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Medicina
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Osseointegration and Dental Implants: An Update
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Osseointegration and Dental Implants: An Update

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry and Oral Health".

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 14654

Special Issue Editor

Dr. Gaia Pellegrini

E-Mail Website
Guest Editor
Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
Interests: wound healing; histology; biomarkers; bone; gingiva; biomaterial; periodontal disease; tissue engineering
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The clinical success of implant-supported prosthetic rehabilitation is strictly related to a firm bone–implant connection. Several factors may affect these clinical and histological outcomes. During the treatment plan, systemic and local conditions of the patient and surgical technique, as well as the anatomy of the host bed, implant design, implant surface characteristics and biological features of bone-substituted materials, need to be carefully considered by the clinician for the achievement of osseointegration. Furthermore, even after rehabilitation, oral hygiene and loading conditions need to be constantly controlled for the maintenance of the bone–implant interface. In the panorama of dental research, the study of factors that accelerate and increase the predictability of achieving osseointegration still remains an important topic. Both the technological progress and the knowledge acquired in the biomedical field have allowed for an even more personalized approach of the implant treatment also with the introduction of customized solutions.

This Special Issue of Medicina, entitled “Osseointegration and Dental Implants: An Update”, welcomes submissions of original articles, systematic reviews, meta-analyses, and overviews that investigate biological aspects of osseointegration, as well as clinical procedures and innovative biotechnological solutions developed to enhance osteogenic responses of bone tissue to the implant surface.

Dr. Gaia Pellegrini
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • osseointegration
  • bone-implant interface
  • dental implants
  • surface properties
  • biomaterials
  • biomedical devices

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Published Papers (6 papers)

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12 pages, 3713 KiB  
Article
Quantitative Evaluation of Inflammatory Markers in Peri-Implantitis and Periodontitis Tissues: Digital vs. Manual Analysis—A Proof of Concept Study
by Dolaji Henin, Luiz Guilherme Fiorin, Daniela Carmagnola, Gaia Pellegrini, Marilisa Toma, Aurora Cristofalo and Claudia Dellavia
Medicina 2022, 58(7), 867; https://doi.org/10.3390/medicina58070867 - 29 Jun 2022
Cited by 1 | Viewed by 2334
Abstract
Background and Objectives: In dentistry, the assessment of the histomorphometric features of periodontal (PD) and peri-implant (PI) lesions is important to evaluate their underlying pathogenic mechanism. The present study aimed to compare manual and digital methods of analysis in the evaluation of [...] Read more.
Background and Objectives: In dentistry, the assessment of the histomorphometric features of periodontal (PD) and peri-implant (PI) lesions is important to evaluate their underlying pathogenic mechanism. The present study aimed to compare manual and digital methods of analysis in the evaluation of the inflammatory biomarkers in PI and PD lesions. Materials and Methods: PD and PI inflamed soft tissues were excised and processed for histological and immunohistochemical analyses for CD3+, CD4+, CD8+, CD15+, CD20+, CD68+, and CD138+. The obtained slides were acquired using a digital scanner. For each marker, 4 pictures per sample were extracted and the area fraction of the stained tissue was computed both manually using a 594-point counting grid (MC) and digitally using a dedicated image analysis software (DC). To assess the concordance between MC and DC, two blinded observers analysed a total of 200 pictures either with good quality of staining or with non-specific background noise. The inter and intraobserver concordance was evaluated using the intraclass coefficient and the agreement between MC and DC was assessed using the Bland–Altman plot. The time spent analysing each picture using the two methodologies by both observers was recorded. Further, the amount of each marker was compared between PI and PD with both methodologies. Results: The inter- and intraobserver concordance was excellent, except for images with background noise analysed using DC. MC and DC showed a satisfying concordance. DC was performed in half the time compared to MC. The morphological analysis showed a larger inflammatory infiltrate in PI than PD lesions. The comparison between PI and PD showed differences for CD68+ and CD138+ expression. Conclusions: DC could be used as a reliable and time-saving procedure for the immunohistochemical analysis of PD and PI soft tissues. When non-specific background noise is present, the experience of the pathologist may be still required. Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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14 pages, 3640 KiB  
Article
Periodontal Pathogen Adhesion, Cytotoxicity, and Surface Free Energy of Different Materials for an Implant Prosthesis Screw Access Hole
by Hsin-Ying Lu, Jason Hou, Yuta Takahashi, Yukihiko Tamura, Shohei Kasugai, Shinji Kuroda and Hidemi Nakata
Medicina 2022, 58(2), 329; https://doi.org/10.3390/medicina58020329 - 21 Feb 2022
Cited by 2 | Viewed by 2437 | Correction
Abstract
Background and Objectives: Oral implant restorations are an excellent treatment option for edentulous patients; however, periodontopathogenic bacteria have been found in the microgaps between implant−abutment junctions. Implant designs to limit the microgaps have been extensively studied. However, studies have shown microgaps continue [...] Read more.
Background and Objectives: Oral implant restorations are an excellent treatment option for edentulous patients; however, periodontopathogenic bacteria have been found in the microgaps between implant−abutment junctions. Implant designs to limit the microgaps have been extensively studied. However, studies have shown microgaps continue to exist, allowing for the leakage of bacteria into the implant system. Screw access hole materials are used to fill the access hole void. The use of materials with beneficial properties could provide bacterial leakage prevention. The aim of this study was to examine the surface free energy, cytotoxicity, and bacterial adhesion of selected screw access hole materials such as cotton, polytetrafluoroethylene (PTFE) tape, paraffin wax−polyolefin thermoplastic (PF), paraffin wax (Wax), gutta-percha (GP), and caviton EX (CE). Materials and Methods: A sessile drop test was performed to observe the contact angle and calculate the surface free energy of each material in order to determine the level of hydrophobicity. Cytotoxicity was examined in a mouse gingival epithelial cell line for day 1 and day 3. Bacterial adhesion was tested with Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans. Results: PTFE, PF, and wax presented low surface free energies of 19.34, 23.041, and 24.883 mN.m-1, respectively. No cytotoxicity was observed, except for GP and CE. Concurrently, the bacterial adhesion was also the lowest in PTFE and PF. Conclusions: Within the limits of this study, PTFE and PF showed an excellent biocompatibility with few bacterial adhesions. These materials could be potential screw access hole materials in clinical settings. Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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17 pages, 5554 KiB  
Article
Understanding the Role of Surface Modification of Randomized Trabecular Titanium Structures in Bone Tissue Regeneration: An Experimental Study
by Elena Canciani, Vincenza Ragone, Carlo Alberto Biffi, Fabrizio Valenza, Riccardo D’Ambrosi, Matteo Olimpo, Aurora Cristofalo, Emanuela Galliera and Claudia Dellavia
Medicina 2022, 58(2), 315; https://doi.org/10.3390/medicina58020315 - 18 Feb 2022
Cited by 4 | Viewed by 2259
Abstract
Background and Objectives: Three-dimensional (3D) metallic trabecular structures made by additive manufacturing (AM) technologies promote new bone formation and osteointegration. Surface modifications by chemical treatments can improve the osteoconductive properties of metallic structures. An in vivo study in sheep was conducted to assess [...] Read more.
Background and Objectives: Three-dimensional (3D) metallic trabecular structures made by additive manufacturing (AM) technologies promote new bone formation and osteointegration. Surface modifications by chemical treatments can improve the osteoconductive properties of metallic structures. An in vivo study in sheep was conducted to assess the bone response to randomized trabecular titanium structures that underwent a surface modification by chemical treatment compared to the bone response to the untreated specimens. Material and Methods: Sixteen specimens with a randomized trabecular titanium structure were implanted in the spongious bone of the distal femur and proximal tibia and the cortical bone of the tibial diaphysis of two sheep. Of them, eight implants had undergone a chemical treatment (treated) and were compared to eight implants with the same structure but native surfaces (native). The sheep were sacrificed at 6 weeks. Surface features of the lattice structures (native and treated) were analyzed using a 3D non-contact profilometer. Compression tests of 18 lattice cubes were performed to investigate the mechanical properties of the two structures. Excellent biocompatibility for the trabecular structures was demonstrated in vitro using a cell mouse fibroblast culture. Histomorphometric analysis was performed to evaluate bone implant contact and bone ingrowth. Results: A compression test of lattice cubic specimens revealed a comparable maximum compressive strength value between the two tested groups (5099 N for native surfaces; 5558 N for treated surfaces; p > 0.05). Compared to native surfaces, a homogenous formation of micropores was observed on the surface of most trabeculae that increased the surface roughness of the treated specimens (4.3 versus 3.2 µm). The cellular viability of cells seeded on three-dimensional structure surfaces increased over time compared to that on plastic surfaces. The histomorphometric data revealed a similar behavior and response in spongious and cortical bone formation. The percentage of the implant surface in direct contact with the regenerated bone matrix (BIC) was not significantly different between the two groups either in the spongious bone (BIC: 27% for treated specimens versus 30% for native samples) or in the cortical bone (BIC: 75% for treated specimens versus 77% for native samples). Conclusions: The results of this study reveal rapid osseointegration and excellent biocompatibility for the trabecular structure regardless of surface treatment using AM technologies. The application of implant surfaces can be optimized to achieve a strong press-fit and stability, overcoming the demand for additional chemical surface treatments. Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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10 pages, 2936 KiB  
Article
A Six-Year Prospective Comparative Study of Wide and Standard Diameter Implants in the Maxillary and Mandibular Posterior Area
by Puneet Wadhwa, Seung-Kook Kim, Hyun-Jin Kim, Ho-Kyung Lim, Qi Jia, Heng-Bo Jiang and Eui-Seok Lee
Medicina 2021, 57(10), 1009; https://doi.org/10.3390/medicina57101009 - 25 Sep 2021
Cited by 5 | Viewed by 2385
Abstract
Background and Objectives: The aim of our study was to test whether wide diameter (6 mm) implants perform differently from standard diameter (4 mm) implants in terms of marginal bone level and survival rate. Materials and Methods: Our sample comprised 72 [...] Read more.
Background and Objectives: The aim of our study was to test whether wide diameter (6 mm) implants perform differently from standard diameter (4 mm) implants in terms of marginal bone level and survival rate. Materials and Methods: Our sample comprised 72 patients who underwent surgery; a total of 80 implants were placed in the maxillary or mandibular molar region. Patients were divided into two groups according to the diameter of the implant, and were followed up for six years after the final setting of the prosthetics. In the test group, 40 implants with 6-mm diameter were inserted; in the control group, 40 standard diameter implants were inserted. Using panoramic radiographs, we investigated mesial and distal marginal bone levels around the implant fixtures. Results: After the first implant surgery, three implants, including one wide diameter and two standard diameter implants, failed due to lack of osseointegration. We did not note any fixture fracture during the six-year follow-up. After loading, we observed a six-year survival rate of 97.29% with no statistically significant difference from standard diameter implants, with a survival rate of 94.87%. Conclusions: This study shows that 6-mm diameter implants may be considered in the presence of adequate alveolar ridge width in the posterior maxillary and mandibular regions. Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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3 pages, 1026 KiB  
Correction
Correction: Lu et al. Periodontal Pathogen Adhesion, Cytotoxicity, and Surface Free Energy of Different Materials for an Implant Prosthesis Screw Access Hole. Medicina 2022, 58, 329
by Hsin-Ying Lu, Jason Hou, Yuta Takahashi, Yukihiko Tamura, Shohei Kasugai, Shinji Kuroda and Hidemi Nakata
Medicina 2022, 58(10), 1413; https://doi.org/10.3390/medicina58101413 - 9 Oct 2022
Viewed by 1233
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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13 pages, 603 KiB  
Systematic Review
A Systematic Analysis of the Available Human Clinical Studies of Dental Implant Failure in Patients with Inflammatory Bowel Disease
by Andrada Voina-Tonea, Anca Labunet, Adriana Objelean, Florin Onisor, Simion Bran, Alexandru Mester, Andra Piciu and Sorina Sava
Medicina 2022, 58(3), 343; https://doi.org/10.3390/medicina58030343 - 24 Feb 2022
Cited by 3 | Viewed by 2952
Abstract
Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn’s disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic [...] Read more.
Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn’s disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn’s disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn’s disease may determine early and late implant failure. Besides Crohn’s disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy. Full article
(This article belongs to the Special Issue Osseointegration and Dental Implants: An Update)
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