Biological factors contributing to failures of osseointegrated oral implants, (II). Etiopathogenesis

Abstract

The aim of the present review is to evaluate the English language literature regarding factors associated with the loss of oral implants. An evidence-based format in conjunction, when possible, with a meta-analytic approach is used. The review identifies the following factors to be associated with biological failures of oral implants: medical status of the patient, smoking, bone quality, bone grafting, irradiation therapy, parafunctions, operator experience, degree of surgical trauma, bacterial contamination, lack of preoperative antibiotics, immediate loading, nonsubmerged procedure, number of implants supporting a prosthesis, implant surface characteristics and design. Excessive surgical trauma together with an impaired healing ability, premature loading and infection are likely to be the most common causes of early implant losses. Whereas progressive chronic marginal infection (peri-implantitis) and overload in conjunction with the host characteristics are the major etiological agents causing late failures. Furthermore, it appears that implant surface properties (roughness and type of coating) may influence the failure pattern. Various surface properties may therefore be indicated for different anatomical and host conditions. Finally, the histopathology of implant losses is described and discussed in relation to the clinical findings.

Covalent attachment of P15 peptide to titanium surfaces enhances cell attachment, spreading, and osteogenic gene expression

“…1,2 Despite its excellent mechanical properties (a low elastic modulus), corrosion resistance (passive oxide layer on surface) 2,3 , and biocompatibility, it sometimes fails to integrate with the surrounding bone. 4,5 This problem becomes more acute in at-risk patient populations such as diabetics, smokers, or those with osteoporosis. 6,7 When an implant fails to fully osseointegrate, revision surgeries, which are associated with additional pain and suffering and have less successful outcomes, may be necessary.…”

Análisis Descriptivo de la Reparación Ósea Asociada a Implantes Dentales Endóseos Instalados en Perros con Técnica Sumergida en Dos Períodos de Evaluación

“…La presencia de vasos sanguíneos periféricos permitiría esta reparación, ya que las regiones que presentaron mayor angiogénesis mostraron mayores áreas de remodelación ósea, demostrando algunas semejanzas con los resultados de Kleinheinz et al (2005), quienes señalaron un frente angiogénico en fenómenos de regeneración ósea. La calidad de la estructura ósea en esta etapa aun es débil, lo cual podría llevar a una deformación plástica tisular debido a la aplicación inadecuada de fuerzas y tensiones (Hanawa et al, 1997;Dhert et al, 1998;Esposito et al, 1998), lo que se enmarca también en una ventana temporal en la que la reparación ósea podría cambiar desde una oseointegración hacia una fibrointegración debido a la ausencia de mineralización del tejido conectivo (Goodman et al, 1993), probablemente por influencias biomecánicas en el implante.…”

Mikroschädigungen von Implantatoberflächen

“…Rauheit und Mikrotopographie eines Implantats resultieren aus den Eigenschaften des Strahlmittels und den Parametern des Strahlvorgangs [9,10]. Nachteil solcher Strahlbehandlungen sind Kontaminationen mit Strahlmittelrückständen auf der Implantatoberfläche [15], welche zu kritischen Zellreaktionen wie Zellmetabolismus und periprothetische Knochenresorption führen [16,17], Die biologische Relevanz der Korundpartikel ist derzeit noch unklar [18], so können u.a. in vivo keine Beeinträchtigung der Osseointegration durch Korundpartikel nachgewiesen werden [19].…”