osseointegration by means of X-ray photoelectron spectoscopy, electron microscopy and histological studies

In this work, we analysed 56 clinically failed and retrieved implants by means of scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and histological studies. The surface contamination was compared to that of unused control implants and with that of the same implants after cleaning in a basic medium. The surfaces of the unused implants presented considerable contamination. In particular, high levels of carbon were detected. The nature of this C was elucidated by XPS analysis of the lubricant used in the machining process. The same contamination was observed in the retrieved implants. Histological studies were carried out by means of light microscopy. Fibrosis and granulomatous lesions were detected in the tissues. XPS analysis indicated the presence of traces of other elements (Na, Ca, Zn, S, F, etc.) that were not related to impurities in cpTi. We examined a cleaning process in a basic medium that eliminates the organic components of the implant surfaces. The cleaned implants were implanted in the patients and the results were excellent. None of the implants failed in following 7 months.

Replacing Missing Teeth with Dental Implants in Pubescent Patients—A Case Report

Tooth loss due to traumatic dental injury or congenital absence can cause functional and social- psychological consequences in youth. Pubescent children with missing teeth are often targets for school bullying. The treatment modality chosen can impact their well-being during their formative years. Despite the high success rate in adult patients, implant placement in young patients is not common due to its ankylosed nature and concerns with possible infra-occlusion in the future. However, skeletal growth and remodeling is a continuous process throughout life and postponement of dental implant placement does not necessary prevent future complication or need for replacement. Dental implant placement should be considered as a viable treatment option for pubescent patients if all other conventional alternatives fail to alleviate patients’ concerns both functionally and psychologically. This case report evaluates the considerations required to place dental implants in pubescent patients, as well as its advantages and disadvantages.

Reactivity of Titanium Dental Implants in Salivary Environment in the Presence of Foods Consumed in the Republic of the Congo

In this work, samples of titanium dental implants in salivary environment in the presence of certain foods were studied. 24 samples were prepared and subjected to the reactivity of certain foods for 6, 5, 6 and 7 weeks. The ICP-MS technique was used to analyze the prepared samples. The results obtained showed no corrosion of the titanium alone in an artificial salivary medium. Significant corrosion was observed in the presence of food, which is manifested by the presence of traces of titanium in the samples.

A Comparative Analysis on the Curative Effects of Different Treatment for Infections Around Dental Implants

Objective:To analyze and evaluate the clinical efficacy of different treatment options for patients with peri-implant infection.Methods:The study period was from June 2019 to June 2020.Seventy-six patients with peri-implant infection that were treated in Stomatological Hospital of Hefei were selected as study samples.The patients were divided into a research group and a control group by random number table method in which the sample size of each group was n=38.Patients in the control group were treated with drugs combined with ultrasonic cleaning while patients in the research group were treated with guided bone regeneration combined with flap curettage.The indicators of the two groups were compared and analyzed.Results:The plaque index(PLI),probing depth(PD),and sulcus bleeding index(SBI)of the two groups after treatment were lower than those before treatment(P<0.05).There was no significant difference between the groups(P>0.05).However,the height of the implant marginal bone of the study group after treatment was higher than that of the control group(P<0.05)..Conclusion:The use of guided bone regeneration combined with flap curettage for patients with infection around dental implants promotes the fusion of bone and implants.The clinical effect was significant and this should be comprehensively promoted in medical institutions at all levels.

Surface modification strategies to reinforce the soft tissue seal at transmucosal region of dental implants

Soft tissue seal around the transmucosal region of dental implants is crucial for shielding oral bacterial invasion and guaranteeing the long-term functioning of implants.Compared with the robust periodontal tissue barrier around a natural tooth,the peri-implant mucosa presents a lower bonding efficiency to the transmucosal region of dental implants,due to physiological structural differences.As such,the weaker soft tissue seal around the transmucosal region can be easily broken by oral pathogens,which may stimulate serious inflammatory responses and lead to the development of peri-implant mucositis.Without timely treatment,the curable peri-implant mucositis would evolve into irreversible peri-implantitis,finally causing the failure of implantation.Herein,this review has summarized current surface modification strategies for the transmucosal region of dental implants with improved soft tissue bonding capacities(e.g.,improving surface wettability,fabricating micro/nano topographies,altering the surface chemical composition and constructing bioactive coatings).Furthermore,the surfaces with advanced soft tissue bonding abilities can be incorporated with antibacterial properties to prevent infections,and/or with immunomodulatory designs to facilitate the establishment of soft tissue seal.Finally,we proposed future research orientations for developing multifunctional surfaces,thus establishing a firm soft tissue seal at the transmucosal region and achieving the long-term predictability of dental implants.

Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction

Background Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors. Methods We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed. Results In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants respectively. The main reasons for failure of the dental proliferation. The fibula flap presents many advantages for implant-supported prosthetic rehabilitation difficult. placed into the fibula bone grafts were 95% and 87%, replants were infection, tumor recurrence and soft tissue implant placement, but its limited height sometimes makes Conclusions Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.

Eleven dental implants placed in a liver transplantation patient： a case report and 5-year clinical evaluation

Due to an increased risk of infection, dental implant in organ transplantation patients has long been considered questionable, particularly when the restoration is complicated. Five-year follow-up data of a 45-year-old liver transplant recipient with long-term immunosuppressive therapy was reported. One year after liver transplantation, 11 Br（a）nemark implants were inserted in the maxilla and mandible, using minimally invasive surgery. Oral clinical parameters included peri-implant bone absorption, probing depth, and implant mobility. The measured fifth-year parameters were within normal ranges indicating a stable osseointegration with moderate vertical bone loss. This case report suggests that immunocompromised patients can be successfully rehabilitated with dental implants through careful examination,suitable antibiotic administration, and minimally invasive dental implant procedure.

Antibacterial hydroxyapatite coatings on titanium dental implants

Titanium and its alloys are often used as substrates for dental implants due to their excellent mechanical properties and good biocompatibility.However,their ability to bind to neighboring bone is limited due to the lack of biological activity.At the same time,they show poor antibacterial ability which can easily cause bacterial infection and chronic inflammation,eventually resulting in implant failure.The preparation of composite hydroxyapatite coatings with antibacterial ability can effectively figure out these concerns.In this review,the research status and development trends of antibacterial hydroxyapatite coatings constructed on titanium and its alloys are analyzed and reviewed.This review may provide valuable reference for the preparation and application of high-performance and multi-functional dental implant coatings in the future.