Maluf, G., Caldas , RJ, Fregnani, ER et al. Kasus langka osteonekrosis rahang terkait bevacizumab terkait dengan implan gigi. Penyok Implan Int J 5, 34 (2019). https://doi.org/10.1186/s40729-019-0188-0
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Diterima: 01 Juli 2019
Diterima: 30 Agustus 2019
Diterbitkan: 01 Oktober 2019
DOI: https://doi.org/10.1186/s40729-019-0188-0
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Persyaratan Deklarasi Helsinki dipatuhi, dan pasien memberikan persetujuan untuk semua tindakan bedah prosedur.Informed consent tertulis diperoleh dari pasien untuk publikasi laporan ini dan semua gambar yang menyertainya.Gustavo Maluf, Rogério Jardim Caldas, Eduardo Rodrigues Fregnani, dan Paulo Sérgio da Silva Santos menyatakan bahwa mereka tidak memiliki kepentingan yang bersaing.
Klinik Swasta, Brasilia, DF, BrasilGustavo MalufBrasilia, BrasilGustavo MalufDepartment of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, BrazilRogério Jardim CaldasDepartemen Kedokteran Mulut, Rumah Sakit Sírio-Libanês, São Paulo, SP, BrasilEduardo Rodrigues FregnaniDepartment of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, BrazilP...
Otto S, Schreyer C, Hafner S, dkk. Osteonekrosis rahang terkait bifosfonat—karakteristik, faktor risiko, gambaran klinis, lokalisasi, dan dampak pada pengobatan onkologis. J Craniomaxillofac Surg. 2012;40:303–9 .Agrillo A, Filiaci F, Ramieri V, dkk. Osteonekrosis rahang terkait bifosfonat (BRONJ): Pengalaman 5 tahun dalam pengobatan 131 kasus dengan terapi ozon. Eur Rev Med Pharmacol Sci. 2012...
Pakosch D, Papadimas D, Munding J, dkk. Osteonekrosis mandibula karena agen anti-angiogenik, bevacizumab. Oral Maxillofac Surg. 2013;17:303–6.
Corbella S, Taschieri S, Samaranayake L, Tsesis I, dkk. Pilihan perawatan implan setelah pencabutan gigi yang retak vertikal. Sebuah proposal untuk klasifikasi klinis defek tulang berdasarkan tinjauan sistematis literatur. Clin Implan Oral Res. 2014;25:9...
Watters AL, Epstein JB, Agulnik M. Komplikasi oral dari terapi kanker yang ditargetkan: tinjauan literatur naratif. Oral Oncol. 2011;47:441–8.
Herbst RS, O'Neill VJ, Fehrenbacher L, et al. Studi fase II tentang kemanjuran dan keamanan bevacizumab dalam kombinasi dengan kemoterapi atau erlotinib dibandingkan dengan kemoterapi saja untuk pengobatan kanker paru-paru sel kecil yang berulang atau re...
Osteonekrosis rahang terkait Bevacizumab
Tulang meruncing
Tomografi komputer
Osteonekrosis rahang terkait pengobatan
Faktor pertumbuhan endotel vaskular A
Berbagi data tidak berlaku untuk artikel ini karena tidak ada kumpulan data yang dibuat atau dianalisis selama penelitian saat ini.
Temuan kasus ini menunjukkan bahwa pemasangan implan gigi merupakan faktor risiko osteonekrosis rahang pada pasien yang terpapar bevacizumab. Oleh karena itu, studi prospektif acak harus didorong untuk menentukan rejimen bevacizumab yang lebih aman yang mempertimbangkan baik operasi mulut dan risiko implan gigi untuk pengelolaan osteonekrosis dalam pengaturan klinis.
MRONJ adalah efek samping obat dengan predileksi pada mandibula [24] , yang dapat dikaitkan dengan vaskularisasi mandibula yang relatif rendah dibandingkan dengan rahang atas [13] Infeksi gigi, intervensi bedah, pengobatan kortikosteroid, dan kemoterapi telah digambarkan sebagai faktor risiko osteonekrosis [25]. pasien mengalami osteonekrosis stadium 2 dengan infeksi gigi di area mandibula, bahkan...
Pemberian agen antiangiogenik jangka panjang tidak secara langsung menunjukkan risiko tinggi MRONJ [16], meskipun beberapa penulis telah menetapkan interval 7-, 14-, dan 28 hari dari suspensi bevacizumab untuk bedah mulut [17,18,19] Dalam kasus ini, obat antiangiogenik dihentikan selama 28 hari sebelum penempatan implan; namun, ini tidak cukup untuk mencegah MRONJ. Permukaan implan Straumann® SLa...
Sebuah meta-analisis menunjukkan bahwa penempatan implan gigi pada pasien yang terpapar bifosfonat tidak mengurangi tingkat keberhasilan implan gigi [11], meskipun pasien ini mungkin mengalami komplikasi Berdasarkan analisis ini, penilaian risiko harus dilakukan berdasarkan kasus per kasus, karena MRONJ jarang terjadi tetapi salah satu di antara komplikasi serius terapi bifosfonat [11] Namun, stud...
Lima minggu pascaoperasi, nyeri, drainase sekret purulen, dan tulang terbuka di sekitar implan diamati (Gbr. 4), meskipun tidak ada implan yang menunjukkan mobilitas. Sepuluh sesi terapi ozon yang terkait dengan levofloxacin dilakukan. Setelah 4 minggu terapi dengan minyak ozon (Philozon®, Balneário Cambori, SC, Brasil), tidak ada rasa sakit atau drainase dari sekresi purulen. Namun, sekuestrasi...
Seorang wanita bule berusia 54 tahun mengeluhkan rasa tidak enak dan nyeri di mulut. Riwayat medisnya termasuk kanker payudara dengan metastasis, yang didiagnosis pada tahun 2007. Pasien tidak memiliki penyakit penyerta dan tidak ada riwayat merokok. Telah dilakukan mastektomi radikal dengan diseksi aksila. Pasien tidak memiliki riwayat radioterapi kepala sebelumnya. dan leher atau penggunaan bifo...
Pengobatan keganasan sering kali melibatkan penggunaan terapi bertarget untuk mengontrol pertumbuhan dan kelangsungan hidup keganasan sel dengan mengganggu agen molekuler spesifik yang terlibat dalam karsinogenesis [1]. Bevacizumab adalah antibodi monoklonal manusiawi rekombinan yang dirancang untuk secara selektif mengikat dan menghambat aktivitas biologis semua isoform faktor pertumbuhan endotel...
Fig. 7. Panoramic radiograph at 7-month follow-up
Fig. 6. Image obtained 7 months postoperatively showing no lesions
Fig. 5. a, b Histological image of the lesion
Fig. 4. Bone exposure surrounding the implants with drainage of purulent secretion
Fig. 3. Panoramic radiograph after dental extractions with subsequent dental implants
Fig. 2. a, b Tomographic findings: lesions, measurements, and bone quality
Fig. 1. Initial clinical image showing oral infection foci
Maluf, G., Caldas, R.J., Fregnani, E.R. et al. A rare case of bevacizumab-related osteonecrosis of the jaw associated with dental implants.
Int J Implant Dent 5, 34 (2019). https://doi.org/10.1186/s40729-019-0188-0
Download citation
Received: 01 July 2019
Accepted: 30 August 2019
Published: 01 October 2019
DOI: https://doi.org/10.1186/s40729-019-0188-0
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The requirements of the Helsinki Declaration were observed, and the patient gave informed consent for all surgical procedures.
Written informed consent was obtained from the patient for the publication of this report and all accompanying images.
Gustavo Maluf, Rogério Jardim Caldas, Eduardo Rodrigues Fregnani, and Paulo Sérgio da Silva Santos declare that they have no competing interests.
Private Clinic, Brasília, DF, Brazil
Gustavo Maluf
Brasília, Brasil
Gustavo Maluf
Department of Stomatology, Bauru Dental School, USP–University of São Paulo, Bauru, SP, Brazil
Rogério Jardim Caldas
Department of Oral Medicine, Hospital Sírio-Libanês, São Paulo, SP, Brazil
Eduardo Rodrigues Fregnani
Department of Stomatology, Bauru Dental School, USP–University of São Paulo, Ba...
Otto S, Schreyer C, Hafner S, et al. Bisphosphonate-related osteonecrosis of the jaws—characteristics, risk factors, clinical features, localization and impact on oncological treatment. J Craniomaxillofac Surg. 2012;40:303–9.
Agrillo A, Filiaci F, Ramieri V, et al. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): 5 year experience in the treatment of 131 cases with ozone therapy. Eur ...
Pakosch D, Papadimas D, Munding J, et al. Osteonecrosis of the mandible due to anti-angiogenic agent, bevacizumab. Oral Maxillofac Surg. 2013;17:303–6.
Corbella S, Taschieri S, Samaranayake L, Tsesis I, et al. Implant treatment choice after extraction of a vertically fractured tooth. A proposal for a clinical classification of bony defects based on a systematic review of literature. Clin Oral I...
Watters AL, Epstein JB, Agulnik M. Oral complications of targeted cancer therapies: a narrative literature review. Oral Oncol. 2011;47:441–8.
Herbst RS, O’Neill VJ, Fehrenbacher L, et al. Phase II study of efficacy and safety of bevacizumab in combination with chemotherapy or erlotinib compared with chemotherapy alone for treatment of recurrent or refractory none small-cell lung cancer. J Cli...
Bevacizumab-related osteonecrosis of the jaw
Bone level tapered
Computed tomography
Medication-related osteonecrosis of the jaw
Vascular endothelial growth factor A
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
The findings of the present case indicate that insertion of dental implants is a risk factor for osteonecrosis of the jaw in patients exposed to bevacizumab. Therefore, prospective randomized studies should be encouraged to determine a safer bevacizumab regimen that considers both oral surgeries and the risk of dental implants for the management of osteonecrosis in clinical settings.
MRONJ is a side effect of drugs with a predilection for the mandible [24], which can be attributed to the relatively low vascularization of the mandible as compared to the maxilla [13]. Dental infections, surgical interventions, corticosteroid treatment, and chemotherapy have been described as risk factors for osteonecrosis [25]. In this case, the patient presented with stage 2 osteonecrosis with ...
Long-term administration of antiangiogenic agents does not directly indicate a high risk of MRONJ [16], though some authors have established 7-, 14-, and 28-day intervals of bevacizumab suspension for oral surgery [17,18,19]. In this case, the antiangiogenic medication was suspended for 28 days before implant placement; however, this was not enough to prevent MRONJ. The surfaces of Straumann® S...
A meta-analysis showed that the placement of dental implants in patients exposed to bisphosphonates did not reduce the success rate of the dental implant [11], although these patients may experience complications. Based on this analysis, a risk assessment should be performed on a case-by-case basis, since MRONJ is rare but one among serious complication of bisphosphonate therapy [11]. However, a c...
Five weeks postoperatively, pain, drainage of purulent secretion, and bone exposure around the implants were observed (Fig. 4), although none of the implants showed mobility. Ten ozone therapy sessions associated with levofloxacin were performed. After 4 weeks of therapy with ozone oil (Philozon®, Balneário Camboriú, SC, Brazil), no pain or drainage of purulent secretion were present. Bone s...
A 54-year-old Caucasian woman complained of an unpleasant taste and pain in the mouth. Her medical history included breast cancer with metastasis, which was diagnosed in 2007. The patient had no comorbidities and no history of smoking. A radical mastectomy with axillary dissection was performed. The patient had no previous history of radiotherapy of the head and neck or use of bisphosphonates. The...
The treatment of malignancies often involves the use of targeted therapies to control the growth and survival of malignant cells by interfering with specific molecular agents involved in carcinogenesis [1]. Bevacizumab is a recombinant humanized monoclonal antibody designed to selectively bind and inhibit the biological activity of all human vascular endothelial growth factor (VEGF-A) isoforms. It...
Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification
...
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...
Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...
Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...
Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification
Fig. 3. Photomicrographs of decalcified sect...
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow)
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...
Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures
Fig. 1. Clinical view of the surgical procedures....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....
Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits.
Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2
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Received: 20 October 2019
Accepted: 21 January 2020
Published: 04 March 2020
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496.
Not applicable.
Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...
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GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...
Private practice, London, UK
Giacomo Favero
Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain
Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago
Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...
Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.
Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40.
Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...
Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32.
Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...
Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186.
...
Animal Research Reporting In Vivo Experiments
Cone beam computed tomography
Deproteinized bovine bone mineral
Tricalcium phosphate
The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...
In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...
The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...
After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively).
After 1 week of healing (Table...
Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively.
After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...
Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0).
The histo...
Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...
Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...
Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.
Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...
To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation.
Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...
Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification
...
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...
Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...
Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...
Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification
Fig. 3. Photomicrographs of decalcified sect...
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow)
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...
Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures
Fig. 1. Clinical view of the surgical procedures....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....
Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits.
Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2
Download citation
Received: 20 October 2019
Accepted: 21 January 2020
Published: 04 March 2020
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496.
Not applicable.
Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...
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GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...
Private practice, London, UK
Giacomo Favero
Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain
Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago
Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...
Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.
Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40.
Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...
Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32.
Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...
Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186.
...
Animal Research Reporting In Vivo Experiments
Cone beam computed tomography
Deproteinized bovine bone mineral
Tricalcium phosphate
The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...
In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...
The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...
After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively).
After 1 week of healing (Table...
Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively.
After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...
Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0).
The histo...
Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...
Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...
Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.
Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...
To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation.
Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...
Figure 6.
Figure 6. Cultivation and osteogenic differentiation of DFCs on PA after modification with collagen I. (Left) Relative cell number and (Right) normalized ALP activity.
Figure 5. resentative results are shown for dNC-PCs.
Figure 5. Evaluation of osteogenic differentiation. (A) Clustergram of PCR-array results; (B-C) histology of differentiated dental cells on AP (B) and SB (C). Representative results are shown for dNC-PCs.
Figure 4. dishes for control.
Figure 4. Osteogenic differentiation of dental stem cells. Normalized ALP activity of dNC-PCs and DFCs on AP and SB (A) and on silicone (B). Cells were differentiated on standard cell culture dishes for control.
Figure 3. (black number), apoptotic cells (blue number), and dead cells (red number). (B) Western blot analyses show the expression of the pro-apoptotic marker BAX and the anti-apoptotic marker BCL2.
Figure 3. Evaluation of programmed cell death (apoptosis) in dental stem cells. (A) Flow cytometry analyses (for details materials and methods) show percentage of vital cells (black number), apop...
Figure 2. spheroid cell clusters on silicone (representative pictures for DFCs); Silicone (24 and 48 h).
Figure 2. C ell proliferation of dNC-PCs and DFCs on tested materials. (A) and (B) Relative cell numbers; (C) spheroid cell clusters on silicone (representative pictures for DFCs); Silicone (24 and 48 h).
Figure 1. ative pictures of DFCs.
Figure 1. Cell attachment on tested materials. (A) Relative cell adherence of DFCs and dNC-PCs; (B) dental cells did little adhere on PA; representative pictures of DFCs.
Gosau, M., Viale-Bouroncle, S., Eickhoff, H. et al. Evaluation of implant-materials as cell carriers for dental stem cells under in vitro conditions.
Int J Implant Dent 1, 2 (2015). https://doi.org/10.1186/s40729-014-0002-y
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Received: 17 September 2014
Accepted: 20 November 2014
Published: 12 February 2015
DOI: https://doi.org/10.1186/s40729-014-0002-y
DFCs and dNC-PCs expressed typical markers for dental stem cells.
Martin Gosau, Sandra Viale-Bouroncle, Hannah Eickhoff, Esthera Prateeptongkum, Anja Reck, W Götz, Christoph Klingelhöffer, Steffen Müller and Christian Morsczeck declare that they have no competing interests.
SVB, HE, and EP carried out all cell biology experiments, performed real-time PCRs, Western blots, and the statistical analysis and made figures for the manuscript. AR carried out and ana...
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Correspondence to
Christian Morsczeck.
Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
Martin Gosau, Sandra Viale-Bouroncle, Hannah Eickhoff, Esthera Prateeptongkum, Anja Reck, Christoph Klingelhöffer, Steffen Müller & Christian Morsczeck
Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Nuernberg, B...
This study was supported by a grant from the Deutschen Gesellschaft für Implantologie (DGI) e.V.
Marino G, Rosso F, Cafiero G, Tortora C, Moraci M, Barbarisi M, Barbarisi A. Beta-tricalcium phosphate 3D scaffold promote alone osteogenic differentiation of human adipose stem cells: in vitro study. J Mater Sci Mater Med. 2010; 21:353–63.
Arnold U, Lindenhayn K, Perka C. In vitro-cultivation of human periosteum derived cells in bioresorbable polymer-TCP-composites. Biomaterials. 2002; 23:2303...
Felthaus O, Gosau M, Morsczeck C. ZBTB16 induces osteogenic differentiation marker genes in dental follicle cells independent from RUNX2.
J Periodontol. 2014; 85:e144–51.
Viale-Bouroncle S, Gosau M, Küpper K, Möhl C, Brockhoff G, Reichert TE, Schmalz G, Ettl T, Morsczeck C. Rigid matrix supports osteogenic differentiation of stem cells from human exfoliated deciduous teeth (SHED).
Differ Re...
Kagami H, Agata H, Tojo A. Bone marrow stromal cells (bone marrow-derived multipotent mesenchymal stromal cells) for bone tissue engineering: basic science to clinical translation.
Int J Biochem Cell Biol. 2011; 43:286–89.
Robey PG. Cell sources for bone regeneration: the good, the bad, and the ugly (but promising).
Tissue Eng Part B Rev. 2011; 17:423–30.
Morsczeck C, Shi S, Huang G. Stem/...
In conclusion, our work supports our hypothesis that soft implant materials are not suitable for dental tissue engineering. Moreover, our study also supports the results of our previous studies with DFCs and TCP that induction of apoptosis did not impair the proliferation and the differentiation in dental stem cells.
In a previous study, we showed that TCP induced the programmed cell death (apoptosis) in DFCs [11]. Our new study investigated therefore the induction of apoptosis in dental cells. While SB and soft materials did not induce apoptosis or cell death, AP induced obviously cell death and apoptosis in dental cells. Here, the results for dNC-PCs and DFCs were almost the same. Interestingly, neither sili...
Scaffolds play an important role in tissue engineering. However, little is known about the proliferation and differentiation of DFCs and dNC-PCs on different types of materials. As we have learned from previous studies mechanical properties such as surface stiffness are decisive for a successful osteogenic differentiation of dental stem cells [13,14]. Moreover, we showed that bone substitute mater...
The soft material PA was also treated with the extracellular matrix protein collagen to improve cell adherence. We tested representatively DFCs with collagen I modified PA. DFCs adhered and proliferated on modified PA, but, however, the specific ALP activity was reduced in comparison to that of DFCs on standard cell culture dishes (Figure 6). This reduction of the specific ALP activity was simila...
Dental cells were cultivated in standard cell culture media until passage 6. Cell adherence and cell proliferation/growth were measured for the estimation of cell viability on tested rigid and soft materials. In Figure 1, the cell adherence of dNC-PCs on bone substitute materials was better than that of DFCs. However, both dental cells types adhered very well on silicone. Unluckily, dental cells ...
DFCs were cultivated until sub-confluence (>80%) in standard cell culture medium before the differentiation starts with the osteogenic differentiation medium (ODM) comprised DMEM (PAA) supplemented with 10% fetal bovine serum (Sigma-Aldrich), 100 μmol/L ascorbic acid 2-phosphate, 10 mmol/L KH2PO4, 1 × 10−8 mol/L dexamethasone sodium phosphate (Sigma-Aldrich, St. Louis, MO, USA), HEPES (20 ...
Numbers of vital cells were evaluated after days 1, 2, 3, and 6. For cell counting, cell cultures were incubated with the cell counting kit 8 (CCK8) ready to use solution according to manufactures instructions (Dojindo, Rockville, MD, USA). The optical density (O.D.) was measured at a wavelength of 450 nm. For the evaluation of the cell adherence (normalized to standard cell culture dishes), cell...
The bone substitutes Maxgraft® (AP) and Maxresorb® (SB) were obtained from the company Botiss (botiss dental GmbH, Berlin, Germany). Maxgraft® is a sterile, high-safety allograft product (AP), derived from human donor bone. It is processed by an audited and certified bone bank (Cells+ Tissue Bank Austria, Berlin, Germany). In contrast, Maxresorb® is a fully synthetic bone graft substitute (SB)...
The isolation and characterization of DFCs and dNC-PCs were described in previous studies [4,7,12]. DFCs were routinely cultivated in DMEM (Sigma-Aldrich, St. Louis, MO, USA) supplemented with 10% fetal bovine serum (Sigma-Aldrich, St. Louis, MO, USA) and 100 μg/ml penicillin/streptomycin (standard cell culture medium). dNC-PCs were cultivated in DMEM (Sigma-Aldrich) supplemented with 15% fetal ...
Unfortunately, an additional study showed that TCP induced apoptosis in DFCs [11]. However, the induction of apoptosis exposed a risk for cellular therapies. We decided therefore to evaluate additional implant materials for the identification of a suitable scaffold for dental stem cells. Soft materials such as silicone are successfully used in regenerative medicine, and they are suitable for tissu...
While bone substitute materials are routinely used, especially vertical bone, augmentation of the jaws is still a problematic step. Dental stem cells in combination with bone substitute materials may accelerate the augmentation of alveolar bone and perhaps, stem cell-based therapies can become an alternative to autologous, allogenic, or synthetic bone transplants and substitutes [1,2]. However, sc...
Dental stem cells in combination with implant materials may become an alternative to autologous bone transplants. For tissue engineering different types of soft and rigid implant materials are available, but little is known about the viability and the osteogenic differentiation of dental stem cells on these different types of materials. According to previous studies we proposed that rigid bone sub...
Figure 2. poietic stem cells; MP, macrophages; OC, osteoclasts.
Figure 2. Summary of biological processes identified via gene expression during early peri-implant bone healing. CKs, cytokines; GFs, growth factors; EPC, endothelial progenitor cells; EC, endothelial cells; MSC, mesenchymal stem cells; OB, osteoblasts; ECM, extracellular matrix; HSC, haematopoietic stem cells; MP, macrophages; O...
Figure 1. Flowchart for study selection (
Figure 1. Flowchart for study selection ( n = number of studies).
Process
Upregulated genes
Category (gene code)
Inflammation/immune response
Pro-inflammatory cytokines
Tumor necrosis factor (TNF-a, TNFSF9)
Interleukin (IL-6, IL-2, IL-1 F9, IL-23A, ...
Study
Ivanovski et al. [
34
]
Donos et al. [
35
]
Bryington et al. [
36
]
Thalji et al. [
37
]
Design
9 patients; 9 implants placed
18 patients; 18 implants placed
10 patients;...
Category
Ivanovski et al. [ 34 ]
Donos et al. 2011 [ 35 ]
Bryington et al. [ 36 ]
Thalji et al. [ 37 ]
Study design
Comparison
None (only SLActive)
SLA vs. SLActive
TiOBlast vs. Osseospeed
TiOBlast vs. Osseospeed
Setting
University
University
University
University
Population, inclusion criteria
9 healthy volunteers with no mandibular thi...
Methodology
Ivanovski et al. [
34
]
Donos et al. [
35
]
Bryington et al. [
36
]
Thalji et al. [
37
]
Tissue harvesting
Tissue attached to implant carefully removed with a curette, preexisting hard tissue discarded
Tissue attached to ...
Shanbhag, S., Shanbhag, V. & Stavropoulos, A. Genomic analyses of early peri-implant bone healing in humans: a systematic review. Int J Implant Dent 1, 5 (2015). https://doi.org/10.1186/s40729-015-0006-2
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Received: 14 November 2014
Accepted: 27 January 2015
Published: 01 March 2015
DOI: https://doi.org/10.1186/s40729-015-0006-2
The authors declare that they have no competing interests.
SS conceived and carried out the study and drafted the manuscript. VS and AS participated in carrying out the study and drafting the manuscript. All authors read and approved the final manuscript.
Department of Periodontology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 214 21, Malmö, Sweden
Siddharth Shanbhag & Andreas Stavropoulos
Centre for Oral Rehabilitation & Implant Dentistry, 1 Laxmi Niwas, 87 Bajaj Road, Vile Parle West, Mumbai, 400056, India
Siddharth Shanbhag & Vivek Shanbhag
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Donos N, Retzepi M, Wall I, Hamlet S, Ivanovski S. In vivo gene expression profile of guided bone regeneration associated with a microrough titanium surface. Clin Oral Implants Res. 2011;22(4):390–8. doi:10.1111/j.1600-0501.2010.02105.x.
Skaper SD. The neurotrophin family of neurotrophic factors: an overview. Methods Mol Biol. 2012;846:1–12. doi:10.1007/978-1-61779-536-7_1.
Vaillant AR, Mazz...
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Ziebart T, Schnell A, Walter C, Kämmerer PW, Pabst A, Lehmann KM, et al. Interactions between endothelial progenitor cells (EPC) and titanium implant surfaces. Clin Oral Investig. 2013;17(1):301–...
Rocci M, Rocci A, Martignoni M, Albrektsson T, Barlattani A, Gargari M. Comparing the TiOblast and Osseospeed surfaces. Histomorphometric and histological analysis in humans. Oral Implantol (Rome). 2008;1(1):34–42.
Qin C, Baba O, Butler WT. Post-translational modifications of sibling proteins and their roles in osteogenesis and dentinogenesis. Crit Rev Oral Biol Med. 2004;15(3):126–36.
Vlaci...
Chehroudi B, Ghrebi S, Murakami H, Waterfield JD, Owen G, Brunette DM. Bone formation on rough, but not polished, subcutaneously implanted Ti surfaces is preceded by macrophage accumulation. J Biomed Mater Res A. 2010;93(2):724–37. doi:10.1002/jbm.a.32587.
Heng BC, Cao T, Stanton LW, Robson P, Olsen B. Strategies for directing the differentiation of stem cells into the osteogenic lineage in vit...
Nishimura I. Genetic networks in osseointegration. J Dent Res. 2013;92(12 Suppl):109S–18. doi:10.1177/0022034513504928.
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Lin Z, Rios HF, Volk SL, Sugai JV, Jin Q, Giannobile WV. Gene expression dynamics during bone healing and osseointegration. J Periodontol. 2011;82(7):1007–17. doi:10.1902/jop.2010.100577.
Ai-Aql ZS, Alagl AS, Graves DT, Gerstenfeld LC, Einhorn TA. Molecular mechanisms controlling bone formation during fracture healing and distraction osteogenesis. J Dent Res. 2008;87(2):107–18.
Albrektsson T...
Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93(1):19–26. doi:10.1177/0022034513504782.
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155–70.
Berglundh T, Abrahamsson ...
Based on limited evidence of gene expression data from four studies involving 43 patients, the following remarks can be made:
Early peri-implant healing (2 weeks) involves a sequence of biological events which are similar to those observed in other bone wound healing scenarios (fractures, extraction-sockets).
Osseointegration depends on osteogenesis at the implant interface, but other simultane...
It can be hypothesized that peri-implant neurogenesis is one of the underlying mechanisms governing the phenomenon of osseoperception, defined as the tactile sensibility of osseointegrated implants to occlusal forces induced via activation of nerve endings and/or receptors in the peri-implant environment [82,83]. Moreover, recent evidence suggests that implant surface properties may influence the ...
In the present review, a significant simultaneous upregulation of several angiogenesis-related genes was identified at day 7 in all included studies. Pro-angiogenic factors (ANXA2, EPAS-1) were upregulated at TiOBlast and Osseospeed surfaces at day 7 [37]. Genes associated with VEGF and P13K-AKT signaling pathways were upregulated at SLActive (but not SLA) surfaces on day 7 and continued to be upr...
Furthermore, genes associated with collagen fibril formation/organization (heat-shock protein-47 (HSP-47), pro-collagen C-endopeptidase enhancer (PCOLCE), small leucine-rich proteoglycans (SLRP)) and post-translational modification (pro-collagen lysyl-hydroxylases (PLOD1, PLOD2, PLOD3) and lysyl-oxidase (LOX)) were upregulated on Osseospeed and TiOBlast surfaces [37]. Collagen comprises approximat...
The key signaling pathways, via which GFs guide osteogenic cell differentiation, are the TGF-β/BMP- and Wnt-mediated pathways [19,47]. While the BMP pathway ensures differentiation of MSCs into osteo-chondro-progenitors (OCPs), the Wnt pathway is essential for subsequent osteoblastic commitment, i.e., Wnt acts ‘downstream’ of BMP to ensure that OCPs differentiate into osteoblasts and not chon...
Cells along the osteogenic differentiation pathway may be artificially categorized as (1) undifferentiated MSCs, (2) osteo-chondro-progenitor cells, (3) pre-osteoblasts, and (4) osteoblasts; although in reality, a developmental continuum without distinct boundaries may exist [43]. While pre-differentiated osteoblasts in the marrow compartment only play a minor role in bone wound healing, a more pr...
Thus, high risk of bias should be considered when interpreting the results, due to the above methodological limitations and the overall limited information (four studies) available.
Conventional implant surgery involves osteotomy preparation and insertion of the implant into the alveolar bone. The immediate local effects of this procedure, functionally relevant to subsequent healing processes, ar...
The included studies basically report on commercially available implants from two major manufacturers and involve comparisons of different implant surface technologies in regard with topography and/or chemistry modifications within each implant system. Various analyses were performed in the included studies; however, an attempt has been made to synthesize the various findings and discuss them here...
Both reviewers independently extracted data from the full texts of included articles using specially designed forms. Data on author(s), study design, implant type/surface, any additional procedures performed, number of patients (in each group), presence of a control group, procedure and time of implant retrieval, methods of gene expression analysis, and main results, were extracted. Descriptive su...
A study protocol for a systematic qualitative literature review was developed based on recommended methods [29]. The focused question was ‘what biological processes are reflected by gene expression analyses in peri-implant tissues of humans during the early stages (up to 4 weeks) of healing?’
All studies, controlled (using different implants) or uncontrolled, reporting gene expression analys...
Recent in vitro [24] and preclinical in vivo [25] studies have focused on the early molecular biological responses to various titanium implant surfaces. Understanding these early responses is essential for efforts aiming to accelerate and enhance the process of osseointegration [26]. Upregulation or downregulation of specific genes in peri-implant tissues identified by analyses of genetic material...
Osseointegrated oral implants are an integral part of modern reconstructive dentistry and are associated with favorable long-term therapeutic outcomes [1]. Osseointegration was originally defined as the direct contact between vital bone and a load-bearing implant observed at the light microscopic, i.e., histological, level [2]. Morphogenesis of implant osseointegration has been assessed in several...
The objective of the study was to systematically review the literature for studies reporting gene expression analyses (GEA) of the biological processes involved in early human peri-implant bone healing.
Electronic databases (MEDLINE, EMBASE) were searched in duplicate. Controlled and uncontrolled studies reporting GEA of human peri-implant tissues - including ≥5 patients and ≥2 time points - ...
Fig. 4. Comparative illustration of mean ISQ values
Fig. 4. Comparative illustration of mean ISQ values
Fig. 3. Implants were placed after application of CGF membrane
Fig. 3. Implants were placed after application of CGF membrane
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 1. CGF was obtained after centrifugation
Fig. 1. CGF was obtained after centrifugation
Control group
Study group
Immediate–1st week
−2.25 ± 1.713
1.40 ± 1.847
Immediate–4th week
−2.30 ± 2.774
0.60 ± 2.798
1st Week–4th week
−0.05 ± 1.572
−0.80 ± 2.215
Table 3 Mean ISQ value changes between study and control groups
Control group
Study group
Immediate
75.75 ± 5.552
78.00 ± 2.828
1st week
73.50 ± 5.226
79.40 ± 2.604
4th week
73.45 ± 5.680
78.60 ± 3.136
Table 2 Mean ISQ values in the study and control groups
Case no.
Age
Sex
Group
Implant number
1
20
F
Study
1
2
28
M
Control
3
3
35
F
Study
4
4
32
F
Study
4
5
60
M
Control
5
6
64
F
Study
5
7
52
F
Study
5
8
34
M
Study
1
9
45
F
Control
3
10
48
F
Control
2
11
42
M
Control
3
12
68
F
Control
4
Table 1 Demographic data of patien...
Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration. Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3
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Received: 16 December 2016
Accepted: 16 February 2017
Published: 03 March 2017
DOI: https://doi.org/10.1186/s40729-017-0069-3
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey
Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban
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Anitua E. Plasma rich in growth factors: preliminary results o...
Bone morphogenetic protein
Concentrated growth factor
Computed tomography
Insulin-like growth factor
Platelet-derived growth factor
Platelet-rich fibrin
Platelet-rich plasma
Resonance frequency analysis
Transforming growth factor-β1
Transforming growth factor-β2
Vascular endothelial growth factor
Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.
In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...
Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32].
In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...
Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ
The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...
Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque.
A value of p
All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...
That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17].
It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...
Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...
Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration.
Twelve patients with maxillary anterior toothless were included in the study. Implant ca...
Fig. 7 Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 6 Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
ple. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
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Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
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Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
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Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gi...
Patient
Gender (m/f)
Age (years)
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...
Lorenz, J., Lerner, H., Sader, R.A. et al. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system.
Int J Implant Dent 3, 41 (2017). https://doi.org/10.1186/s40729-017-0104-4
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the Medical Center of the Goethe University Frankfurt. The procedures to be performed were explained in detail, and the patients signed the consent form.
Jonas Lorenz, Henriette Lerner, Robert Sader, an...
Department for Oral, FORM-Lab, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Robert A. Sader & Shahram Ghanaati
HL-Dentclinic, Baden-Baden, Germany
Henriette Lerner
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Lerner H, Lorenz J, Sader R, Ghanaati S. Two-year retrospective study of periimplant health and periimplant bone stability after immediate implant placement of a newly developed bone level implant system—a first report. EDI Journal (European Association of Dental Implantologists, Teamwork Media); 2017; ahead of print.
Ghanaati S, Lorenz J, Obreja K, Choukroun J, Landes C, Sader R. Nanocrystalli...
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res. 2016; doi: 10.1111/clr.12944
Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res. 2012;14(6):792–807.
Berglundh T, Lindhe J, Ericsson I, Marinello C, Liljenberg B, Thomsen P....
β-tricalcium phosphate
Bleeding on probing
Fixed prosthetics
Guided bone regeneration
Hydroxyapatite
Multinucleated giant cells
Pink Esthetic Score
Removable prosthetics
In the present study, the implant and peri-implant hard- and soft-tissue stability was analyzed in a bone level implant system placed simultaneously with a GBR procedure 3 years after prosthetic loading. Peri-implant hard- and soft-tissue parameters such as width and thickness of peri-implant keratinized gingiva, probing depth, BOP, PES, peri-implant bone loss, and the presence of peri-implant os...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the investigat...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-implant tis...
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24 implants) of 20 p...
Investigation of the esthetic appearance via PES revealed a mean point score of 10.1 (ranging from 7 to 13) from a maximum of 14. The highest values and therefore acceptance were found in the alveolar process deficiency and the soft-tissue level, which can be interpreted as a benefit of the augmentation procedure around the implant shoulder.
Peri-implant bone loss calculated using the average bon...
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3.5 mm (32 ...
Investigation parameters:
Implant being in situ
Width and thickness of peri-implant keratinized gingiva
Pink Esthetic Score (PES)
Probing depth
BOP
Peri-implant bone loss
Presence of peri-implant osteolysis
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implant system is manufacture...
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commission of the medical department of ...
The aim of the present retrospective investigation was to assess clinically and radiologically peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure after at least 3 years of loading.
The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage desig...
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of peri-implantitis [...
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. The aim of the present retrospective analysis was to assess peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure.
A total of 47 implants, which were placed ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
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Keratin 13
DAKO
DE-K13
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Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
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Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Fig. 4. Comparative illustration of mean ISQ values
Fig. 4. Comparative illustration of mean ISQ values
Fig. 3. Implants were placed after application of CGF membrane
Fig. 3. Implants were placed after application of CGF membrane
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 1. CGF was obtained after centrifugation
Fig. 1. CGF was obtained after centrifugation
Control group
Study group
Immediate–1st week
−2.25 ± 1.713
1.40 ± 1.847
Immediate–4th wee...
Control group
Study group
Immediate
75.75 ± 5.552
78.00 ± 2.828
1st week
...
Case no.
Age
Sex
Group
Implant number
1
20
...
Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration.
Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3
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Received: 16 December 2016
Accepted: 16 February 2017
Published: 03 March 2017
DOI: https://doi.org/10.1186/s40729-017-0069-3
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey
Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban
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Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011;10(1):45–9.
Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7.
Ademokun JA, Chapman C, Dunn J, Lander D, Mair K, Proctor SJ, et al...
Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 2007;18(3):275–80.
Kroese-Deutman HC, Vehof JW, Spauwen PH, Stoelinga PJ, Jansen JA. Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defe...
Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008;13:3532–48.
Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70.
He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and ...
Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2005;20(3):425–31.
Oncu E, Bayram B, Kantarci A, Gulsever S, Alaaddinoglu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal. 2016;21(5):e601–7.
Anitua E. Plasma rich in growth factors: preliminary results o...
Bone morphogenetic protein
Concentrated growth factor
Computed tomography
Insulin-like growth factor
Platelet-derived growth factor
Platelet-rich fibrin
Platelet-rich plasma
Resonance frequency analysis
Transforming growth factor-β1
Transforming growth factor-β2
Vascular endothelial growth factor
Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.
In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...
Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32].
In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...
Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ
The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...
Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque.
A value of p
All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...
That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17].
It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...
Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...
Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration.
Twelve patients with maxillary anterior toothless were included in the study. Implant ca...
Fig. 8. Soft tissue dehiscence (a) CCXBB exposure 15 weeks after bone augmentation, the dehiscence healed 2 weeks later after reducing the graft exposure (b) after soft tissue augmentation and abutment connection leading to the loss of the mesial implant. After partial removal of the bone graft and place a connective tissue graft the area healed properly and a month later it was possible to re...
Fig. 7. Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 7. Second stage sur...
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view aized bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
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TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
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Mean
Standard deviation
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CI 95%
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...
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Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
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Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
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Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
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Staining
Keratin 13
DAKO
DE-K13
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Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
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Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Maiorana, C., Pivetti, L., Signorino, F. et al. The efficacy of a porcine collagen matrix in keratinized tissue augmentation: a 5-year follow-up study.
Int J Implant Dent 4, 1 (2018). https://doi.org/10.1186/s40729-017-0113-3
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Received: 06 September 2017
Accepted: 20 December 2017
Published: 10 January 2018
DOI: https://doi.org/10.1186/s40729-017-0113-3
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the IRCCS Ospedale Maggiore Policlinico di Milano, Fondazione Ca’ Granda. The procedures to be performed were explained in detail, and the patients signed the consent form.
Carlo Maiorana, Luca Pivett...
Correspondence to
F. Signorino.
Oral Surgery, Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda—Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
C. Maiorana
Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda—Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122,...
The authors declare no funds for the research.
Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft®) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Impl Res. 2016;27:e125–33.
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Harris RJ. Gingival augmentation with an acellular dermal matrix: human histologic evaluation of a case—placement of the graft on periosteum. Int J Periodontics Restorative Dent. 2004;24(4):378–85.
Wei PC, Laurell L, Geivelis M, Lingen MW, Maddalozzo D. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 1. A clinical study. J Periodontol. 2000;71(8):1297–305.
Ha...
Vignoletti F, Nuñez J, Discepoli N, De Sanctis F, Caffesse R, Muñoz F, et al. Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class-I recession defects: an experimental study in the minipig. J Clin Periodontol. 2011;38(9):847–55.
Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, et al. ...
Forman G. Presenile mandibular atrophy: its aetiology, clinical evaluation and treatment by jaw augmentation. Br J Oral Surg. 1976;14(1):47–56.
Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):237–59.
Grusovin MG, Coulthard P, Worthington HV, Esposito M. Maintaining and recovering soft tissue health around...
With the limits of this study, it can be assessed that the CM is an effective option for the keratinized tissue augmentation. The percentage of shrinkage of the graft is comparable to data recovered from other studies and does not represent a problem also after 5 years. The CM integration is slow and constant, providing the necessary scaffold to regenerate keratinized mucosa and ensuring a perfec...
The study was carried out to evaluate the efficacy of a xenogeneic CM when used as a soft tissue substitute in the reconstruction of an adequate amount (at least 2 mm) of keratinized tissue around dental implants. The xenogeneic CMs have already been investigated in order to check their compatibility and effectiveness as scaffold [19, 20]. One of the first studies was conducted by Schoo and Coppe...
A total of 15 patients were enrolled for the study, 12 females and 3 males, aged between 43 and 72 years old. Of these patients, 11 received surgery in the mandible and 4 in the maxilla. No complications were registered during surgeries and the immediate post-operative course was uneventful for all patients. At 1 year, 2 patients dropped out of the study: the first patient experienced a peri-imp...
Since a split-mouth design was not feasible and the defects being corrected by the mucosa particularly in the vestibular portion of the study are not usually symmetrical or bilateral, the use of paired subjects was not a reliable format. All the data were analyzed with IBM’s SPSS Statistics using ANOVA Repeated Measurements statistical method. Mean values for keratinized mucosal width and probin...
The primary endpoints were to evaluate the shrinkage degree of the width of keratinized mucosa and length of the re-epithelization process. The secondary endpoints assessed clinical evaluation of the grafted area, post-operative hemostatic effect, pain level, and length of surgery. Follow-up control visits were scheduled at 3 days after surgery and then 10 days, 2 weeks, 3 weeks, 1 month, 2 ...
The study was designed as a multicentered (Milan University—School of Dentistry/Loma Linda University—School of Dentistry) prospective observational (non-controlled) clinical study according to the STROBE criteria. The participants of the study presented areas of deficient attached and unattached mucosa precluding the construction of effective functioning prosthesis. The study included a total...
A variety of factors can lead to teeth loss. From periodontal disease to trauma, the bone remodeling that always follows this event can complicate the subsequent prosthetical rehabilitation [1]. Both removable and implant-fixed restorations require both an adequate quantity of bone and sorrounding soft tissue. Even in severe atrophies of the jaw, nowadays, many bone augmentation techniques are app...
When keratinized tissue width around dental implants is poorly represented, the clinician could resort to autogenous soft tissue grafting. Autogenous soft tissue grafting procedures are usually associated with a certain degree of morbidity. Collagen matrices could be used as an alternative to reduce morbidity and intra-operatory times. The aim of this study was to assess the efficacy of a xenogene...
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical com...
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 2. PRISMA flowchart of the screening process
Fig. 2. PRISMA flowchart of the screening process
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting techn...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Le...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secre...
Ragucci, G.M., Elnayef, B., Suárez-López del Amo, F. et al. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review.
Int J Implant Dent 5, 6 (2019). https://doi.org/10.1186/s40729-019-0157-7
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Received: 09 October 2018
Accepted: 06 January 2019
Published: 05 February 2019
DOI: https://doi.org/10...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Not applicable
Not applicable
Gian Maria Ragucci, Basel Elnayef, Fernando Suárez López del Amo, Hom-Lay Wang, Federico Hernández-Alfaro, and Jordi Gargallo-Albiol declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Basel Elnayef.
Department of Oral and Maxillofacial Surgery, International University of Catalonia, C/Josep Trueta Sn, Sant Cugat del Vallés, C.P 08195, Barcelona, Spain
Gian Maria Ragucci, Basel Elnayef, Federico Hernández-Alfaro & Jordi Gargallo-Albiol
Department of Periodontics, University of Oklahoma Health Sciences Center – College of Dentistry, Oklahoma City, OK, USA
Fernando Suárez-López del ...
The authors want to thank Mr Juan Luis Gómez Martínez for the support in the statistical analysis.
Not applicable
Not applicable
The authors do not have any financial interests, either directly or indirectly, in the products or information listed in the paper.
Schwarz L, Schiebel V, Hof M, Ulm C, Watzek G, Pommer B. Risk factors of membrane perforation and postoperative complications in sinus floor elevation surgery: review of 407 augmentation procedures. J Oral Maxillofac Surg. 2015;73:1275–82.
Jung JA, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, Lee HJ, Li J. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications....
Ardekian L, Oved-Peleg E, Mactei EE, Peled M. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006 Feb;64(2):277–82.
Anavi Y, Allon DM, Avishai G, Calderon S. Complications of maxillary sinus augmentations in a selective series of patients. Oral Surg Oral Med Oral Patho Oral RadiolEndod. 2008;106(1):34–8.
Van den Ber...
Curi MM, Cardoso CL, de Ribeiro C. Retrospective study of pterygoid implants in the atrophic posterior maxilla: implant and prosthesis survival rates up to 3 years. Int J Oral Maxillofac Implants. 2015;30(2):378–83.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38(8):613–6.
Tatum H.Jr. Maxillary and sinus implant reconstructions....
Roccuzzo M, Bonino L, Dalmasso P, Aglietta M. Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface. Clin Oral Implants Res. 2014;25(10):1105–12.
Esposito M, Grusovin MG, Rees J, Karasoulos D, Felice P, Alissa R, Worthington H, Coulthard P. Effectiveness of sinus lift procedures...
The current review showed that the exposure of dental implants in the sinus cavity without the augmentation procedure or graft materials shows a high survival rate of 95.6%, without statistically significant differences according to the level of penetration (lower or higher to 4 mm). Changes in maxillary sinuses in relation to protruding implants within the sinus cavity do not statically affect ...
Consequently, it seems that maxillary sinus changes in relation to protruded implants inside the sinus cavity and does not statically affect to implant survival rate neither to clinical nor radiographic complications.
Several limitations could be described for the present review. Firstly, there is a lack of a control group in the included studies, to compare outcomes and complications, with impla...
Pneumatization of the maxillary sinus and resorption of the residual alveolar ridge following tooth extraction can compromise the dental implant placement. Similarly, extension of the dental implants inside the maxillary sinus cavity is not rare. Some studies have observed some differences in relation to the depth of the implant extension inside the sinus cavity. When the implants penetrate inside...
Seven studies [27,28,29,30,31,32,33] provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal secretion, mucopurul...
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles [26,27,28,29,30,31,32,33] (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Rea...
Heterogeneity was assessed based on calculation of the I2 statistic (percentage variability of estimated effect that can be attributed to the heterogeneity of the effects) and the null statistic test. Galbraith graphs displayed the degree of heterogeneity. In studies where great heterogeneity was detected, a sensitivity analysis was performed to determine its source. Funnel plots and the Egger tes...
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur during drilling or implant p...
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effect on implant survival or increase clinica...
Intrusion of dental implants into the maxillary sinus perforating through the Schneiderian membrane is considered a cause of undesirable complications [24, 25]. However, this phenomenon has never been properly evaluated and systematically studied. For this reason, the aim of this systematic review was to assess the implant survival and complication rates of implants intruding into the sinus cavity...
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry [1]. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The most conserv...
The overall survival rate of the implants into the sinus cavity was 95.6%, without statistical differences according to the level of penetration. The clinical and radiological complications were 3.4% and 14.8% respectively. The most frequent clinical complication was the epistaxis, and the radiological complication was thickening of the Schneiderian membrane, without reaching statistical significa...
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order to compensate for the lack of bone height, several treatment options have been proposed. These treatment alternatives aimed at the installation o...
Figure 7. Post-operative occlusal photograph of the maxilla
Figure 6. Post-operative lateral view of the right maxillary arch
Figure 5. Post-operative lateral view of the left maxillary arch
Figure 4. Post-operative frontal view with teeth in occlusion
Date
Site number
Implant diameter (mm)
Implant length (mm)
Immediate load
Bone graft augmentation
3/26/14
12
4.3
10
Yes
Allograft
3/26/14
14
4.3
10
Yes
None
11/10/14
10
3.5
13
Yes
Allograft
3/5/15
7
3.5
13
Yes
Allograft
4/19/16
11
4.3
11.5
Yes
None
2/22/17
3
4.3
10
Yes
Allograft
2/22/17
4
5.0
10
Yes
Allograft
...
Figure 1. Characteristic blue sclerae
Table 1 Osteogenesis imperfecta classifications
Type
Inheritance
Gene
Locus
Clinical features
OMIM
I
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Variable bone fragility, moderate bone deformity, blue sclerae, possible dentinogenesis imperfecta
166,200
II
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Perinatally lethal
166,210
III
AD
COL1A1 or COL1A2
17q21....
References
Sillence DO, Senn A, Danks DM. Genetic heterogeneity in osteogenesis imperfecta. J Med Genet. 1979;16:101–16.
Orioli IM, Castilla EE, Barbosa-Neto JG. The birth prevalence rates for the skeletal dysplasias. J Med Genet. 1986;23:328–32.
Stevenson DA, Carey JC, Byrne JL, Srisukhumbowornchai S, Feldkamp ML. Analysis of skeletal dysplasias in the Utah population. Am J Med Genet...
Discussion
The vast majority of published articles regarding OI type I revolve around fractures of the long bones and treatment strategies. An extensive literature search for manuscripts detailing the implant therapy for patients diagnosed with OI produced a marginal amount of literature (Table 3). Our case posits that oral restoration is attainable without implant failure for OI type I patien...
Surgical technique
The patient underwent implant therapy in stages under general anesthesia with immediate load protocol. Intravenous access was obtained, and the patient was anesthetized under general anesthesia by our anesthesiologist. Carpules of 2% lidocaine with 1:100,000 epinephrine, 4% articaine hydrochloride with 1:100,000 epinephrine (Septocaine), and 0.5% bupivacaine hydrochloride w...
Case presentation
Evaluation
A 53-year-old male diagnosed with OI type I was referred to our clinic for extraction of the remaining maxillary teeth and evaluation for full arch immediate load hybrid prosthesis. His clinical history included osteogenesis type 1, bipolar disorder, alopecia, and hypothyroidism. The patient presented with normal stature, measuring 170.18 cm and weighing 81.65 kg...
Introduction
Osteogenesis imperfecta (OI), colloquially known as “brittle bone disease,” is a broad term for a group of congenital disorders affecting the connective tissue resulting in a susceptibility to fractures. In 1979, Sillence et al. conducted an epidemiological and genetic study of OI patients [1]. These patients were grouped according to four distinct syndromes: (1) dominantly inh...
Implant therapy for a patient with osteogenesis imperfecta type I: review of literature with a case report
Abstract
Bone fragility and skeletal irregularities are the characteristic features of osteogenesis imperfecta (OI). Many patients with OI have weakened maxillary and mandibular bone, leading to poor oral hygiene and subsequent loss of teeth. Improvements in implant therapy have allowed f...
Figure 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Figure 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gingiva (mm)
Pink Esthetic Score (PES)
Probing depth (mm) at four sites (mb, db, mo, do)
Bleeding on Probing (+/−) at four sites (mb, db, mo, do)
Peri-implant bone loss (mm)
Presence of peri-implant osteolysis (+/−)
...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
Implant length (mm)
Augmentation material
Prosthetic rehabilitation
1
f
50
32
3.5
13
HA + β-TCP
r.p
34
4.3
11
HA + β-TCP
r.p
42
3.5
13
HA + β-TCP
r.p
44
4.3
11
HA + β-TCP
r.p
2
m
61
36
3.5
11
HA + β-TCP
...
Abbreviations
β-TCP:
β-tricalcium phosphate
BOP:
Bleeding on probing
F.P.:
Fixed prosthetics
GBR:
Guided bone regeneration
HA:
Hydroxyapatite
MNGCs:
Multinucleated giant cells
PES:
Pink Esthetic Score
R.P.:
Removable prosthetics
References
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency o...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the inve...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-impla...
Discussion
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24...
Results
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3...
C-Tech implant system
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implan...
Methods
Patient population
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commissio...
Regarding the stability of peri-implant hard and soft tissue, biological or anatomical factors are not the only elements that could be proven to have an impact. Technical factors such as the implant-abutment connection are also known to be key factors for long-term stable hard- and soft-tissue health [11]. Regarding the implant-abutment connection, which seems to be the key issue, located on the i...
However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and establish...
Background
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of ...
Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system
Abstract
Background
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. T...
Figure 3. Data from the VAS of patient-related outcome measures at the time of mounting of the implant-supported crown and at the final follow-up of the PRF and control group
Figure 2. Box plot of the radiographic peri-implant marginal bone level at different time points in millimeter. Baseline: the time of implant placement; abutment: the time of abutment operation; impression: the time of impression taking; follow-up: the time of the final follow-up
Figure 1. Intraoperative photos illustrating bone harvesting and lateral bone augmentation in the PRF group. Initially, an incision is made at the lateral aspect of the posterior part of the mandibular corpus (a) followed by exposing the mucoperiosteal flap (b), before making the osteotomy line (c). The bone block (d) is then retrieved before adjusted to the contour at the recipient site and...
Table 4 Patient-related outcome measures at baseline and at the final follow-up
Test group
Control group
Difference
p value
Mean (95% CI)
Mean (95% CI)
Mean (95% CI)
Baseline
9.44 (9.09 to 9.78)
9.57 (9.20 to 9.95)
0.13 (− 0.40 to 0.66)
0.61
Follow-up
9.66 (9.30 to 10.02)
9.55 (9.15 to 9.96)
− 0.10 (-0.66 to 0.46)
0.71
Difference
0.22 (...
Table 3 Radiographic marginal bone level and clinical recession on neighbouring tooth surface
Group
Baseline (mean, 95% CI)
Follow-up (mean, 95% CI)
Difference (mean, 95% CI)
p value
Radiographic marginal bone level in mm
Test
1.94 (1.50 to 2.38)
2.07 (1.64 to 2.51)
− 0.14 (− 0.25 to − 0.02)
p = 0.03
Control
2.34 (1.62 to 3.08)
2.49 (1.73...
Table 2 Radiographic peri-implant marginal bone level in mm
Test group
Control group
Mean difference
95% CI
p value
Obs
Mean
95% CI
Obs
Mean
95% CI
Baseline
14
− 0.24
− 0.48 to 0.00
13
− 0.28
− 0.52 to 0.03
0.04
− 0.314 to 0.39
p = 0.82
Abutment
14
0.07
− 0.17 to 0.30
13
− 0.01
− 0.26 to 0.25
0.08
− 0.278...
Table 1 Demographics and survival rates of implants and implant crowns
Test group (PRF)
Control group
Number of implants
14
13
Mean age, years (range)
47.9 (23–66)
52.3 (24–72)
Gender
Female
6
6
Male
8
7
Smokers
Total
2
1
20 cigarettes per day
1
1
Number of implants
14
13
Implant length (mm) and imp...
Abbreviations
ASC:
Angulated screw channel
BOP:
Bleeding on probing
DBBM:
Deproteinised bovine bone mineral
GBR:
Guided bone regeneration
ICC:
Intraclass correlation coefficient
KT:
Keratinised peri-implant tissue
PCR:
Plaque control record
PD:
Probing depth
PRF:
Platelet-rich fibrin
PROM:
Patient-related outcome measures
RCF:
...
A minor, but statistically significant, radiographic bone loss occurred from baseline to the final follow-up at the neighbouring tooth surfaces in both groups. Moreover, both groups experienced a minor recession of the marginal gingiva from baseline to the final follow-up, but the change was not significant. Recession and the bone level of the neighbouring tooth surfaces to implants placed in ...
The combination of the NobelParallel CC implant launched in 2015 and an abutment with ASC is relatively new and has so far been lined to only few mechanical problems [39, 40], among which rotation of the crown when torqueing the abutment screw was not stated. In both patients, a new implant was placed without any need for additional bone augmentation and without further complications. ...
Discussion
The present study focused on clinical and radiographic characteristics of staged implants placed in autogenous bone grafts covered by either a PRF membrane (PRF group) or a standard procedure (gold standard) involving coverage of the autogenous bone graft using a deproteinised bovine bone mineral and a resorbable collagen membrane (control group).
The PRF group demonstrated a hi...
One patient (control group) expressed minimally changed extraoral sensation in the chin region at both the 1- and 2-week follow-up. However, the extra- and intraoral clinical examination revealed no sensory disturbances. The patient was not affected by this and described the same changed sensation at the final clinical follow-up after 29 months.
Another patient (PRF group) experienced sensory d...
Radiographic peri-implant marginal bone change
The mean peri-implant marginal bone level at the different time points is shown in Table 2 and Fig. 2. The mean marginal bone level at follow-up was 0.26 mm (95% CI: 0.01–0.50 mm) in the PRF group and 0.68 mm (95% CI: 0.41–0.96 mm) in the control group. The difference between the groups was − 0.43 mm (95% CI: − 0.80 to − 0....
Bleeding on probing
The estimated probability or observed proportion of BOP for implants was 0.31 (95% CI: 0.14–0.70) in the PRF group and 0.30 (95% CI: 0.12–0.77) in the control group. The ratio of the probability of observing BOP was 1.046 (95% CI: 0.91–1.20), indicating that the probability of observing BOP is 4.6% higher in the PRF group than in the control group. No statistical differe...
Results
Implant survival
Two of the 27 initially placed implants were lost in the control group (Table 1). Twenty months after placement of the implant-supported crown, one implant (first premolar, regular platform (4.3 mm), length: 13 mm) was lost due to failed osseointegration. No periodontitis or peri-implant marginal bone resorption was obvious at the time of implant removal. A second...
The distance from the implant-abutment connection to the peri-implant marginal bone level was measured mesially and distally in parallel with the long axis of the implant using open-source software (ImageJ, National Institutes of Health, Bethesda, MD, USA). The distance from the cemento-enamel junction to the marginal bone level at the neighbouring tooth surfaces was also measured in parallel with...
Prosthodontic treatment
Forty-nine days (range: 27–113 days) after placement of the healing abutment, the abutment was removed and the implant position was registered by an impression coping on the implant.
The final implant-supported restoration was fabricated by using an individually designed angulated screw channel (ASC) zirconium abutment (Nobel Biocare®, Zürich, Switzerland) and venee...
Methylprednisolone was prescribed the following morning (16 mg) and evening (16 mg). Additionally, postoperative ibuprofen (400 mg, four times daily) and paracetamol (1000 mg, four times daily) were prescribed for 1 week. The patients were instructed to rinse with 0.12% chlorhexidine digluconate twice daily and discontinue the use of their prostheses (if any). Patients were seen for ...
The bone graft was retrieved by making a continuous osteotomy line with a cylindrical and a round bur at the lateral part of the mandible, with a uniform size of approximately 15 × 25 mm (Fig. 1c, d). The bone block containing mainly cortical bone was then gently separated from the mandible using a raspartorium. The block graft was covered with a saline-moistened gauze until used. In the PRF g...
At the time of the bone augmentation procedure, two patients (14%) in the PRF group and one (8%) patient in the control group were smokers. Patients were partially edentulous due to trauma (n = 22), agenesis (n = 3) or marginal periodontitis [2]. Two patients were unavailable for the final follow-up. The referring dentist followed the non-attenders, and telephone interview revealed no subjective o...
Material and methods
The study was performed according to the Declaration of Helsinki and internationally accepted guidelines for RCT, including the CONSORT statement (www.consort-statement.org). The volumetric changes of the augmented bone [26], the histological composition of the augmented bone [27] and pain after the primary bone augmentation procedure [28] were previously described in d...
Despite the shape of a membrane, the PRF membrane does not have the properties of a resorbable barrier membrane [21, 22], due to its fast degradation in the same manner as a natural blood clot (1–2 weeks) [23]. Therefore, the PRF membrane is not believed to replace a barrier membrane in the classic understanding of guide bone regeneration (GBR), but rather to enhance the healing capacity of t...
Background
Implant-supported single crowns are characterised by high long-term survival and few biological and technical complications, which typically includes peri-implant marginal bone loss, screw-loosening and fracture of veneering material complications [1,2,3]. To achieve a successful treatment outcome, the implants must be inserted in sufficient bone volume of an adequate quality to obta...
A clinical and radiographic study of implants placed in autogenous bone grafts covered by either a platelet-rich fibrin membrane or deproteinised bovine bone mineral and a collagen membrane: a pilot randomised controlled clinical trial with a 2-year follow-up
Abstract
Purpose
To compare the survival and clinical performance of implants placed in sites previously augmented with autogenous ...
RDX
No RDX
Author
Year of publication
No. of implants placed into autogenous bone grafts with RDX (and failures)
Overall implant survival of implants placed into autogenous bone grafts with RDX
No. of patients who had implants placed into autogenous bone grafts with RDX (and failures)
Patient based implant survival of implant placed into autogenous bone grafts with RDX
No. of...
Non-vascularised bone graft
Vascularised bone graft
Author
Year of publication
No. of patients who had implants placed into non-vascularised autogenous bone grafts (and failures)
Overall patient implant survival in non-vascularised autogenous bone grafts
No. of implants placed into non-vascularised autogenous bone grafts (and failures)
Overall implant survival in non-vasculari...
Implant survival
Implant success
Author
Year of publication
Donor site of autogenous bone graft
Radiotherapy/chemotherapy to bone graft site
Complications
No. of patients who had implants placed into autogenous bone grafts (and failures)
Overall patient implant survival in autogenous bone grafts
No. of implants placed into autogenous bone grafts (and failures)
Overall i...
Author
Year of publication
Study design
Outcome measure
Criteria—survival
Criteria—success
Quality assessment using the MINORS assessment tool
Head and neck cancer diagnosis
Patients age range
Follow-up period
Implant site
Implant system
Implant placement protocol
Prosthodontic rehabilitation
Studies with an average follow-up of 3 years or greater
Watzinger et...
Figure 1. Flow chart of study selection procedure
References
Schoen PJ, Reintsema H, Raghoebar GM, Vissink A, Roodenburg JLN. The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning. Oral Oncol. 2004;40:862–71.
Müller F, Schädler M, Wahlmann U, Newton JP. The use of implant-supported prostheses in the functional and psychosocial rehabi...
Conclusion
Within the limitations of the current review, it can be concluded that implant survival in autogenous bone grafts in H&N oncology patients appears to be promising with implant survival being reported at over 80% in 16 of the 20 studies included with 11 of these reporting implant survival of over 90% in follow-up ranging from 3 months [28] to 15 years [5]. However, there i...
A clear deficiency of many of the studies was the imprecise and inconsistent definitions of implant survival or implant success, as detailed in Table 1. In addition, in a number of studies, the terminology ‘implant success’ and ‘implant survival’ were used interchangeably within the narrative making comparison of the studies challenging and rendering statistical analysis of the surv...
The implant placement protocol with regard to primary (immediate) or secondary (delayed) implant placement was also reviewed, and there is limited evidence from Fenlon et al. that implant failure is significantly worse in immediately placed implants in comparison with a delayed approach in free vascularized grafts.
Implant success was shown to be lower than implant survival and was related ...
Discussion
Summary of evidence
Dental implants are now perceived to be a vital part of the clinician’s armamentarium in the provision of oral and dental rehabilitation for patients with acquired deformity following management of their H&N cancer, and therefore, this systematic review is relevant to clinicians and stakeholders involved in the treatment and management of H&N cancer patient...
Six of these studies (Schultes et al., Wang et al., Zou et al., Chiapasco et al., Chiapasco et al., Wu et al.) reported some of this lack of success to the peri-implant soft tissue which was most frequently the soft tissue component of a combined bone and soft tissue free flap (most commonly the external skin).
Complications
A variety of implant-based complications were documented. Complicatio...
Implant survival and Peri-implant soft tissue
Only one study (Linsen et al. ) reported on the effect of the peri-implant soft tissue and implant survival of implants placed into autogenous bone grafts. Linsen et al. reported a higher implant failure of implants placed into bone and soft tissue grafts in comparison to implants placed into a bone grafts with residual soft tissues. This difference...
However, in two studies (Teoh et al., Burgess et al.), no statistical significance was found despite higher implant failure.
Primary and secondary implant placement and implant survival
Six studies clearly reported the use of both primary and secondary implant placement within their study (Fenlon et al., Ch’ng et al., Zou et al., Burgess et al., Watzinger et al., Wu et al.); however, only on...
Two studies (Fenlon et al., Burgess et al. ) reported no significant effect on implant survival in varying graft donor sites; however, three studies (Hessling et al., Shaw et al., Chiapasco et al.) reported varying implant survival rates within different autogenous bone grafts but only one study (Hessling et al.) reported that implant loss was significant with this being for implants placed into...
Autogenous bone graft type and implant survival
Seventeen studies reported on the specific bone graft type (non-vascularised or vascularised) into which the implants were placed. In the remaining three studies (Buddula et al., Fierz et al., Yerit et al.), this distinction was not possible.
Of these 17 studies, 8 studies reported on implant survival in non-vascularised bone grafts and 14 studie...
The surgical and loading implant protocols were reported in 17 studies with no description given in 3 studies (Barrowman et al., Fierz et al., Hessling et al.). The implant placement protocols were diverse with variables including the use of surgical templates/guides, primary and/or secondary implant placement following autogenous bone grafting, and immediate and/or delayed implant loading; howe...
These 20 studies were published over a range of 21 years (1996 to 2017) and provide cumulative data on 1905 implants placed into autogenous bone grafts in H&N cancer patients with both benign and malignant tumours being reported. The exact patient number for this intervention within some of the studies was unclear as a result of the studies reporting on implant rather than patient number or ther...
Results
Study selection
Searches of EMBASE, the Cochrane Central Register of Controlled Trials, Science Direct and MEDLINE generated 619 articles. After duplicate articles were removed, 566 unique articles were remaining. After the review of the titles and abstracts, 151 articles were accepted for further consideration, and 415 were rejected. After the full text was attained and reviewed for t...
Data items
Data was collected for implant survival, implant success, implant failure, implant complications, surgical implant placement protocol, implant system used, clinical follow-up, how the author defined success/survival, the type of autogenous bone graft, implant site, the prosthodontic rehabilitation and type of cancer, and the use of radiotherapy were documented where possible.
Risk of ...
Information sources
Four electronic databases were used to systematically search the available literature: (1) The National Library of Medicine (MEDLINE via PubMed), (2) EMBASE, (3) Cochrane Central Register of Controlled Trials and (4) Science Direct. The searches were limited to studies involving human subjects and publication dates from January 1980 to August 2017 that satisfied the inclusion ...
Methods
Protocol
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for describing and summarising the results of our review was used.
A quality assessment of all selected full-text articles was performed using the Methodological Index for Non-Randomized Studies (MINORS) assessment tool to assess the risk of bias of the included studies. The MINORS scoring list co...
Introduction
Rationale
The use of implants to retain prostheses as part of oral and dental rehabilitation of head and neck (H&N) cancer patients is becoming an increasingly common treatment approach. A number of benefits advocating implant anchorage over conventionally secured prostheses have been proposed but importantly include a significant improvement in the reported quality of life (QoL) of...
Survival of dental implants placed in autogenous bone grafts and bone flaps in head and neck oncology patients: a systematic review
Abstract
Using implants to retain prostheses as part of the oral rehabilitation of head and neck cancer patients is an increasingly common treatment modality, particularly in transported bone which is used to reconstruct defects following oncological surgical ...
Figure 6. Cultivation and osteogenic differentiation of DFCs on PA after modification with collagen I. (Left) Relative cell number and (Right) normalized ALP activity.
Figure 6. Cultivation and osteogenic differentiation of DFCs on PA after modification with collagen I. (Left) Relative cell number and (Right) normalized ALP activity.
Figure 5. Evaluation of osteogenic differentiation. (A) Clustergram of PCR-array results; (B-C) histology of differentiated dental cells on AP (B) and SB (C). Representative results are shown for dNC-PCs.
Figure 5. Evaluation of osteogenic differentiation. (A) Clustergram of PCR-array results; (B-C) histology of differentiated dental cells on AP (B) and SB (C). Representative result...
Figure 4. Osteogenic differentiation of dental stem cells. Normalized ALP activity of dNC-PCs and DFCs on AP and SB (A) and on silicone (B). Cells were differentiated on standard cell culture dishes for control.
Figure 4. Osteogenic differentiation of dental stem cells. Normalized ALP activity of dNC-PCs and DFCs on AP and SB (A) and on silicone (B). Cells were differentiated on standar...
Figure 3. Evaluation of programmed cell death (apoptosis) in dental stem cells. (A) Flow cytometry analyses (for details materials and methods) show percentage of vital cells (black number), apoptotic cells (blue number), and dead cells (red number). (B) Western blot analyses show the expression of the pro-apoptotic marker BAX and the anti-apoptotic marker BCL2.
Figure 2. Cell proliferation of dNC-PCs and DFCs on tested materials. (A) and (B) Relative cell numbers; (C) spheroid cell clusters on silicone (representative pictures for DFCs); Silicone (24 and 48 h).
Figure 1. Cell attachment on tested materials. (A) Relative cell adherence of DFCs and dNC-PCs; (B) dental cells did little adhere on PA; representative pictures of DFCs.
In a previous study, we showed that TCP induced the programmed cell death (apoptosis) in DFCs. Our new study investigated therefore the induction of apoptosis in dental cells. While SB and soft materials did not induce apoptosis or cell death, AP induced obviously cell death and apoptosis in dental cells. Here, the results for dNC-PCs and DFCs were almost the same. Interestingly, neither sil...
Discussion
Scaffolds play an important role in tissue engineering. However, little is known about the proliferation and differentiation of DFCs and dNC-PCs on different types of materials. As we have learned from previous studies mechanical properties such as surface stiffness are decisive for a successful osteogenic differentiation of dental stem cells. Moreover, we showed that bone substi...
Results
Cell viability
Dental cells were cultivated in standard cell culture media until passage 6. Cell adherence and cell proliferation/growth were measured for the estimation of cell viability on tested rigid and soft materials. In Figure 1, the cell adherence of dNC-PCs on bone substitute materials was better than that of DFCs. However, both dental cells types adhered very well on silicone...
Cells positive for Caspase3/7 Green Detection Reagent were identified as apoptotic cells, while dead cells were positive for SYTOX® AADvanced dead cell stain. However, vital cells were negatively stained for both staining solutions.
Western blotting
For protein isolation, cells were treated with lysis buffer (250 μl phosphatase, 100 mM Na3VO4, 137 mM NaCl, 200 mM Tris, 480 mM NaF, 1% NP-4...
This incubation step with the implant material was repeated twice with fresh cell culture media. Three eluates were pooled for cell culture experiments. DFCs were seeded onto cell culture plates and cultivated in standard cell culture media. After cell seeding (12 to 24 h), cell culture media were changed, and cells were cultivated in cell culture media with material eluates. After 24 h of cultiva...
After washing with PBS, the gels were stored in PBS at 4°C. Before platting the cells, the gel was exposed to UV for 15 min for the sterilization and replace PBS with complete culture medium for 1 h at 37°C.
Implant materials
The bone substitutes Maxgraft® (AP) and Maxresorb® (SB) were obtained from the company Botiss (botiss dental GmbH, Berlin, Germany). Maxgraft® is a sterile, high-saf...
Methods
Cell culture
The isolation and characterization of DFCs and dNC-PCs were described in previous studies. DFCs were routinely cultivated in DMEM (Sigma-Aldrich, St. Louis, MO, USA) supplemented with 10% fetal bovine serum (Sigma-Aldrich, St. Louis, MO, USA) and 100 μg/ml penicillin/streptomycin (standard cell culture medium). dNC-PCs were cultivated in DMEM (Sigma-Aldrich) supplemented ...
Background
While bone substitute materials are routinely used, especially vertical bone, augmentation of the jaws is still a problematic step. Dental stem cells in combination with bone substitute materials may accelerate the augmentation of alveolar bone and perhaps, stem cell-based therapies can become an alternative to autologous, allogenic, or synthetic bone transplants and substitutes. How...
Abstract
Background
Dental stem cells in combination with implant materials may become an alternative to autologous bone transplants. For tissue engineering different types of soft and rigid implant materials are available, but little is known about the viability and the osteogenic differentiation of dental stem cells on these different types of materials. According to previous s...
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting technique (lateral sinus lift or transalveolar technique)
Jensen et al. (1994), Winter et al. (2002), Toffler et al. (2004), Chappuis et al. (2009), Soltan et al. (2011), Xiao et al. (2011), Cricchio et al. (2011), Scala et al. (2012), Brus...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Length and diameter (mm)
Implant system
Shihab 2017
Retrospective
60
35
70
NA
5–12 × 3.0–5.7
IDI FMD Nucleoss
Ghanem 2014
Retrospective
72
10
10
NA
NA
NA
Nooh 2013
Prospective
12
56
63
0
4 × 8 4.3 × 10 5 × 8 5 × 10
Nobel Biocare
...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secretion
Bone reaction to the implants
Headache and pain or tenderness in the region of the sinus
Sinus pathology
Decreased sense of smell
Figure 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Figure 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Figure 2. PRISMA flowchart of the screening process
The secondary outcome of this review was the analysis of the clinical and radiological complications related to the penetration of implants in the maxillary sinus. Clinical complication among the different authors ranges from 0 to 14.3%, with a weighted mean complication rate of 3.4%, without finding statistical difference according to the level of implant penetration. The most common clinic...
Figure 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Analysis of clinical complications
Seven studies provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal sec...
Results
Study screening
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Re...
Eligibility criteria
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur du...
Materials and methods
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
Focus question
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effec...
Introduction
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The ...
Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review
Abstract
Background
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order ...
Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)
Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)
Figure 2. Microscopical images of the healing abutments after the electrochemical treatments under different currents at constant 10 V with different electrodes. The healing abutments were stained with phloxine B after electrolysis. Images from side (a, c, e, g, i, k) and from top (b, d, f, h, j, l). a, b 1 A group I. c, d 1.5 A group I. e, f 1 A group II. g, h 1.5 A group II. i, j 1 A...
Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005
Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005
Table 3. Composition (%wt) of the surface of the healing abutment analyzed with EDS. Mean of 5 samples was presented
Groups
Charges and currents
Titanium
Carbon
Others
I
+ 0.5 A
24.77
75.23
-
− 0.5 A
35.13
64.87
-
+ 1 A
62.82
37.18
-
− 1 A
84.10
15.90
-
+ 1.5 A
63.86
36.14
-
− 1.5 A
81.71
18.29
-
II
...
Mean roughness score of 4 SEM images per electrolysis of different charges and currents
Mean all examiners
P value compared to Control
Ex 1
Ex 2
Ex 3
Control
2.00 ± 0.00
2.00 ± 0.00
2.00 ± 0.00
2.00 ± 0.00
-
− 1 A, group I
4.00 ± 0.00
3.00 ± 0.00
3.25 ± 0.50
3.42 ± 0.17
*
− 1.5 A, group I
4.00 ± 0.00
3.75 ± 0.50
4.00 ± 0.00
...
Table 1 pH after electrolysis. pH was measured after electrolysis for 5 min under different charges and current at constant 10 V. pH of original electrolyte, 7.5% NaHCO3, before electrolysis was 7.8
Charges and currents
Group I
Group II
Group III
−, 0.5 A
7.91
7.92
7.94
+, 0.5 A
7.02
7.03
7.02
−, 1 A
7.94
8.02
8.01
+, 1 A
6.6
6.2
7.72
...
Although EDS analysis was performed in three areas on each sample, the atomic percentage of carbon on the contaminated area was higher than that on the clean area and the atomic percentage of titanium was lower on the contaminated areas than on the clean area except cathodic potential 1 A and 1.5 A in group III. The possible sources of carbon conta...
According to the previous studies, complete killing of bacteria was seen at anode with low current. However, in this study, complete removal of contaminant was seen in electrolysis after cathodic potential 1 A and 1.5 A in group III. This complete removing action can be attributed to the alkaline environment generated at cathodic potential. Moreover, decrease in electro...
However, copper deposition was formed on the sample after electrolysis of anodic potential in group II. It is believed that anodic current was preferentially supplied by the electrolysis of water, which occurred on the surface of the sample because deposition attained electroconductivity. Thus, it was confirmed that copper could be incorporated into the titanium surface sample, t...
Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based contaminants and considerable changes in titanium surfaces composition even after sterilization. This could be the reas...
Therefore, in this study, phloxine B staining was used to detect residual contamination on the surface of the healing abutments.
Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based c...
Discussion
The current study showed that electrolysis could be an effective means to decontaminate the healing abutment surfaces with complete removal of contaminants without any surface changes at 10 V, 1 A into 5 min, cathodic potential in group III. A minimally invasive approach to remove and disinfect dental implants utilizes the fact that titanium is an electrically conducting me...
Analysis of healing abutment surface roughness after electrolysis
Representative SEM images after electrolysis of two different charges (cathodic and anodic) and two different currents (1 A and 1.5 A) are presented in Fig. 3. The SEM images showed surface modification ranging from smoothening to roughening. The surfaces were between the electrolytic healing abutments and control unused healin...
Results
Analysis of the electrolytes’ pH before and after electrolysis
As shown in Table 1, pH of electrolyte (catholyte) was not changed after electrolysis of different currents. However, the pH decreased after electrolysis of anodic potential of 1 A and 1.5 A in group I and II.
Evaluation of the amount of stained area (contamination) of the healing abutments
The perce...
Ninety healing abutments removed from patients at the Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, were used. As this clinical study is an in vitro experimental study, the university ethical committee decided that ethical approval was not necessary.
These healing abutments were at least for 4 weeks up to 6 weeks in patients’ oral cavities. All the healing abu...
Background
A healing abutment is a small metal cap placed on the dental implant. In dental implant treatment, a healing abutment is first placed on the implant. The top of the healing abutment is exposed in the oral cavity, while its body penetrates the soft mucosal tissue. During the implant treatment, the healing abutment is temporarily removed and replaced into several times until the prosth...
Abstract
Background
To evaluate the effects of electrolysis on cleaning the contaminated healing abutment surface and to detect the optimal condition for cleaning the contaminated healing abutment.
Methods
Ninety healing abutments removed from patients were placed in 1% sodium dodecyl sulfate solution and randomly divided for electrolysis with 7.5% sodium bicarbonate in the following three d...
Figure 6. Sample images of misdetected implants. a Both implants could not be detected because of the shadow of the spina. b Left implant was detected correctly as MK III/IIIG, but the right implant was not detected because of an unclear image
Figure 5. Average precision (AP) of each implant system in all images. MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 4. Ratio of implant systems detected correctly to all detected systems (True Positive ratio). MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 3. The total number of implant systems detected correctly (TPs) and those detected as other prostheses (FPs). MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 2. Total number of objects of each implant systemin all images. MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 1. Sample image for calculating IoU (MK III implant). The light gray square indicates the ground-truth bounding box, and the dark gray square indicates the predicted bounding box. IoU value was calculated that the overlapped area of light gray and dark gray squares was divided by the united area of light gray and dark gray squares.
Conclusion
Though there are several issues that still need to be addressed, implant systems can be identified from panoramic radiographic images using deep learning-based object detection. To increase the learning performance and apply this system in clinical practice, a higher quality and larger number of implant images and images of other implants will be needed in subsequent studies.
...
To identify implant systems from radiographic images, dental radiography, panoramic radiography, and computed tomography were considered. In this system, it is thought that implant systems are identified by the shape of the collar, groove, and apex of the implant images, which are unique characteristics of each implant. Consequently, the quality of the training images is important so that these ...
The second system employs nine questions about implant characteristics. The database returns candidate matching implants based on the answers to these questions, and dentists must match them with those of the patient. Both of these systems require dentists to check whether two images of an implant are the same to identify the implant system. In contrast, the system in this study is based on de...
Results
At least 240 instances of each implant system were detected in the panoramic radiographic images: the most common type was MK III/IIIG (1919 instances) and the least common was Genesio (240 instances; Fig. 2). The number of implants detected correctly (True Positive: TP), and those detected as other systems (false positive: FP) are shown in Fig. 3. The number of both TP and FP were the ...
Methods
Data collection
Panoramic radiographs were obtained from patients who received implant treatment in the Department of Prosthodontics, Gerodontology and Oral Rehabilitation at Osaka University Dental Hospital after January 2000. Panoramic radiographs with unknown implants were excluded and totally 1282 images were used to annotate implants. All images were JPEG files that were resized t...
Background
Dental implants were developed in the 1980s, and they are now used for patients with missing teeth globally. Their effect on dental treatment is great, and various improvements in patients’ quality of life have been reported. Implant treatment is no longer unusual for either patients or dentists. However, because more than 30 years have passed since implants were introduced into cl...
Abstract
Background
In some cases, a dentist cannot solve the difficulties a patient has with an implant because the implant system is unknown. Therefore, there is a need for a system for identifying the implant system of a patient from limited data that does not depend on the dentist’s knowledge and experience. The purpose of this study was to identify dental implant systems using a deep le...
Graft autogenous
Intension healing
Indikasi
Referensi
Graft gusi bebas
Primer
Augmentasi KTW di seputar gigi
Agudio et al. 200972
Augmentasi KTW peri-implant
Roccuzzo et al. 2016,21 Oh et al. 201722
Peningkatan kedalaman vestibulum
Yadav et al. 201473
Sekunder
Cakupan akar
Cortellini et al. 2012,16 Zucchelli and De Sancti...
Cangkok jaringan lunak autogenous untuk rekonstruksi bedah periodontal & bedah plastik peri‐implant
Abstrak
Tinjauan canggih ini menyajikan bukti yang relatif baru dan status terkini pencangkokan jaringan lunak autogenous untuk augmentasi jaringan lunak dan cakupan resesi pada gigi dan situs implant gigi. Indikasi dan prediktabilitas dari teknik cangkok gusi bebas dan teknik cangkok jaring...
Figure 1. Contemporary model of host–microbe interactions in the pathogenesis of periodontitis
Model masa kini interaksi inang-mikroba pada pathogenesis periodontitis, di mana tanggapan inang menggerakkan disbiosis yang baru (gingivitis). Jika biofilm tidak diganggu/ dihapus, disbiosis terang-terangan metuken dan melanggengkan peradangan kronis yang tidak terselesaikan dan merusak.
Simpulan
Komposit Col-HA berpori yang dikembangkan dalam penelitian ini biocompatible dan bisa dipakai sebagai perancah untuk regenerasi jaringan tulang. Rasio Col-HA adalah faktor penting dalam memperbaiki perlekatan dan perkembangbiakan MSCs tikus. Kompleks komposit Col-HA punya potensi yang kuat dalam penerapan regenerasi jaringan tulang. hPDSCs bisa jadi sumber daya sel untuk regenerasi max...
Wedharan
Temuan dari penelitian ini menunjukkan bahwa komposit Col-HA yang seperti spons berpori memiliki biokompatibilitas dan watak biomimetik yang baik, sehingga bisa digunakan sebagai perancah untuk regenerasi jaringan tulang. Komposit Col-HA dengan rasio 80:20 dan 50:50 mendukung perlekatan dan perkembangbiakan MSCs tikus dan hPDSC. Temuan ini menunjukkan bahwa kompleks komposit Col-HA memil...
Weton
Sumbat seperti spons dari prototipe komposit Col-HA kasembadan dibuat dengan rasio kolagen dan HA yang berbe da. Tampilan makroskopis dan SEM untuk prototipe kolagen tipe I tanpa HA dan 3 rasio komposit kolagen-HA yang berbeda (20% Col - 80% HA; 50% Col - 50% HA; 80% Col - 20% HA) ditampilkan dalam Gambar 1. Pandangan SEM menunjukkan struktur mikro bagian dalam prototipe kolagen tipe I ...
Bahan dan metode
Sintesis komposit Col-HA dengan pengendapan langsung in situ
Larutan garam kalsium dan asam fosfat (Ca / P = 1,66 mol) digunakan untuk mensintesis partikel HA dan menggabungkannya pada fibril kolagen sapi tipe I dengan teknik pengendapan langsung in situ. Teknik ini dioptimalkan untuk menghasilkan 3 rasio komposit Col-HA yang berbeda (20% Col-80% HA; 50% Col-50% HA; dan 80% ...
Pendahuluan
Menggabungkan perancah dan sel hidup untuk membentuk konstruksi rekayasa jaringan adalah konsep yang penting untuk memajukan perbaikan dan regenerasi jaringan tulang. Sel induk mesenkim sering digunakan dalam konstruksi seperti itu karena kemampuannya untuk berkembangbiak dan berdiferensiasi menuju pembentuk sel tulang. Desain dan pembuatan perancah, isolasi dan karakterisasi sel indu...
Abstrak
Bahan pencangkokan tulang masa ini memiliki keterbatasan yang signifikan untuk memperbaiki defisiensi tulang maxillofacial dan dentoalveolar. Konstruksi rekayasa jaringan tulang yang ideal masih kurang. Tujuan dari penelitian ini adalah pertama untuk mensintesis dan mengembangkan komposit kolagen-hidroksiapatit (Col-HA) melalui mineralisasi in situ terkontrol pada fibril kolagen tipe I de...
RISET
Perancah kolagen-hidroksiapatit berpori dengan sel induk mesenkim untuk regenerasi tulang
Li Ning, DDS, PhD , Hans Malmström, DDS , Yan-Fang Ren, DDS, MPH, PhD
Korespondensi:
* Korespondensi pengarang, e-mail: yanfang_ren@urmc.rochester.edu
Kutipan artikel:
Li Ning, Hans Malmström, Yan-Fang Ren, Porous Collagen-Hydroxyapatite Scaffolds With Mesenchymal Stem Cells for Bo...
Conclusions
The porous Col-HA composites developed in the present study are biocompatible and can be used as scaffolds for bone tissue regeneration. The Col-HA ratio is an important factor in promoting the attachment and proliferation of mouse MSCs. The Col-HA composite complexes have strong potentials in bone tissue regeneration applications. hPDSCs may be a suitable resource of cells for maxi...
Discussion
The findings of the presented study indicate that the porous sponge-like Col-HA composites have good biocompatibility and biomimetic properties and may be used as scaffolds for bone tissue regeneration. The Col-HA composites with ratios 80:20 and 50:50 supported the attachments and proliferations of mouse MSCs and hPDSCs. These findings indicate that Col-HA composite complexes have str...
Results
The sponge-like plugs of prototype Col-HA composites were successfully fabricated with different collagen and HA ratios. The macroscopic and SEM views of the prototype type I collagen without HA and 3 different ratios of collagen-HA (20%Col-80%HA; 50%Col-50%HA; 80%Col-20%HA) composites are shown in Figure 1. The SEM views show the inside microstructures of the prototype pure type I colla...
Materials and Methods
Synthesis of the Col-HA composites by direct precipitation in situ
Solutions of calcium salt and phosphoric acid (Ca/P = 1.66 mol) were used to synthesize HA particles and incorporate them on bovine type I collagen fibrils by a direct precipitation technique in situ. This technique was optimized to produce 3 different ratios of Col-HA composites (20%Col-80%HA; 50%Col-50%H...
Introduction
Combining a scaffold and living cells to form a tissue-engineering construct is an important concept for promoting the repair and regeneration of bone tissues. Mesenchymal stem cells are often used in such constructs due to their abilities to proliferate and differentiate toward bone-forming cells. The design and fabrication of scaffolds, stem cell isolation and characterization, and...
Abstract
Current bone grafting materials have significant limitations for repairing maxillofacial and dentoalveolar bone deficiencies. An ideal bone tissue-engineering construct is still lacking. The purpose of the present study was first to synthesize and develop a collagen-hydroxyapatite (Col-HA) composite through controlled in situ mineralization on type I collagen fibrils with nanometer-sized...
RESEARCH
Porous Collagen-Hydroxyapatite Scaffolds With Mesenchymal Stem Cells for Bone Regeneration
Li Ning, DDS, PhD , Hans Malmström, DDS , Yan-Fang Ren, DDS, MPH, PhD
Correspondence:
* Corresponding author, e-mail: yanfang_ren@urmc.rochester.edu
Article Citation:
Li Ning, Hans Malmström, Yan-Fang Ren, Porous Collagen-Hydroxyapatite Scaffolds With Mesench...
Sel stroma yang berasal dari sumsum tulang dan sel induk ligamen periodontal dipakai sebagai sumber sel untuk regenerasi periodontal. Karena periodontium berasal dari folikel gigi, maka sel induk folikel gigi bisa jadi sumber sel alternatif untuk terapi regenerasi periodontal. Penelitian lebih lanjut tentang prakara ini perlu dilakukan.
Pada mulanya, Honda et al (2010) berupaya menghasilkan gigi ...
Generasi pertama implant yang sukses berpadu dengan tulang punya permukaan yang relatif halus hasil dari pemrosesan dengan mesin (Branemark et al. 1969).
Permukaan implant mesin hanya sedikit berubah dan dianggap tidak kasar (lihat gambar). Apabila dilihat tanpa bantuan mikroskop, permukaan implant macem pertama tersebut terlihat halus, kekasarannya tidak terlihat. Sejak kesuksesan implant moder...
Titanium murni dan titanium yang dipadukan dengan logam lain telah lama menjadi bahan standar mapan untuk memproduksi implant gigi karena logam ini punya kombinasi kekuatan mekanik, stabilitas kimia, dan biokompatibilitas yang menguntungkan. Paduan implant titanium dengan tulang yang berada di sekitarnya sangat penting untuk mencapai kesuksesan regenerasi dan penyembuhan tulang pasca operasi impla...
[Lanjutan] Tanda lain yang juga penting dari infeksi odontogenik adalah trismus, yaitu ketidakmampuan pasien untuk membuka lebar mulutnya. Pada infeksi odontogenik, trismus dihasilkan dari keterlibatan otot-otot mastikasi dalam proses inflamasi. Trismus bisa didefinisikan sebagai bukaan interincisal maksimum antara 20 sampai 30 mm (trismus ringan), 10 sampai 20 mm (tahap sedang), dan kurang dari 1...
[Lanjutan] Tipe infeksi odontogenik ini bisa menghasilkan bengkak dalam ruang fasial yang dalam di daerah leher. Dampak nyata dari pembengkak di daerah ini adalah saluran napas jadi tertekan dan dapat menyimpang.
Kriteria selanjutnya yang menyarankan agar pasien dirujuk adalah pasien mendapat kesulitan bernapas (dyspnea) atau disebut juga sesak napas. Pasien bisa merasakan napasnya seolah seper...
Infeksi odontogenik di seputar gigi ditangani oleh dokter gigi. Tapi, jika infeksi odontogenik itu sudah menyebar ke mana-mana, maka prakara itu perlu ditangani oleh dokter spesialis yang relevan. Misalnya, infeksi odontogenik yang menyebar ke paru-paru perlu dokter spesialis paru dan yang menyebar ke mata perlu dokter spesialis mata, dan yang menyebar ke jantung perlu dokter spesialis jantung.
...
A. Respon imun non-spesifik
Sitokin meliputi antara lain IL-1, IL-6, TNF-α, dan interferon-gamma. Sitokin-sitokin ini diproduksi terutama oleh makrofag dan limfosit aktif. Mereka menjadi perantara untuk terjadinya respon fase akut apapun mikroorganisme yang menyerang. Respon tersebut meliputi demam dan peningkatan produksi neutrofil oleh sumsum tulang. Sel-sel endotel juga memproduksi sejumlah...
[Lanjutan] Keberadaan nanah biasanya menunjukkan bahwa tubuh telah melakukan perlawanan terhadap infeksi odontogenik pada area lokal dan bahwa mekanisme resistensi inang lokal berupaya mengendalikan infeksi itu.
Dalam banyak situasi klinis, abses dan selulitis yang parah sulit sekali dibedakan, terutama jika letak abses berada jauh di dalam jaringan lunak. Pada beberapa orang pasien, selulitis ...
[Lanjutan] Setelah pemeriksaan fisik, dokter gigi merasakan tahap infeksi dengan jarinya. Bengkak edematosa yang lembut dan empuk menunjukkan tahap inokulasi. Bengkak yang mengeras menunjukkan tahap selulitis seperti pada gambar di atas. Keberadaan fluktuansi di bagian tengah bengkak menunjukkan tahap abses.
Infeksi jaringan lunak pada tahap inokulasi bisa disembuhkan dengan menghapuskan penyeba...
[Lanjutan] Setelah mengambil tanda-tanda vital, perhatian selanjutnya diarahkan pada pemeriksaan fisik pasien. Bagian pertama pemeriksaan fisik meliputi pemeriksaan tampilan umum pasien. Pasien dengan infeksi lokal yang tidak lagi minor terlihat lelah, demam, dan tidak enak badan. Tampilan ini disebut "toxic appearance (tampilan toksik)", seperti yang ditunjukkan pada gambar di atas.
Kepala dan l...
Pemeriksaan fisik dimulai dari mendapatkan tanda-tanda vital pasien, termasuk suhu badan, tekanan darah, denyut nadi, dan laju respirasi. Suhu badan tentu perlu diperiksa karena pasien penderita infeksi biasanya suhu badannya naik, terutama di sekitar daerah yang terkena infeksi. Pasien yang infeksinya parah suhu badannya naik di atas 38,3°C atau lebih.
Denyut nadi pasien meningkat kala suhu ba...
[Lanjutan] Karakteristik infeksi yang ketiga adalah calor atau panas/ hangat. Pasien hendaknya ditanya apakah daerah infeksi terasa hangat kala disentuhnya. Pasien dapat membandingkan suhu daerah infeksi dengan daerah badan lainnya yang tidak mengalami infeksi.
Ciri lain yang perlu dievaluasi adalah warna merah pada daerah di sekitar atau di atas daerah terjadinya infeksi. Pada gusi, warna merah ...
Riwayat infeksi yang diderita oleh pasien mengikuti pedoman umum yang sama seperti pedoman umum untuk sejarah penyakit apapun. Tujuan utamanya adalah untuk menemukan apa keluhan utama pasien. Keluhan utama pasien yang tipikal untuk infeksi odontogenik adalah:
Gigi saya rasanya ngilu.
Rahang saya bengkak.
Ada benjolan di gusi saya.
Keluhan dari pasien hendaknya direkam menggunakan kata-k...
Setelah infeksi odontogenik mengikis tulang, maka dimana lokasi infeksi pada jaringan lunak bisa diketahui dari posisi perforasi relatif terhadap perlekatan otot.
Pada gambar A di atas, infeksi telah mengikis tulang melalui proses alveolar pada arah fasial dan pada posisi yang lebih rendah dari perlekatan otot buccinator. Hal ini menyebabkan infeksi jadi terlihat sebagai abses vestibular. Pada ga...
Asal-usul infeksi odontogenik terutama dari 2 hal, yaitu:
Periapikal
Asal periapikal dihasilkan oleh nekrosis pulpa yang diikuti dengan serbuan bakteri ke dalam jaringan periapikal.
Periodontal
Asal periodontal dihasilkan oleh kantung periodontal yang dalam. Kantung ini memungkinkan inokulasi bakteri dalam jaringan lunak yang mendasar.
Di antara keduanya, infeksi odontogenik paling u...
Serbuan pasukan gabungan bakteri aerobik dan anaerobik menimbulkan infeksi odontogenik. Tahap-tahap penyerbuan itu kini telah berhasil dikenali.
Tahap pertamanya adalah inokulasi ke dalam jaringan yang lebih dalam. Setelah inoculasi itu sukses, organisme-organisme kelompok S. milleri bisa mensintesa hyaluronidase yang memungkinkan organisme-organisme penginfeksi menyebar melalui jaringan ...
Kelompok bakteri Streptococcus milleri ditemukan dalam 65% kasus infeksi odontogenik. Inilah kelompok bakteri aerobik yang paling dominan dalam infeksi itu.
Kelompok bakteri Streptococcus milleri terdiri dari tiga anggota kelompok bakteri S. viridans, yaitu: S. anginosus, S. intermedius, dan S. constellatus. Organisme-organisme fakultatif ini bisa tumbuh tanpa adanya oksigen. Karena tidak pe...
Infeksi odontogenik pada umumnya terjadi karena serangan dari bakteri yang sudah lama menetap dan tinggal dalam mulut manusia selama bertahun-tahun. Bakteri-bakteri ini biasanya tinggal dalam plak dan dapat ditemukan dalam kehidupan sehari-hari di permukaan mukosa dan sulkus gingiva. Ada infeksi odontogenik yang terjadi karena serangan bakteri baru dari luar tubuh manusia, tapi prakara semacam in...
Satu di antara sekian perkara yang tidak mudah di bidang kedokteran gigi adalah infeksi odontogenik. Infeksi odontogenik berasal dari gigi. Jenis infeksi ini punya flora yang khas.
Infeksi ini bisa dimulai dari perkara karies, penyakit periodontal, dan pulpitis. Infeksi lalu menyebar ke luar dari gigi menuju daerah proses alveolar dan ke jaringan yang lebih dalam pada bagian wajah, rongga mulut...
Kita telah membahas secara umum mengenai dentinogenesis imperfekta. Kali ini, kita membahas tentang bagaimana merawat dentinogenesis imperfecta.Tujuan perawatanTujuan perawatan dini pada dentisi primer meliputi hal-hal berikut ini:Merawat kesarasan gigi dan mempertahankan vitalitas, bentuk dan ukuran dentisi.Membuat tampilan gigi pasien jadi lebih bagus untuk mencegah perkara psikologis yang dit...
Dentinogenesis imperfecta atau dentinogenesis imperfekta adalah gangguan perkembangan gigi yang menyebabkan gigi jadi berwarna biru keabu-abuan atau kuning-kecoklatan dan tembus cahaya. Gigi juga jadi lebih lemah bila dibandingkan dengan gigi normal serta lebih mudah aus, patah, dan copot serta bisa menyebabkan gigi jadi sensitif pada suhu. Dentinogenesis imperfecta dideskripsikan pertama pada ab...
Amelogenesis imperfekta adalah gangguan genetik yang menyebabkan lapisan enamel gigi jadi kurang berkembang sehingga lapisan enamel jadi sangat tipis, berwarna kuning atau abu-abu, mudah patah, dan ada lubang-lubangnya. Kerusakan terjadi pada jumlah enamel, pertumbuhan kristal enamel, pendewasaan kristal enamel, dan mineralisasi. Kerusakan-kerusakan tersebut menyebabkan gigi jadi mudah patah dan a...
Dr. C. Edmund KellsDokter C Edmund Kells lahir pada tanggal 21 Oktober 1856. Ayahnya adalah seorang dokter gigi. Kells muda menerima pendidikan kedokteran gigi dari ayahnya dan dari sekolah di New York Dental College dari tahun 1876-1878. Selama di New York, dia berteman dengan orang-orang Menlo Park lab, laboratorium Thomas Edison, di New Jersey, di mana lampu listrik ditemukan untuk pertama ka...
Kolagen adalah protein fibrosa tak larut dalam matriks ekstraseluler dan jaringan ikat. Ada sekurang-kurangnya 16 tipe kolagen, tapi 80-90% kolagen dalam tubuh manusia terdiri dari tipe I, II, dan III. Kolagen disekresi oleh fibroblas dalam jaringan ikat, osteoblas, dan sel-sel epitel.TipeKomposisi MolekulFitur StrukturalJaringan RepresentatifKolagen FibrilI2Fibril dengan panjang 300 nmKulit, t...
IstilahIstilah "Osteogenesis" berasal dari kata dalam bahasa Yunani, yaitu kata "ostō" (οστο) yang berarti tulang dan kata "genesē" (γενεση) yang berarti kejadian atau penciptaan. Istilah ini merujuk pada proses pembentukan tulang. Istilah ini bersinonim dengan sebutan "Pembentukan Tulang."Istilah "osteogenesis" agak dekat dengan istilah "osifikasi" dan "mineralisasi". Istilah "os...
Kesuksesan implan gigi ditentukan oleh pembentukan tulang baru. Pembentukan tulang baru ditentukan oleh pembentukan osteoblas. Pembentukan osteoblas ditentukan oleh gen. Gen adalah salah satu faktor penentu apakah implan gigi akan jadi.Sel induk mesenkim atau sel prekursor dapat berdiferensiasi jadi osteoblas, kondrosit, mioblas, adiposit, dan sel tendon. Faktor-faktor transkripsi menentukan se...
Bone Morphogenitic Proteins (BMP) atau Protein Morfogenetik Tulang diperkenalkan pada tahun 1965. Tetapi, protein yang bertanggung jawab atas induksi tulang belum diketahui sampai dasawarsa 1980an ketika sekelompok peneliti berhasil melakukan purifikasi dan sekuens BMP-3 sapi (osteogenin) dan mengkloning BMP-2 dan BMP-4 manusia. Kelompok protein BMP diketahui termasuk dalam kelompok TGF-β...
Faktor eksogen penyebab kegagalan implant awal ada 2, yaitu: faktor yang berkaitan dengan operator dan faktor yang berkaitan dengan biomaterial.1. Faktor kegagalan implant terkait operatorSejumlah penelitian implan gigi oleh Listgarten (1997), Morris, Manz, dan Tarolli (1997), Lambert, Morris, dan Ochi (1997), Preiskel dan Tsolka (1995), dan Truhlar, Morris, Ochi, dan Winkler (1994) menyarankan ...