Publications by authors named "Daniel Wismeijer"

122 Publications

A Randomized Clinical Trial comparing the clinical fit of CAD/CAM monolithic zirconia Fixed Dental Prostheses (FDP) on ti-base abutments based on digital or conventional impression techniques. One year follow-up.

Int J Prosthodont 2021 Mar 3. Epub 2021 Mar 3.

Purpose: To compare the fit and clinical performance of screw-retained monolithic zirconia implant fixed dental prostheses (FDPs) based on either intraoral optical scanning (IOS) or conventional impressions.

Materials And Methods: Patients with two posterior tissue-level implants (Straumann Regular Neck) replacing two or three adjacent teeth were recruited. Impressions were taken with both IOS (True Definition Scanner, 3M ESPE) and a conventional (polyether) pick-up impression. Double-blind randomization was performed after impression-taking, and patients were to receive an FDP based on either the digital or the conventional impression. The fit was evaluated, and the time required for adjustments was recorded. Additionally, survival and technical complication rates with a follow-up of 1 year were documented.

Results: A total of 38 patients requiring 45 FDPs were included: 24 FDPs in the test (IOS) and 21 in the control (conventional) group. The average adjustment time was 6.92 minutes (SD: ± 10.84, range: 0 to 49 minutes) for digital vs 12.38 minutes (SD: ± 14.52, range: 0 to 54 minutes) for conventional impressions (P = .090). A proper fit (no adjustments) was achieved in 33.3% of the digital and 28.6% of the conventional group. Forty-two FDPs could be placed within the two planned appointments, and 3 FDPs exhibited an unacceptable fit and required an extra appointment. Eight technical complications occurred during the first year of function. The overall restoration survival rate was 100%.

Conclusion: The clinical fit of CAD/CAM FDPs based on digital impressions is comparable to conventional impressions. Screw-retained monolithic zirconia FDPs on Ti-base abutments show low major complication and survival rates in the short term.
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http://dx.doi.org/10.11607/ijp.7074DOI Listing
March 2021

A review of virtual planning software for guided implant surgery - data import and visualization, drill guide design and manufacturing.

BMC Oral Health 2020 09 10;20(1):251. Epub 2020 Sep 10.

Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.

Background: Virtual implant planning systems integrate (cone beam-) computed tomography data to assess bone quantity and virtual models for the design of the implant-retained prosthesis and drill guides. Five commercially available systems for virtual implant planning were examined regarding the modalities of integration of radiographic data, virtual dental models and the design of drill guides for guided implant surgery. The purpose of this review was to describe the limitations of these available systems regarding the import of imaging data and the design and fabrication of a drill guide.

Methods: The following software systems were examined regarding the import of imaging data and the export of the virtual implant planning for the design and fabrication of a drill guide with the help of two clinical situations requiring dental implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria included data formats and management as well as the workflow for the design and production of drill guides.

Results: All systems have a DICOM-interface ("Digital Imaging and Communication in Medicine") for the import of radiographic data. Imaging artefacts could be reduced but not eliminated by manual data processing. The import of virtual dental models in a universal format (STL: Standard Tesselation Language) was possible with three systems; one system could only be used with a proprietary data format. All systems display three-dimensional surface models or two-dimensional cross-sections with varying orientation for virtual implant planning. Computer aided design and manufacturing (CAD/CAM) of drill guides may be performed by the user with the help of default parameters or solely by the provider of the software and thus without the influence of the clinician.

Conclusion: Data bases of commonly used implant systems are available in all tested software, however not all systems allow to plan and execute fully guided implant placement. An individual design and in-house manufacturing of the drill guide is only available in some software systems. However, at the time of publication most recent software versions showed flexibility in individual design and in-house manufacturing of drill guides.
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http://dx.doi.org/10.1186/s12903-020-01208-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488021PMC
September 2020

Surgical treatment of peri-implantitis defects with two different xenograft granules: A randomized clinical pilot study.

Clin Oral Implants Res 2020 Nov 9;31(11):1047-1060. Epub 2020 Sep 9.

Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.

Objectives: To investigate whether xenograft EB (EndoBon) is non-inferior to xenograft BO (Bio-Oss) when used in reconstructive surgery of peri-implant osseous defects.

Materials And Methods: Dental patients with one implant each demonstrating peri-implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post-treatment.

Results: Twenty-four patients (n = 11 BO, n = 13 EB) completed the study. Both groups demonstrated significant within-group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5-3.0 mm on average. The inter-group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test, p = .199).

Conclusions: Within the limitations of this pilot study, the application of xenograft EB showed to be non-inferior to xenograft BO when used in reconstructive surgery of peri-implant osseous defects.
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http://dx.doi.org/10.1111/clr.13651DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693249PMC
November 2020

Associations between sleep bruxism and (peri-)implant complications: lessons learned from a clinical study.

BDJ Open 2020 30;6. Epub 2020 Jan 30.

Department of Orofacial Pain & Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Objective: To report and discuss the lessons learned from the conduct of a clinical study on the associations between sleep bruxism and (peri-)implant complications, the protocol of which has been pre-published.

Materials And Methods: A single-center, double-blind, prospective cohort study with a 2 year follow-up was performed in the Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. Eleven adult participants were included, where an inclusion of 98 was planned. Sleep bruxism was assessed by multiple single-channel electromyographic (EMG) recordings. Main outcomes were biological and technical complications. Results of the study are presented alongside with comments on encountered difficulties.

Results: Insufficient participant recruitment and failed EMG recordings were encountered. The small sample size did not allow answering the study's main aim, and was mainly attributed to the study's protocol complexity. EMG recording failures were attributed to insufficient quality of the EMG signal and detachments of the electrode.

Discussion: The lessons learned from the conduct of this study can be used to design successful future clinical studies.

Conclusions: Adequate participant recruitment, effective EMG recordings, and a careful selection of predictor variables are important ingredients for the successful conduct of a longitudinal clinical study on the association between sleep bruxism and (peri-)implant complications.
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http://dx.doi.org/10.1038/s41405-020-0028-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299950PMC
January 2020

Burst, Short, and Sustained Vitamin D Applications Differentially Affect Osteogenic Differentiation of Human Adipose Stem Cells.

Int J Mol Sci 2020 Apr 30;21(9). Epub 2020 Apr 30.

Department of Oral Cell Biology, Academic Centre For Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands.

Incorporation of 1,25(OH) vitamin D (vitD) into tissue-engineered scaffolds could aid the healing of critical-sized bone defects. We hypothesize that shorter applications of vitD lead to more osteogenic differentiation of mesenchymal stem cells (MSCs) than a sustained application. To test this, release from a scaffold was mimicked by exposing MSCs to exactly controlled vitD regimens. Human adipose stem cells (hASCs) were seeded onto calcium phosphate particles, cultured for 20 days, and treated with 124 ng vitD, either provided during 30 min before seeding ([200 nM]), during the first two days ([100 nM]), or during 20 days ([10 nM]). Alternatively, hASCs were treated for two days with 6.2 ng vitD ([10 nM]). hASCs attached to the calcium phosphate particles and were viable (~75%). Cell number was not affected by the various vitD applications. VitD (124 ng) applied over 20 days increased cellular alkaline phosphatase activity at Days 7 and 20, reduced expression of the early osteogenic marker at Day 20, and strongly upregulated expression of the vitD inactivating enzyme . VitD (124 ng) also reduced and increased applied at [100 nM] for two days, but not at [200 nM] for 30 min. These results show that 20-day application of vitD has more effect on hASCs than the same total amount applied in a shorter time span.
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http://dx.doi.org/10.3390/ijms21093202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247321PMC
April 2020

Adjunctive effect of mouthrinse on treatment of peri-implant mucositis using mechanical debridement: A randomized clinical trial.

J Clin Periodontol 2020 07 27;47(7):883-891. Epub 2020 May 27.

Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Aim: To study effect of delmopinol hydrochloride (DEL) in comparison with chlorhexidine digluconate (CHX) and a placebo (PLA) in addition to non-surgical mechanical debridement in patients with peri-implant mucositis.

Materials And Methods: Eighty-nine patients with at least one implant diagnosed with peri-implant mucositis were randomly assigned to one of three study groups (DEL, CHX and PLA). Professional non-surgical mechanical debridement was performed at baseline. Mouth rinsing was carried out by the patients twice a day in addition to their regular oral hygiene practices. Assessments of efficacy were performed for the primary outcome - Implant bleeding on probing (IBOP%) and secondary outcomes - modified Bleeding Index (mBI) and modified Plaque Index (mPI) at 1 and 3 months.

Results: At 3 months, there was statistically significant reduction in IBOP% and mBI within the study groups compared to baseline. However, there was no statistically significant difference between the study groups at 3 months follow-up. Moreover, there was a statistically significant difference according to mPI at 1 month between the chlorhexidine and placebo group (p = .004).

Conclusions: This study confirms that mechanical debridement combined with oral hygiene instruction is effective in treatment of peri-implant mucositis. The clinical effects between groups were comparable.
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http://dx.doi.org/10.1111/jcpe.13295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317778PMC
July 2020

Virtual implant planning and fully guided implant surgery using magnetic resonance imaging-Proof of principle.

Clin Oral Implants Res 2020 Jun 12;31(6):575-583. Epub 2020 Mar 12.

Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Translational Implantology, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.

Objectives: To present a workflow of virtual implant planning and guided implant surgery with magnetic resonance imaging (MRI) and virtual dental models without the use of ionizing radiation.

Methods: Five patients scheduled for implant placement underwent an MR examination at three Tesla using individualized 2D and 3D turbo spin-echo (TSE) sequences and dedicated head coils. The MRI data and virtual dental models derived from either optical model scans or intraoral scans were imported to a virtual implant planning software (coDiagnostiX, Dental Wings, Montreal, Canada). Virtual prosthetic planning and implant planning were performed regarding the hard and soft tissue anatomy. A drill guide was designed on the virtual dental model using computer-aided design (CAD) and manufactured in-house, using a 3D printer (Eden 260V, Stratasys, Eden Prairie, MN, USA).

Results: The MRI displayed all relevant anatomical structures for dental implant planning such as cortical and cancellous bone, floor of the nasal and maxillary sinus, inferior alveolar nerve and neighboring teeth. The manual alignment of virtual dental models with the MRI was possible using anatomical landmarks. Dental implant planning, CAD/CAM of a drill guide and fully guided implant placement were successfully performed.

Conclusions: Guided implant surgery is feasible with MRI without ionizing radiation. Further studies will have to be conducted to study the accuracy of the presented protocol and compare it to the current workflow of guided surgery using CBCT.
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http://dx.doi.org/10.1111/clr.13592DOI Listing
June 2020

Clinical and esthetic outcomes of two different prosthetic workflows for implant-supported all-ceramic single crowns-3 year results of a randomized multicenter clinical trail.

Clin Oral Implants Res 2020 May 25;31(5):495-505. Epub 2020 Feb 25.

Department of Oral Implantology and Prosthetic Dentistry, ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands.

Objective: The aim of this randomized multicenter clinical trial was to evaluate and compare the performance of anterior all-ceramic implant crowns based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with the hand build-up technique. The null hypothesis was that there is no statistically significant difference between the two study groups.

Material And Methods: Forty implants were inserted in sites 14-24 (World Dental Federation [FDI]) in two centers, the Universities of Bern and Geneva, Switzerland. Twenty patients each were randomized into either Group A and restored with one-piece single crown made of a prefabricated zirconia abutment with pressed ceramic, or Group B using an individualized CAD/CAM zirconia abutment with the hand-layered technique. After 3 years, clinical, esthetic, and radiographic parameters were assessed.

Results: Group A exhibited one dropout patient and one failure resulting in a survival rate of 89% after 3 years and two failures for Group B (90%). Clinical parameters presented healthy peri-implant soft tissues. Overall, no crestal bone level changes were observed (mean DIB of 0.13 mm [Group A] and 0.24 mm [Group B]). There were no significant differences at baseline, 6 months, and 1 and 3 years for DIB values between the two groups. PES and WES values evaluated at all three time points indicated stability over time for both groups and pleasing esthetic outcomes.

Conclusions: Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of implant crowns in the anterior maxilla.
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http://dx.doi.org/10.1111/clr.13586DOI Listing
May 2020

A histomorphometric study on treated and untreated ceramic filled PEEK implants versus titanium implants: Preclinical in vivo study.

Clin Oral Implants Res 2020 Mar 19;31(3):246-254. Epub 2019 Dec 19.

Department of Prosthodontics, Faculty of Dentistry, Cairo University, Giza, Egypt.

Objectives: To investigate the osseo-integrative behavior of untreated (UCFP) and sandblasted ceramic filled PEEK (SCFP) implants in comparison with titanium implants through measurement of bone implant contact (BIC) and bone density (BD).

Materials And Methods: Nine implants from each type were inserted into 9 dogs in which every experimental dog received the three different implants in the lower border of the mandible. The animals were euthanized after 3 months and extracting bone blocks containing implants followed by blocks preparation for histological examinations.

Results: BIC and BD were significantly higher in titanium and SCFP compared with UCFP group (p = .007) and (p = .012), respectively. Aluminum blasting increased the bone ingrowth and bone implant contact when compared to machined surfaces of untreated PEEK implants.

Conclusion: In conclusion, sandblasting with 110 µm aluminum oxide particles can be proposed as a suitable surface treatment that enhances hydrophilicity of CFP. Further in vivo animal studies are still needed to confirm the findings of this study.
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http://dx.doi.org/10.1111/clr.13562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162379PMC
March 2020

A Human Clinical and Histomorphometrical Study on Different Resorbable and Non-Resorbable Bone Substitutes Used in Post-Extractive Sites. Preliminary Results.

Materials (Basel) 2019 Jul 28;12(15). Epub 2019 Jul 28.

Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.

Background: The healing of sockets following teeth extraction results in a marked reduction of the height and width of the ridge. This in vivo study aims to assess and compare the efficacy of calcium sulphate (CS) and sintered nano-hydroxyapatite (NHA) in postextraction sockets.

Materials And Methods: 10 subjects were enrolled for single or multiple tooth extraction and implant placement. Each site was randomly assigned to one of four groups and filled with CS, NHA, a combination of CS and NHA, or left to normal healing. After five months tissue samples were harvested from the extraction sites and prepared for histological investigations.

Results: Histomorphometric analysis showed that the average percentages of vital bone was 13.56% ± 13.08% for CS, 17.84% ± 7.32% for NHA, 58.72% ± 8.77% for CS + NHA%, and 80.68% ± 21.8% for the controls; for the connective tissue the results were 33.25% ± 35.75% for CS, 55.88% ± 21.86% for NHA, 17.34% ± 8.51% for CS + NHA, and 22.62% ± 0.52% for the controls; for residual biomaterial the results were 0.56% ± 0.52% for CS group, 21.97% ± 0.79% for NHA, and 47.54% ± 20.13% for CS + NHA. : Both biomaterials led to bone tissue formation after five months of healing. The combination of the biomaterials presented a better behavior when compared to the individual application.
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http://dx.doi.org/10.3390/ma12152408DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695925PMC
July 2019

The accuracy of computer-guided implant surgery with tooth-supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study.

Clin Oral Implants Res 2019 Oct 9;30(10):1005-1015. Epub 2019 Sep 9.

Section of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Objectives: The purpose of this prospective cohort study was to evaluate computer-guided implant surgery with tooth-supported drill guides based on CBCT scans and intraoral scanning.

Materials And Methods: For partially edentulous patients, a prosthetic and surgical planning was completed in the guided surgery software (coDiagnostiX) and drill guides were 3D-printed accordingly. Three months after implant placement, an intraoral scan of the implant's position was used to evaluate the accuracy of placement using the coDiagnostiX treatment evaluation tool. Deviations were reported in degrees and in distance at implant's entry point and apex. Several risk factors, which might influence the accuracy, were evaluated separately: treated jaw, flap design, prior augmentations, amount of unrestored teeth, crowding, location of implants, cortical interference, and implant's length and diameter.

Results: A total of 66 patients received 145 Straumann tissue level implants that were eligible for accuracy analysis. The mean angular deviation was 2.72° ± 1.42. The mean three-dimensional deviation at the implant's entry point was 0.75 mm ± 0.34. At implant's apex, the mean was 1.06 mm ± 0.44. The amount of unrestored teeth (p = .002 & p = .003), the implant's location (p < .001), the implant's length (p = .004), and cortical interference (p = .033) had a significant influence on the accuracy of placement. Implant survival was 99.3% (n = 1 failed implant) at 12 and 24 months.

Conclusions: Guided surgery with tooth-supported drill guides made in a digital workflow is a feasible treatment option. However, deviations do occur and the implant's length, location, cortical interference and the amount of unrestored teeth have a significant influence on the accuracy.
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http://dx.doi.org/10.1111/clr.13514DOI Listing
October 2019

Comparison of Proliferation and Differentiation of Human Osteoblast-like Cells Harvested During Implant Osteotomy Preparation Using Two Different Drilling Protocols.

Int J Oral Maxillofac Implants 2020 January/February;35(1):141–149. Epub 2019 Jun 1.

Purpose: Autogenous bone grafts are considered a "gold standard." The success of autografts mainly depends on their ability to promote an osteogenic response. The aim of this study was to collect autogenous bone during implant osteotomy preparation using two different drilling protocols and to evaluate and compare the proliferation and differentiation ability of the collected bone particles.

Materials And Methods: Autogenous bone particles were harvested from 20 patients during implant osteotomy preparation using two different drilling protocols: (1) standard drilling protocol with saline irrigation (according to the manufacturer's recommendation) and (2) low-speed drilling protocol without saline irrigation (speed < 200 rpm). Bone samples collected were cultured in growth medium, and after 2 to 3 weeks, cells that grew out from bone grafts were cultured in the normal medium as well as in osteogenic medium for days 0, 4, 7, and 20. Scanning electron microscopy, alizarin red/toluidine blue staining, DNA, ALP, and calcium content measurements were performed. Repeated measures analysis of variance (ANOVA) with Bonferroni's test was employed to analyze the data of this study.

Results: The total DNA content was significantly higher for the low-speed drilling samples compared with the standard drilling on day 4 (P < .05), day 7 (P < .01), and day 20 (P < .001) in the normal medium and on day 7 (P < .01) and day 20 (P < .01) in the osteogenic medium. Besides, calcium measurements and mineralized matrix formation observed with alizarin red/toluidine blue staining were significantly higher for the low-speed drilling group compared with the standard drilling group.

Conclusion: Osteogenic efficacy (differentiation and proliferation) of autogenous bone particles collected using low-speed drilling was superior compared with standard drilling samples.
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http://dx.doi.org/10.11607/jomi.7648DOI Listing
January 2020

A dual functional bone-defect-filling material with sequential antibacterial and osteoinductive properties for infected bone defect repair.

J Biomed Mater Res A 2019 10 17;107(10):2360-2370. Epub 2019 Jun 17.

Department of Oral Implantology and Prosthetic Dentistry, Academic Centre of Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, The Netherlands.

Infected bone defect healing is hindered by infection and compromised bone regenerative capacity. In this study, we designed a dual functional bone-defect-filling material with a sequential release system, that is, a burst release of a potent antibacterial agent, hydroxypropyltrimethyl ammonium chloride chitosan (HACC), followed by a controlled release of osteoinductive bone morphogenic protein (BMP2) to repair the infected bone defect. Minimum bactericidal concentration (MBC) of HACC against methicillin-resistant Staphylococcus aureus was 40 μg/mL. HACC at 40 μg/mL did not affect preosteoblast proliferation and did not influence the BMP2-induced alkaline phosphatase activity, osteocalcin expression, and matrix mineralization. in vitro release profile revealed burst release of HACC followed by a slow release of BMP2. in vivo bone formation was observed only in the BMP2-containing groups. HACC did not influence of biomimetic calcium phosphate (BioCaP) resorption and BMP2-induced bone formation. In conclusion, the optimized HACC/BMP2-incorporated BioCaP complex showed strong antibacterial effect and robustly enhanced osteoinduction both in vitro and in vivo.
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http://dx.doi.org/10.1002/jbm.a.36744DOI Listing
October 2019

Influence of the fixed implant-supported provisional phase on the esthetic final outcome of implant-supported crowns: 3-year results of a randomized controlled clinical trial.

Clin Implant Dent Relat Res 2019 Aug 7;21(4):649-655. Epub 2019 Jun 7.

Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Objectives: The aim of this investigation was to evaluate whether the use of a provisional implant-supported crown improves the final esthetic outcome of implant crowns that are placed within esthetic sites.

Materials And Methods: Twenty endosseous implants were inserted in sites 13 to 23 (FDI) in 20 patients. Following the reopening procedure, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the "dynamic compression technique" or cohort group 2: without a provisional phase. Screw-retained all ceramic crowns were inserted. Clinical follow-up appointments were completed at 36 months evaluating clinical, radiographic outcomes, and implant success and survival.

Results: After 3 years, all implants survived; one implant-supported crown was excluded from the study due to adjacent tooth failure replaced with a further implant supported crown. Modified pink esthetic score (ModPES) scores were significantly different between groups 1 and 2 (P = .018); white esthetic scores (WES) were not statistically different between both groups (P = .194). Mean values of combined modPES and WES were 15.6 for group 1, with a SD of 3.20. Group 2 had a mean combined modPES and WES of 12.2, with a SD of 3.86. Mean bone loss after 3 year was -0.05 and -0.04 mm for groups 1 and 2 respectively, without being statistically significant.

Conclusion: Fixed implant-supported provisionals improve the final esthetic outcome of the peri-implant mucosa.
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http://dx.doi.org/10.1111/cid.12796DOI Listing
August 2019

Blockade of Cyclophilin D Attenuates Oxidative Stress-Induced Cell Death in Human Dental Pulp Cells.

Oxid Med Cell Longev 2019 4;2019:1729013. Epub 2019 Apr 4.

Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.

Pathological stimuli, such as bacterial activity, dental bleaching, and nonpolymerized resin monomers, can cause death of dental pulp cells (DPCs) through oxidative stress- (OS-) induced mitochondrial dysfunction. However, the crucial molecular mechanisms that mediate such a phenomenon remain largely unknown. OS is characterized by the overproduction of reactive oxygen species (ROS), e.g., HO, O, and OH. Mitochondria are a major source of ROS and the principal attack target of ROS. Cyclophilin D (CypD), as the only crucial protein for mitochondrial permeability transition pore (mPTP) induction, facilitates the opening of mPTP and causes mitochondrial dysfunction, leading to cell death. In the present study, we hypothesized that CypD-mediated mitochondrial molecular pathways were closely involved in the process of OS-induced death of human DPCs (HDPCs). We tested the phenotypic and molecular changes of HDPCs in a well-established OS model-HO treatment. We showed that HO dramatically reduced the viability and increased the death of HDPCs in a time- and dose-dependent manner by performing MTT, flow cytometry, and TUNEL assays and quantifying the expression changes of Bax and Bcl-2 proteins. HO also induced mitochondrial dysfunction, as reflected by the increased mitochondrial ROS, reduced ATP production, and activation of mPTP (decreased mitochondrial membrane potential and enhanced intracellular Ca level). An antioxidant (N-acetyl-L-cysteine) effectively preserved mitochondrial function and significantly attenuated HO-induced cytotoxicity and death. Moreover, HO treatment markedly upregulated the CypD protein level in HDPCs. Notably, genetic or pharmacological blockade of CypD significantly attenuated HO-induced mitochondrial dysfunction and cell death. These findings provided novel insights into the role of a CypD-dependent mitochondrial pathway in the HO-induced death in HDPCs, indicating that CypD may be a potential therapeutic target to prevent OS-mediated injury in dental pulp.
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http://dx.doi.org/10.1155/2019/1729013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476071PMC
December 2019

Bone Tissue Responses to Zirconia Implants Modified by Biomimetic Coating Incorporated with BMP-2.

Int J Periodontics Restorative Dent 2019 May/Jun;39(3):371-379

This study aimed to histologically investigate the bone tissue response to zirconia implants functionalized with a biomimetic calcium phosphate (CaP) coating incorporated with bone morphogenetic protein-2 (BMP-2). Zirconia implants coated with biomimetic CaP were prepared with and without BMP-2. Untreated zirconia implants served as a control. These three groups of implants were placed randomly in the mandibles of six beagle dogs (n = 6). Three months later, samples were harvested for histomorphometric analysis. The present study showed that the application of a biomimetic CaP coating incorporated with BMP-2 enhanced the peri-implant osteogenesis for zirconia implants.
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http://dx.doi.org/10.11607/prd.3980DOI Listing
October 2019

Patient-Reported Outcomes of Maxillary Edentulous Patients Wearing Overdentures Retained by Two Implants from Insertion to 4 Years.

Int J Oral Maxillofac Implants 2019 Mar/Apr;34(2):481-488

Purpose: This cohort study evaluated patient satisfaction for maxillary implant-retained overdentures (IODs) on two implants up to 4 years and assessed the treatment effect over time.

Materials And Methods: Patients encountering problems with their conventional dentures were included and received maxillary IODs on two titanium-zirconium implants and ball anchors in the canine area. Patient satisfaction was assessed using the oral health impact profile (OHIP-20E) questionnaires both for dentures and IODs. Two months after insertion of IODs (baseline), the patients chose the preferred overdenture design with full or reduced palatal coverage. OHIP-20E questionnaires were followed according to the individual choice at 1 and 4 years, and outcomes were compared with baseline.

Results: Sixteen out of 21 patients were evaluated at a mean follow-up of 4 years (range: 2.4 to 4.8 years). There was no significant difference in the OHIP domains for IODs at 1 year (OHIP__: 9.5, SD: 13.0) and 4 years (OHIP__: 14.2, SD: 19.1) compared with baseline (OHIP__: 12.4, SD: 14.7). Patients were most satisfied with social disability both for IODs (OHIP_: 6.0, SD: 7.6; OHIP_: 3.4, SD: 5.4; OHIP_: 5.7, SD: 9.5) and dentures (OHIP__: 28, SD: 29.7; OHIP__: 25.4, SD: 28.67). Patients were least satisfied with functional limitation both for IODs (OHIP_: 6.0, SD: 7.6; OHIP_: 3.4, SD: 5.4; OHIP_: 5.7, SD: 9.5) and dentures (OHIP__: 28, SD: 29.7; OHIP__: 25.4, SD: 28.67).

Conclusion: Patient satisfaction with maxillary IODs on two implants did not change from baseline to 4 years and was high at 4 years of function.
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http://dx.doi.org/10.11607/jomi.6980DOI Listing
May 2019

Effect of dental implant surface roughness in patients with a history of periodontal disease: a systematic review and meta-analysis.

Int J Implant Dent 2019 Feb 13;5(1):12. Epub 2019 Feb 13.

Section of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.

Background: To review the literature on the effect of dental implant surface roughness in patients with a history of periodontal disease. The present review addresses the following focus question: Is there a difference for implant survival, mean marginal bone loss, and the incidence of bleeding on probing in periodontally compromised patients receiving a machined dental implant or rough surface dental implant?

Methods: Electronic and manual literature searches were conducted on PubMed/MEDLINE and the Cochrane Library on studies published until May 2018 to collect information about the effect of machined, moderately rough, and rough dental implant surfaces in patients with a history of periodontal disease. The outcome variables implant survival, mean marginal bone level, and the incidence of peri-implantitis and bleeding on probing were evaluated. Meta-analysis was performed to obtain an accurate estimation of the overall, cumulative results.

Results: Out of 2411 articles, six studies were included in this systematic review. The meta-analysis of the implant survival and implant mean marginal bone loss revealed a risk ratio of 2.92 (CI 95% 0.45, 18.86) for implant failure and a total mean difference of - 0.09 (CI 95% - 0.31, 0.14) for implant mean marginal bone loss measured in a total group of 215 implants, both not statistically significant.

Conclusions: Due to lack of long-term data (> 5 years), the heterogeneity and variability in study designs and lack of reporting on confounding factors, definitive conclusions on differences in implant survival, and mean marginal bone loss between machined and moderate rough implants in periodontally compromised patients cannot be drawn. Future well-designed long-term randomized controlled trials are necessary to reveal that machined surfaces are superior to moderately rough and rough surfaces in patients with a history of periodontal disease.
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http://dx.doi.org/10.1186/s40729-019-0156-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372709PMC
February 2019

Experience with bruxism in the everyday oral implantology practice in the Netherlands: a qualitative study.

BDJ Open 2018 9;4:17040. Epub 2018 Nov 9.

1Section of Oral Kinesiology, Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Objective: To explore how bruxism is dealt with by accredited oral implantologists within daily clinical practice.

Materials And Methods: Nine semi-structured interviews of oral implantologists practicing in non-academic clinical practices in the Netherlands were performed, and thematic analysis was conducted using a framework-based approach.

Results: Oral implant treatments in bruxing patients were a generally well-accepted practice. Complications were often expected, with most being of minor impact. Contradictive attitudes emerged on the topic of bruxism being an etiologic factor for peri-implant bone loss and loss of osseointegration. Views on the ideal treatment plan varied, though the importance of the superstructure's occlusion and articulation features was repeatedly pointed at. Similarly, views on protective splints varied, regarding their necessity and material choice. Bruxism was diagnosed mainly by clinical examination, alongside with patient anamnesis and clinician's intuition. There was little attention for awake bruxism.

Discussion: Bruxism was generally not considered a contraindication for implantological treatments by accredited oral implantologists. Views on the interaction between bruxism and bone loss/loss of osseointegration varied, as did views on the ideal treatment plan.

Conclusions: There is a need for better understanding of the extent to which, and under which circumstances, sleep and/or awake bruxism can be seen as causal factors for the occurrence of oral implant complications.
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http://dx.doi.org/10.1038/s41405-018-0006-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226535PMC
November 2018

The 3D Printing of Calcium Phosphate with K-Carrageenan under Conditions Permitting the Incorporation of Biological Components-A Method.

J Funct Biomater 2018 Oct 17;9(4). Epub 2018 Oct 17.

Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands.

Critical-size bone defects are a common clinical problem. The golden standard to treat these defects is autologous bone grafting. Besides the limitations of availability and co-morbidity, autografts have to be manually adapted to fit in the defect, which might result in a sub-optimal fit and impaired healing. Scaffolds with precise dimensions can be created using 3-dimensional (3D) printing, enabling the production of patient-specific, 'tailor-made' bone substitutes with an exact fit. Calcium phosphate (CaP) is a popular material for bone tissue engineering due to its biocompatibility, osteoconductivity, and biodegradable properties. To enhance bone formation, a bioactive 3D-printed CaP scaffold can be created by combining the printed CaP scaffold with biological components such as growth factors and cytokines, e.g., vascular endothelial growth factor (VEGF), bone morphogenetic protein-2 (BMP-2), and interleukin-6 (IL-6). However, the 3D-printing of CaP with a biological component is challenging since production techniques often use high temperatures or aggressive chemicals, which hinders/inactivates the bioactivity of the incorporated biological components. Therefore, in our laboratory, we routinely perform extrusion-based 3D-printing with a biological binder at room temperature to create porous scaffolds for bone healing. In this method paper, we describe in detail a 3D-printing procedure for CaP paste with K-carrageenan as a biological binder.
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http://dx.doi.org/10.3390/jfb9040057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306897PMC
October 2018

Group 5 ITI Consensus Report: Digital technologies.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:436-442

Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.

Objectives: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed.

Materials And Methods: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted.

Results: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent.

Conclusions: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care.
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http://dx.doi.org/10.1111/clr.13309DOI Listing
October 2018

Proceedings of the 6th ITI Consensus Conference.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:5-7

Melbourne Dental School, University of Melbourne, Parkville, Vic., Australia.

The 6th ITI Consensus Conference was held in Amsterdam on 17-19 April 2018. In preparation for the conference, 21 systematic reviews were written. They were divided into five main topics in dental implantology-surgery, prosthodontics, patient-reported outcomes, complications/risk and digital technologies. Based on these review papers, the working groups prepared consensus statements, clinical guidelines and recommendations for future research.
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http://dx.doi.org/10.1111/clr.13301DOI Listing
October 2018

The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:416-435

Private office, Brighton, Victoria, Australia.

Objectives: To assess the literature on the accuracy of static computer-assisted implant surgery in implant dentistry.

Materials And Methods: Electronic and manual literature searches were conducted to collect information about the accuracy of static computer-assisted implant systems. Meta-regression analysis was performed to summarise the accuracy studies.

Results: From a total of 372 articles. 20 studies, one randomised controlled trial (RCT), eight uncontrolled retrospective studies and 11 uncontrolled prospective studies were selected for inclusion for qualitative synthesis. A total of 2,238 implants in 471 patients that had been placed using static guides were available for review. The meta-analysis of the accuracy (20 clinical) revealed a total mean error of 1.2 mm (1.04 mm to 1.44 mm) at the entry point, 1.4 mm (1.28 mm to 1.58 mm) at the apical point and deviation of 3.5°(3.0° to 3.96°). There was a significant difference in accuracy in favour of partial edentulous comparing to full edentulous cases.

Conclusion: Different levels of quantity and quality of evidence were available for static computer-aided implant surgery (s-CAIS). Based on the present systematic review and its limitations, it can be concluded that the accuracy of static computer-aided implant surgery is within the clinically acceptable range in the majority of clinical situations. However, a safety marge of at least 2 mm should be respected. A lack of homogeneity was found in techniques adopted between the different authors and the general study designs.
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http://dx.doi.org/10.1111/clr.13346DOI Listing
October 2018

Group 3 ITI Consensus Report: Patient-reported outcome measures associated with implant dentistry.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:270-275

Universidad Inter Continental, Mexico City, Mexico.

Objectives: The aim of Working Group 3 was to focus on three topics that were assessed using patient-reported outcome measures (PROMs). These topics included the following: (a) the aesthetics of tooth and implant-supported fixed dental prostheses focusing on partially edentulous patients, (b) a comparison of fixed and removable implant-retained prostheses for edentulous populations, and (c) immediate versus early/conventional loading of immediately placed implants in partially edentate patients. PROMs include ratings of satisfaction and oral health-related quality of life (QHRQoL), as well as other indicators, that is, pain, general health-related quality of life (e.g., SF-36).

Materials And Methods: The Consensus Conference Group 3 participants discussed the findings of the three systematic review manuscripts. Following comprehensive discussions, participants developed consensus statements and recommendations that were then discussed in larger plenary sessions. Following this, any necessary modifications were made and approved.

Results: Patients were very satisfied with the aesthetics of implant-supported fixed dental prostheses and the surrounding mucosa. Implant neck design, restorative material, or use of a provisional restoration did not influence patients' ratings. Edentulous patients highly rate both removable and fixed implant-supported prostheses. However, they rate their ability to maintain their oral hygiene significantly higher with the removable prosthesis. Both immediate provisionalization and conventional loading receive positive patient-reported outcomes.

Conclusions: Patient-reported outcome measures should be gathered in every clinical study in which the outcomes of oral rehabilitation with dental implants are investigated. PROMs, such as patients' satisfaction and QHRQoL, should supplement other clinical parameters in our clinical definition of success.
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http://dx.doi.org/10.1111/clr.13299DOI Listing
October 2018

Patient-reported outcome measures focusing on aesthetics of implant- and tooth-supported fixed dental prostheses: A systematic review and meta-analysis.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:224-240

Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

Objectives: The aim of this systematic review and meta-analysis was to summarize the existing evidence on patient-reported aesthetic outcome measures (PROMs) of implant-supported, relative to tooth-supported fixed dental prostheses.

Material And Methods: In April 2017, two reviewers independently searched the Medline (PubMed), EMBASE, and Cochrane electronic databases, focusing on studies including patient-reported aesthetic outcomes of implant- and tooth-supported fixed dental prostheses (FDPs). Human studies with a mean follow-up period of at least 1 year, a minimum of ten patients, and English, German, or French publication were included. For the comparison of subgroups, random-effects meta-regression for aggregate-level data was used.

Results: The systematic search for implant-supported prostheses focusing on patient-reported outcomes identified 2,675 titles, which were screened by two independent authors. Fifty full-text articles were analyzed, and finally, 16 publications (including 19 relevant study cohorts) were included. For tooth-supported prostheses, no studies could be included. A total of 816 implant-supported reconstructions were analyzed by patients. Overall aesthetic evaluation by the patients' visual analogue scale (VAS) rating was high in implant-supported FDPs (median: 90.3; min-max: 80.0-94.0) and the surrounding mucosa (median: 84.7; min-max: 73.0-92.0). Individual restorative materials, implant neck design (i.e., tissue or bone level type implants), and the use of a fixed provisional had no effect on patients' ratings of the definitive implant-supported FDPs.

Conclusions: Aesthetics is an important patient-reported measure, which lacks in standardized methods; however, patients' satisfaction was high for implant- supported FDPs and the surrounding mucosa.
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http://dx.doi.org/10.1111/clr.13295DOI Listing
October 2018

The accuracy of different dental impression techniques for implant-supported dental prostheses: A systematic review and meta-analysis.

Clin Oral Implants Res 2018 Oct;29 Suppl 16:374-392

Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania.

Aim: This systematic review and meta-analysis were conducted to assess and compare the accuracy of conventional and digital implant impressions. The review was registered on the PROSPERO register (registration number: CRD42016050730).

Material And Methods: A systematic literature search was conducted adhering to PRISMA guidelines to identify studies on implant impressions published between 2012 and 2017. Experimental and clinical studies at all levels of evidence published in peer-reviewed journals were included, excluding expert opinions. Data extraction was performed along defined parameters for studied specimens, digital and conventional impression specifications and outcome assessment.

Results: Seventy-nine studies were included for the systematic review, thereof 77 experimental studies, one RCT and one retrospective study. The study setting was in vitro for most of the included studies (75 studies) and in vivo for four studies. Accuracy of conventional impressions was examined in 59 studies, whereas digital impressions were examined in 11 studies. Nine studies compared the accuracy of conventional and digital implant impressions. Reported measurements for the accuracy include the following: (a) linear and angular deviations between reference models and test models fabricated with each impression technique; (b) three-dimensional deviations between impression posts and scan bodies respectively; and (c) fit of implant-supported frameworks, assessed by measuring marginal discrepancy along implant abutments.) Meta-analysis was performed of 62 studies. The results of conventional and digital implant impressions exhibited high values for heterogeneity.

Conclusions: The available data for accuracy of digital and conventional implant impressions have a low evidence level and do not include sufficient data on in vivo application to derive clinical recommendations.
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http://dx.doi.org/10.1111/clr.13273DOI Listing
October 2018

All-trans retinoic-acid inhibits heterodimeric bone morphogenetic protein 2/7-stimulated osteoclastogenesis, and resorption activity.

Cell Biosci 2018 23;8:48. Epub 2018 Aug 23.

3Department of Oral Implantology and Prosthetic Dentistry, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Background: Bone regenerative heterodimeric bone morphogenetic protein 2/7 (BMP2/7) enhances but all-trans retinoic acid (ATRA) inhibits osteoclastogenesis. However, the effect of ATRA on physiological and/or BMP2/7-induced osteoclastogenesis in still unclear. In this study, we aimed to test the effect of combined treatment of BMP2/7 and ATRA on osteoclastogenesis, and resorption activity.

Results: All-trans retinoic acid (1 µM) ± BMP2/7 (5 or 50 ng/ml) was added in murine pre-osteoclasts cell line RAW264.7 or mouse bone marrow derived macrophages (BMM) cultures. Osteoclast marker gene expression, osteoclastogenesis, and resorption activity were analyzed. BMP2/7 robustly enhanced osteoclast maker gene expression, osteoclastogenesis, and resorption activity. Interestingly, ATRA completely inhibited osteoclast formation in presence or absence of BMP2/7. Pan-antagonist of retinoic acid receptors (RARs) and antagonist of RARα, β or γ failed to reverse the inhibitory effect of ATRA on osteoclastogenesis. ATRA strongly inhibited and expression.

Conclusions: All-trans retinoic acid inhibits BMP2/7-induced osteoclastogenesis, and resorption activity possibly via RANKL-RANK pathway. Our findings from previous and current study suggest that combination of ATRA and BMP2/7 could be a novel approach to treat hyperactive osteoclast-induced bone loss such as in inflammation-induced severe osteoporosis and bone loss caused by cancer metastasis to bone.
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http://dx.doi.org/10.1186/s13578-018-0246-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107948PMC
August 2018

Cleaning effect of osteoconductive powder abrasive treatment on explanted human implants and biofilm-coated titanium discs.

Clin Exp Dent Res 2018 Feb 15;4(1):25-34. Epub 2018 Feb 15.

Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam.

The aim of this study is to test the cleaning effect and surface modification of a new implant surface treatment on explanted dental implants and titanium discs. It is a modified air powder abrasive (APA) treatment applied using osteoconductive powders. Twenty-eight in vitro Ca-precipitated organic film-coated titanium discs and 13 explanted dental implants were treated. In a 2-step approach, 3 powders were used: hydroxylapatite (HA) and biomimetic calcium phosphate (BioCaP), which are osteoconductive, and erythritol, which is not. APA treatment was applied. (Air pressure: 2.4 bar; water flow for cleaning: 41.5 ml/min, for Coating 1: 2.1 ml/min, and for Coating 2: 15.2 ml/min.) The test groups were as follows: Group 1: HA cleaning + BioCaP Coating 1; Group 2: HA cleaning + BioCaP Coating 2; Group 3: erythritol cleaning + BioCaP Coating 1; Group 4: erythritol cleaning + BioCaP Coating 2; Group 5: HA cleaning; Group 6: erythritol cleaning; and control: no powder. Cleaned areas were calculated by point counting method. Surface changes and chemical content were evaluated using light microscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Cleaning effect between groups was compared by a pairwise Student's t test. The significance level was fixed at p < .05. Cleaning effect on the discs was 100% in all test groups and 5% in the control. Powder particles in varying size and shape were embedded on the surface. All HA- or CaP-treated surfaces showed Ca and P content but no surface damage. Calcified biofilm remnants were removed from the implant surface by the test groups, whereas in control groups, they remained. APA treatment with CaP and HA powders under clinically applicable pressure settings gives positive results in vitro; therefore, they could be promising when used in vivo.
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http://dx.doi.org/10.1002/cre2.100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813889PMC
February 2018

Associations between sleep bruxism and (peri-) implant complications: a prospective cohort study.

BDJ Open 2017 14;3:17003. Epub 2017 Apr 14.

Section of Oral Kinesiology, Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.

Objectives/aims: To describe the protocol of a prospective cohort study designed to answer the question: 'Is sleep bruxism a risk factor for (peri-)implant complications?'.

Materials And Methods: Our study is a single-centre, double-blind, prospective cohort study with a follow-up time of 2 years. Ninety-eight participants fulfilling inclusion criteria (planned treatment with implant-supported fixed suprastructure(s) and age 18 years or older) will be included. Sleep bruxism will be monitored at several time points as masticatory muscle activity during sleep by means of a portable single-channel electromyographic device. Our main outcomes are biological complications (i.e., related to peri-implant bleeding, probing depth, marginal bone height, quality of submucosal biofilm and loss of osseointegration) and technical complications (i.e., suprastructure, abutment, implant body or other).

Results: The study is currently ongoing, and data are being gathered.

Discussion: The results of this prospective cohort study will provide important information for clinicians treating bruxing patients with dental implants. Furthermore, it will contribute to the body of evidence related to the behaviour of dental implants and their complications under conditions of high mechanical loadings that result from sleep bruxism activity.

Conclusion: The protocol of a prospective cohort study designed to investigate possible associations between sleep bruxism and (peri-) implant complications was presented.
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http://dx.doi.org/10.1038/bdjopen.2017.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842855PMC
April 2017

Immediate Nonsubmerged Custom Root Analog Implants: A Prospective Pilot Clinical Study.

Int J Oral Maxillofac Implants 2018 Mar/Apr;33(2):e37-e44

Purpose: To evaluate the feasibility of a commercially available immediate root analog implant system Replicate (Natural Dental Implants).

Materials And Methods: Five consecutive patients in need of an implant in the premolar region were recruited for this pilot study. Following clinical examination, a cone beam computed tomography scan was made and the dental impressions digitized. On the basis of the superimposition of these datasets, a three-dimensional (3D) envelope was created for the selected tooth. Subsequently, the tooth root at the prospective implant site was segmented to create a 3D surface, and the obtained mesh data were used as the basis for designing a single-piece root analog implant within the 3D envelope. The designed root analog implant was fabricated using a five-axis computer-aided manufacturing machine. The root analog implants were inserted following flapless minimally invasive root extraction. Following 3 months of uninterrupted healing, definitive restorations were fabricated. Peri-implant clinical and radiographic measurements were obtained up to 12 months follow-up.

Results: All patients functioned well following 12 months of functional loading. Within one patient, one of the two root analog implants failed early. Peri-implant clinical and radiographic measurements demonstrated a stable situation after 12 months of functional loading.

Conclusion: A novel digital approach for immediately restoring single teeth using root analog implants was introduced. In the future, long-term evaluation of the root analog implant technique is necessary to evaluate the success and survival of implants that were inserted using this technique.
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http://dx.doi.org/10.11607/jomi.6048DOI Listing
July 2018