Success Of Dental Implants Research Articles

Assessment of C reactive proteins levels in patients with dental implant failure

Background: The present study was undertaken for assessing C reactive proteins levels in dental implant failure patients. Materials & methods: A total of 100 patients who were schedule to undergo prosthetic rehabilitation of missing mandibular molars were enrolled. Baseline hematological and biochemical variables were evaluated. All the dental implant procedures were carried out under adequate septic conditions. All the patients were put of prescribed antibiotic therapy postoperatively. All the patients were evaluated radiographically after three months for prognosis. C Reactive proteins levels were evaluated in all the patients and were compared between patients on the basis of prognosis. All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software. Results: Mean C Reactive proteins levels among patients with Dental implant failure and among patients with successful dental implants was 0.89 mg/dL and 0.21 mg/dL respectively. Significant results were obtained while comparing the C Reactive proteins levels among patients with Dental implant failure and among patients with successful dental implants.Conclusion: C Reactive proteins could be used as a successful marker for monitoring the success dental implant therapy.

Major cellular and molecular processes and clinical outcomes in bone regeneration for successful dental implantation: a systematic review

Introduction: In the context of bone regeneration, bone defects still represent a major challenge in oral and maxillofacial clinical and surgical treatment. The biomimetic design of biomaterials by simulating the natural structure and composition of bone tissue has gradually become a point of research interest due to its advantages of simplicity and efficiency. Objective: It was to carry out a systematic review on cellular and molecular processes, as well as to present the main clinical approaches of bone regeneration for dental implants. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 142 articles were found. A total of 84 articles were fully evaluated and 33 were included in this study. Literary findings have shown that the lack of bone in the alveolar ridges has been a major problem in functional aesthetic recovery in patients who have suffered dentoalveolar trauma. The osteoinduction process is influenced by several factors, requiring the presence of inducers, which include β-glycerolphosphate, ascorbic acid, and dexamethasone. Mesenchymal stem cells acquire the morphology and components of osteoblastic membranes and begin to express alkaline phosphatase to deposit extracellular matrix rich in calcium and certain proteins, such as osteopontin and osteocalcin. The Bio Oss® (Geistlich) biomaterial, because it is biodegradable, biocompatible, non-toxic, and has low immunogenicity and bio stimulators, can act in the regeneration of bone tissue. Application of FRP and implant placement provides stable clinical results for severely atrophic maxilla 2-4 mm. Bovine xenograft alone and in combination with liquid FRP are both successful in achieving bone augmentation around implants and produce a small change in marginal bone level and a high implant survival rate after loading. Conclusion: Through the results of the present study, it was evidenced that the success of the dental implant is directly related to successful osseointegration.

Major approaches and clinical outcomes of bone regeneration for dental implants: a systematic review

Introduction: In the last decades, the number of dental implant procedures has increased in the world, with about 1.0 million dental implants per year. When a tooth is lost in the posterior region of the maxilla, there is a natural resorption of the alveolar process. There are several surgical techniques that can be used to reconstruct the atrophic alveolar ridge. Objective: A systematic review was carried out to present the key considerations of bone regeneration and bone, cellular and molecular grafts for adequate bone formation for successful dental implants. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 132 articles were found. A total of 74 articles were fully evaluated and 31 were included in this study. Normal bone formation and tissue repair involve coordinated interaction between bone-forming cells and biological signals. TNF-α stimulates bone and cartilage resorption and inhibits collagen and proteoglycan synthesis. IL-1 induces the expression of a wide variety of cytokines. LIF and IL-6 are two such molecules that are known to stimulate the differentiation of mesenchymal progenitor cells into the osteoblastic lineage. The bioactivation of the dental implant surface with FRP has been described and discussed by the scientific community as a surface treatment for the stimulation and acceleration of the osseointegration process, as well as to achieve greater primary stability to the implant. The combination of FRP and Bio-Oss® has been studied with good clinical results, reducing healing time from 180 days to approximately 106 days. The use of bone grafts significantly improves the residual alveolar ridge regardless of the membrane used. Furthermore, implants placed in fresh extraction sockets with and without elevation of the mucoperiosteal flap can be successfully performed with augmentation procedures.

Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections.

This review addresses the different aspects of the use of titanium and its alloys in the production of dental implants, the most common causes of implant failures and the development of improved surfaces capable of stimulating osseointegration and guaranteeing the long-term success of dental implants. Titanium is the main material for the development of dental implants; despite this, different surface modifications are studied aiming to improve the osseointegration process. Nanoscale modifications and the bioactivation of surfaces with biological molecules can promote faster healing when compared to smooth surfaces. Recent studies have also pointed out that gradual changes in the implant, based on the microenvironment of insertion, are factors that may improve the integration of the implant with soft and bone tissues, preventing infections and osseointegration failures. In this context, the understanding that nanobiotechnological surface modifications in titanium dental implants improve the osseointegration process arouses interest in the development of new strategies, which is a highly relevant factor in the production of improved dental materials.

A Novel Method for Digital Reconstruction of the Mucogingival Borderline in Optical Scans of Dental Plaster Casts.

Adequate soft-tissue dimensions have been shown to be crucial for the long-term success of dental implants. To date, there is evidence that placement of dental implants should only be conducted in an area covered with attached gingiva. Modern implant planning software does not visualize soft-tissue dimensions. This study aims to calculate the course of the mucogingival borderline (MG-BL) using statistical shape models (SSM). Visualization of the MG-BL allows the practitioner to consider the soft tissue supply during implant planning. To deploy an SSM of the MG-BL, healthy individuals were examined and the intra-oral anatomy was captured using an intra-oral scanner (IOS). The empirical anatomical data was superimposed and analyzed by principal component analysis. Using a Leave-One-Out Cross Validation (LOOCV), the prediction of the SSM was compared with the original anatomy extracted from IOS. The median error for MG-BL reconstruction was 1.06 mm (0.49–2.15 mm) and 0.81 mm (0.38–1.54 mm) for the maxilla and mandible, respectively. While this method forgoes any technical work or additional patient examination, it represents an effective and digital method for the depiction of soft-tissue dimensions. To achieve clinical applicability, a higher number of datasets has to be implemented in the SSM.

Surface Engineering for Dental Implantology: Favoring Tissue Responses Along the Implant.

Dental implants represent an illustrative example of successful medical devices used in increasing numbers to aid (partly) edentulous patients. Particularly in spite of the percutaneous nature of dental implant systems, their clinical success is remarkable. This clinical success is at least partly related to the effective surface treatment of the artificial dental root, providing appropriate physicochemical properties to achieve osseointegration. The demographic changes in the world, however, with a rapidly increasing life expectancy and an increase in patients suffering from comorbidities that affect wound healing and bone metabolism, make that the performance of dental implants requires continuous improvement. An additional factor endangering the clinical success of dental implants is peri-implantitis, which affects both the soft and hard tissue interactions with dental implants. In this study, we shed light on the optimization of dental implant surfaces through surface engineering. Depending on the region along the artificial dental root, different properties of the surface are required to optimize prevailing tissue response to facilitate osseointegration, improve soft tissue attachment, and exert antibacterial efficacy. As such, surface engineering represents an important tool for assuring the continued future success of dental implants. Impact Statement Dental implants represent a common treatment modality nowadays for the replacement of lost teeth or fixation of prosthetic devices. This review provides a detailed overview of the role of surface engineering for dental implants and their components to optimize tissue responses at the different regions along the artificial dental root. The surface properties steering immunomodulatory processes, facilitating osseointegration, and rendering antibacterial efficacy (at both artificial root and abutment region) are described. The review finally concludes that surface engineering provides a tool to warrant that dental implants will remain future proof in more challenging applications, including an aging patient population and comorbidities that affect bone metabolism and wound healing.

Long-term clinical and radiographic evaluation after maxillary sinus floor augmentation with octacalcium phosphate-collagen composite: A retrospective case series study.

The purpose of this study was to evaluate, using clinical and radiological assessments, the stability of dental implants 5years after maxillary sinus floor augmentation with octacalcium phosphate-collagen composite (OCP/Col). Maxillary sinus floor augmentation was performed through a lateral window approach. Depending on the height of the host bone, a simultaneous approach (≥5mm) or a staged approach (less than 5mm) was employed. The primary outcome was the evaluation of clinical dental implant conditions such as infection, peri-implantitis, dental implant stability, pain, and paresthesia. Secondary outcomes were the evaluation of the augmented bone volume, change rate of augmented bone volume, vertical bone height, and marginal bone loss around dental implant fixture. The conditions of all dental implants were uneventful throughout the follow-up period. Augmented bone volume and changing rate of augmented bone volume were essentially unchanged following maturation of the OCP/Col-derived new bone. The change rate of new bone volume was 21.9% in the simulated approach and 16.8% in the staged approach at 1year and 5years postoperatively. The reduction rate in vertical bone height was 7.1% in the simultaneous approach and 7.5% in the staged approach between 1year and 5years postoperatively. Mean marginal bone loss was 1.76mm with the simultaneous approach, and 0.50mm with the staged approach at 5years postoperatively. In conclusion, the success of dental implants 5years after sinus floor augmentation by OCP/Col implantation was clarified by both clinical and radiological evaluations.

Does Primary Stability Is Mandatory For Dental Implant Success? A Systematic Review Of Literature

Background: Implant primary stability is considered a prerequisite of implant osseointegration and ultimately, implant success. The prognosis of dental implants installed with low or without primary stability is still unclear. The aim of this systematic review was to assess the survival rate of implants placed with low/without primary stability and to diagnose risk factors that might affect outcomes of such implants. Material and methods: Electronic search in the National Library of Medicine (MEDLINE-PubMed) was performed on articles published in English up to September 2020. The terms (MeSH words) used in the search were ‘Dental’ OR ‘Oral’ AND ‘Implant’ AND ‘Survival’ OR ‘Success’ AND ‘Stability’ OR ‘Low stability’ AND ‘Insertion torque’. In addition to the online databases of selected journals. Randomized and controlled clinical trials, cohort studies, case-control studies, and prospective or retrospective case series were included. Results: Of the retrieved 386 publications, 24 studies met the inclusion criteria, with a total of 1632 implants, giving a survival rate of 96.32%. No statistically significant influence of the type and site of implantation on implant survival was recorded. A significant higher failure rate of immediately loaded implants that than those with delayed loading protocols. Conclusion: Poor primary stability might not negatively affect the survival rates of non-immediately loaded dental implants.

Antimicrobial and Antibiofilm Coating of Dental Implants-Past and New Perspectives.

Regarded as one of the best solutions to replace missing teeth in the oral cavity, dental implants have been the focus of plenty of studies and research in the past few years. Antimicrobial coatings are a promising solution to control and prevent bacterial infections that compromise the success of dental implants. In the last few years, new materials that prevent biofilm adhesion to the surface of titanium implants have been reported, ranging from improved methods to already established coating surfaces. The purpose of this review is to present the developed antimicrobial and antibiofilm coatings that may have the potential to reduce bacterial infections and improve the success rate of titanium dental implants. All referred coating surfaces showed high antimicrobial properties with effectiveness in biofilm control, while maintaining implant biocompatibility. We expect that by combining the use of oligonucleotide probes as a covering material with novel peri-implant adjuvant therapies, we will be able to avoid the downsides of other covering materials (such as antibiotic resistance), prevent bacterial infections, and raise the success rate of dental implants. The existing knowledge on the optimal coating material for dental implants is limited, and further research is needed before more definitive conclusions can be drawn.

The role of systemic diseases and local conditions as risk factors.

The role of systemic diseases and local conditions as risk factors.

APPLICATION OF SPECT EXAMINATION WITH 99MTC MDP IN DENTAL IMPLANTOLOGY

Treatment with intraosseous osteointegrable dental implants is a modern therapeutic method that achieves complete rehabilitation by fully restoring the patient's masticatory function and aesthetics. The success of their application is closely related to the process of osseointegration. Osteointegration is the process of bone formation between the alloplastic material and the surrounding biological environment. The quality and quantity of bone available is a major prognostic factor for the success of dental implants. Some authors evaluate metabolic activity of bone after placement of dental implants or bone grafts using conventional scintigraphy and singlephoton emission computed tomography (SPECT). The aim of the publication is to present the application of the SPECT study with 99mTc MDP in dental implantology.

A technique to verify implant abutment position intraorally by using a vacuum thermomolded guide

The precision of fit at the implant-abutment interface is an essential criterion for the long-term success of dental implants.1,2 Implant abutment systems are designed to accommodate definitive restorations in a single position.3 Therefore, accurate transfer and positioning of implant abutments intraorally from the definitive cast is crucial to avoid technical complications caused by a misfit between the prosthesis and the abutment.4 Although several methods have been reported in the literature for accurate positioning of the abutment,5-13 this article presents a straightforward technique that can assist the clinician in positioning and verifying the implant abutment orientation intraorally by using a vacuum thermomolded guide.

Evaluation of bone density by cone-beam computed tomography and its relationship with primary stability of dental implants

One of the critical factors determining the success of dental implants is primary stability. This study aimed to determine the density of jawbones in the implant candidate sites via cone-beam computed tomography (CBCT) and its correlation with the values obtained from resonance frequency analysis during surgery. In this descriptive-analytic study seventeen implant sites requiring implant placement were selected. Impressions were sent to the laboratory to construct a surgical guide via the stereolithographic method. An electronic surgery was performed on the chosen implant sites according to each patient's CBCT information entered into the Kaveh surgical guide software. The bone density of the target areas was calculated using the gray value (voxel value). After preparing the final osteotomy, an implant was installed in the area according to the manufacture's recommendation. The relevant Osstell® SmartPeg was selected and installed on the implant body to determine the primary stability. Kolmogorov-Smirnov test and the correlation pearson correlation statistical test. used for statistical analyze. P value amounts < 0.05 was considered significant. The mean and standard deviation of the gray scale in this study were 563.7 ± 218.8 and 65.3 ± 7.7 implant stability quotient (ISQ) respectively. The correlation between gray scale and ISQ was evaluated by the Pearson correlation test, and the results indicated a strong correlation between the two variables. The voxel value and primary stability had a normal distribution and strong correlation. In other words, the gray scale determined by CBCT imaging techniques at the proposed implant site could be used to assess the bone density before the surgery.

Implant Impression Techniques using Different Materials and Methods: A Review

Dental implants have emerged as the treatment of choice in for restoring missing teeth in situations that require functional and aesthetic replacements. Reproduction of the position and orientation of intraoral implants by means of an accurate impression in the definitive cast is the first step in achieving a passively fitting multi-implant supported prosthesis, to decrease the mechanical and biological complication of the prosthesis. The accuracy of the impression making procedure in the usage of osseointegrated implants used for the rehabilitation of fully and partially edentulous patients is a very important factor for the long-term success of dental implants. It has been reported that the precision of implant impressions is affected by various factors such as impression materials, impression technique, splinting of impression posts, impression level and depth, as well as the angle of the implants. Also, the incompatibility between implant and prosthesis, which may occur as a result of an incorrect impression, may cause problems such as screw loosening, screw fracture, loss of osseointegration and even implant fracture. Today, there are many articles and reviews about implant impressions. Although the authors found consistent results in many studies, there are differences of opinion on some issues. In general, polyether and additional type silicones were found to be successful in the conventional impression technique. Digital impression technique, on the other hand, has been found as successful as conventional measurement techniques in some studies. Controversial results have been obtained about the number of implants and their angulation. In general, the direct open tray splinted impression method is recommended for four or more implants, while there was no difference between the direct or indirect method for three or less implants.

Enhancement the Biological Behavior of Titanium Dental Implants by Laser Pulses Treatment

The long-term success of dental implants largely depends on rapid healing with safe integration into the jaw bone. Geometry and surface topography are crucial for the short and long-term success of dental implants. This work aim to enhancing clinical performance of titanium dental implants by laser Pulses treatment to provide bone in a faster and improved osseointegration process. The results show that using different manufacturing processes (machining and powder technology) produced topographical differences. The topographical change observed from powder technology method was more than the machined one. Also Strong titanium oxide layer was observed after laser pulsed resulted in improving surface roughness and topography and it was the method of choice for complex surface geometries providing energy focused on one spot especially in the inside of implant thread. The release of Ti ion rise in first three days and after that released of Ti ions begins to stabilize after laser treatment. Finally, the histological view of implant samples after 4weeks of implantation, showed active bone formation in all implant surface which give clear indication of tissue acceptance and the appearance of mature bone was observed after laser treatments at short implantation periods.

Impact of Drilling Speed in Implantology: A Review

Background: Drilling speed during osteotomy in implant site preparation is an important factor that affects heat generation, cell vitality and primary stability and consequently Osseointegration of the implant. A thorough understanding of this impact is important for taking suitable precautions for successful dental rehabilitation. Aim: The objective of this study is to review the available literature regarding the impact of drilling speed on heat generation and other related parameters that influence the success of dental implants. Material and Methods: Suitable research papers relevant for study were identified through electronic database of available dental literature in PubMed and MEDLINE for all articles published till February, 2021. Peer-reviewed dental and PubMed indexed journals were selected. Search was done using certain relevant key words and terms. Results: The initial search revealed a total of 281 articles which were then screened and a total of 61 articles were selected based on the inclusion criteria. Focus was laid on the studies related to drilling speed and its impact on osseointegration, heat generation during osteotomy, drilling speed and bone viability, drilling speed and primary stability of implant and particle size of the bone collected. Heat generation during implant placement is affected by multiple factors with drilling speed being one of them. Conclusion: Researchers have reached contradictory conclusions regarding the impact of drilling speed on heat generation during osteotomy and other parameters. However, studies in the recent past are favoring low speed drilling owing to the advantage of perfect control of the drilling depth and the possibility of collection of a considerable amount of viable granular bone grafts during the procedure.

Interaction of KRSR Peptide with Titanium Dioxide Anatase (100) Surface: A Molecular Dynamics Simulation Study.

Due to its tensile strength and excellent biocompatibility, titanium (Ti) is commonly used as an implant material in medicine and dentistry. The success of dental implants depends on the formation of a contact between the oxidized surface of Ti implant and the surrounding bone tissue. The adsorption of proteins and peptides to the implant surface allows the bone-forming osteoblast cells to adhere to such modified surfaces. Recently, it has been observed that tetrapeptide KRSR (Lys-Arg-Ser-Arg) functionalization could promote osteoblast adhesion to implant surfaces. This may facilitate the establishment of an efficient bone-to implant contact and improve implant stability during the healing process. GROMACS, a molecular dynamics software package was used to perform a 200 ns simulation of adsorption of the KRSR peptide to the TiO2 (anatase) surface in an aqueous environment. The molecule conformations were mapped with Replica Exchange Molecular Dynamics (REMD) simulations to assess the possible peptide conformations on the anatase surface, and the umbrella sampling method was used to calculate the binding energy of the most common conformation. The simulations have shown that the KRSR peptide migrates and attaches to the surface in a stable position. The dominant amino acid residue interacting with the TiO2 surface was the N-terminal charged lysine (K) residue. REMD indicated that there is a distinct conformation that is taken by the KRSR peptide. In this conformation the surface interacts only with the lysine residue while the ser (S) and arg (R) residues interact with water molecules farther from the surface. The binding free energy of the most common conformation of KRSR peptide to the anatase (100) surface was ΔG = −8.817 kcal/mol. Our result suggests that the N-terminal lysine residue plays an important role in the adhesion of KRSR to the TiO2 surface and may influence the osseointegration of dental implants.

Success of dental implants in patients with large bone defect and analysis of risk factors for implant failure: a non-randomized retrospective cohort study.

This study aimed to retrospectively investigate the success and survival rates of dental implants used for dentomaxillary prostheses at our hospital and the risk factors associated with large bone defects. A total of 138 external joint system implants used for dentomaxillary prostheses in 40 patients with large bone defects were included in this study. The alveolar bone at the site of implant insertion was evaluated using panoramic radiography and computed tomography. Various risk factors (demographic characteristics, dental status, and operative factors such as the employment of alveolar bone augmentation, the site, the length, and diameter of implants) for implant failure and complete implant loss were investigated using univariate and multivariate analyses. The associations between the variables and the success and survival rates of dental implants were analyzed using the multivariate Cox proportional hazard models. The 10-year overall success and survival rates were 81.3% and 88.4% in this study. Multivariable analysis showed that the male sex (HR 6.22), shorter implants (≤ 8.5mm) (HR 5.21), and bone augmentation (HR 2.58) were independent predictors of success rate. Bone augmentation (HR 5.14) and narrow implants (≤ 3.3mm) (HR 3.86) were independent predictors of the survival rate. Male sex, shorter or narrow implants, and bone augmentation were independent risk factors for dental implants used in dentomaxillary prostheses in patients with large bone defects. Clinicians should consider these risk factors and pay close attention to the management of these patients.

Carbon Nanomaterials Modified Biomimetic Dental Implants for Diabetic Patients.

Dental implants are used broadly in dental clinics as the most natural-looking restoration option for replacing missing or highly diseased teeth. However, dental implant failure is a crucial issue for diabetic patients in need of dentition restoration, particularly when a lack of osseointegration and immunoregulatory incompetency occur during the healing phase, resulting in infection and fibrous encapsulation. Bio-inspired or biomimetic materials, which can mimic the characteristics of natural elements, are being investigated for use in the implant industry. This review discusses different biomimetic dental implants in terms of structural changes that enable antibacterial properties, drug delivery, immunomodulation, and osseointegration. We subsequently summarize the modification of dental implants for diabetes patients utilizing carbon nanomaterials, which have been recently found to improve the characteristics of biomimetic dental implants, including through antibacterial and anti-inflammatory capabilities, and by offering drug delivery properties that are essential for the success of dental implants.

How to design a more stable dental implant: A topology optimization approach.

The body shape design is one of the most influential factors in the success of dental implants. This study presents a strategy to design the geometrical features of a threaded implant. The topology optimization technique is applied to identify appropriate spaces in the implant body to be removed for bone growth. The exact shape, position, and dimensions of the spaces are determined using a finite element model. This model consists of a mandibular segment, implant, abutment, and crown. During the optimization process, some grooves and holes are created in the implant by removing redundant materials. Bone growth into these spaces causes mechanical locking between the implant and surrounding bone. The smoothing process is performed following the optimization to remove stress concentration. The results indicate that this design strategy reduces the maximum displacement of the implant by approximately 20%. Moreover, a reduction in the implant's volume and an increase in the contact area between the implant and bone are obtained. All mentioned issues would increase the stability and reduce the risk of implant loosening. Finally, using conventional production methods, the optimal implant was produced from titanium alloy to demonstrate the possibility of production of the proposed design.