Bone loss around oral and orthopedic implants: An immunologically based condition

Albrektsson, Tomas; Becker, William; Coli, Pierluigi; Jemt, Torsten; Mölne, Johan; Sennerby, Lars

doi:10.1111/cid.12793

Cited by 54 publications

(60 citation statements)

References 88 publications

(182 reference statements)

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“…Osseointegration has been suggested to represent a foreign body reaction to biomaterials and its long-term clinical function depending on a foreign body equilibrium that, if disturbed, may lead to impaired clinical function of the implant [15]. Recently, dental implants have been suggested having more in common to orthopaedic implants in terms of foreign body reaction and failure pattern than to teeth [16]. Given these fundamental differences between the periodontal and peri-implant tissues, can periodontal indices be used as reliable diagnostic tools for peri-implant tissues?…”

Section: Introductionmentioning

confidence: 99%

Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants?

Coli

Sennerby

2019

JCM

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Pocket probing depth (PPD) and bleeding on probing (BOP) measurements are useful indices for the assessment of periodontal conditions. The same periodontal indices are commonly recommended to evaluate the dental implant/tissue interface to identify sites with mucositis and peri-implantitis, which, if not treated, are anticipated to lead to implant failure. The aim of the present narrative review is to discuss the available literature on the effectiveness of probing at dental implants for identification of peri-implant pathology. There is substantial clinical evidence that PPD and BOP measurements are very poor indices of peri-implant tissue conditions and are questionable surrogate endpoints for implant failure. On the contrary, the literature suggests that frequent disturbance of the soft tissue barrier at implants may instead induce inflammation and bone resorption. Moreover, over-diagnosis and subsequent unnecessary treatment may lead to iatrogenic damage to the implant-tissue interface. Despite this, the recommendations from recent consensus meetings are still promoting the use of probing at dental implants. For evaluation of implants, for instance at annual check-ups, the present authors recommend a clinical examination that includes (i) a visual inspection of the peri-implant tissues for the assessment of oral hygiene and the detection of potential redness, swelling, (ii) palpation of the peri-implant tissues for assessment of the potential presence of swelling, bleeding, suppuration. In addition, (iii) radiography is recommended for the assessment of crestal bone level for comparison with previous radiographs to evaluate potential progressive bone loss even if there is a need for more scientific evidence of the true value of the first two clinical testing modes.

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Section: Introductionmentioning

confidence: 99%

Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants?

Coli

Sennerby

2019

JCM

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“…Other foreign bodies routinely seen adjacent to implants such as titanium particles [24,25,26] or the accidental presence of cement in the bone-to-implant interface that, according to some investigators, may be found in 59% of cemented implants [27], may combine to cause peri-implantitis [28].…”

Section: Discussionmentioning

confidence: 99%

On the Cleanliness of Different Oral Implant Systems: A Pilot Study

Duddeck

Albrektsson

Wennerberg

et al. 2019

JCM

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(1) Background: This paper aimed to compare the cleanliness of clinically well-documented implant systems with implants providing very similar designs. The hypothesis was that three well-established implant systems from Dentsply Implants, Straumann, and Nobel Biocare were not only produced with a higher level of surface cleanliness but also provided significantly more comprehensive published clinical documentation than their correspondent look-alike implants from Cumdente, Bioconcept, and Biodenta, which show similar geometry and surface structure. (2) Methods: Implants were analyzed using SEM imaging and energy-dispersive X-ray spectroscopy to determine the elemental composition of potential impurities. A search for clinical trials was carried out in the PubMed database and by reaching out to the corresponding manufacturer. (3) Results: In comparison to their corresponding look-alikes, all implants of the original manufacturers showed—within the scope of this analysis—a surface free of foreign materials and reliable clinical documentation, while the SEM analysis revealed significant impurities on all look-alike implants such as organic residues and unintended metal particles of iron or aluminum. Other than case reports, the look-alike implant manufacturers provided no reports of clinical documentation. (4) Conclusions: In contrast to the original implants of market-leading manufacturers, the analyzed look-alike implants showed significant impurities, underlining the need for periodic reviews of sterile packaged medical devices and their clinical documentation.

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“…As a result, oral implants evoke a mild immunoreaction. And implants survive in the body in a delicate positive immune balance based on the individual host immune system [26,27]. Titanium ion may be a possible factor to disrupt this balance.…”

Section: Discussionmentioning

confidence: 99%

Long Term Retention of Gingival Sealing around Titanium Implants with CaCl2 Hydrothermal Treatment: A Rodent Study

Ayukawa

Oshiro

Atsuta

et al. 2019

JCM

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We previously reported that CaCl2 hydrothermal-treated (Ca-HT) titanium (Ti) implants induced a tight sealing at the interface between the implant and peri-implant epithelium (PIE) after implantation. However, it is not clear how long this improved epithelium sealing can be maintained. We subsequently investigated whether the positive effect of Ca-HT to promote sealing between the PIE and implant was sustained longer term. Maxillary molars were extracted from rats and replaced with either Ca-HT implants (Ca-HT group), distilled water-HT implants (DW-HT group) or non-treated implants (control group). After 16 weeks, the majority of implants in the Ca-HT group remained at the maxillary with no apical extension of the PIE. Conversely, half the number of control implants was lost following down-growth of the PIE. The effect of Ca-HT on migration and proliferation of rat oral epithelial cells (OECs) was also investigated. In OECs cultured on Ca-HT Ti plates, protein expression in relation to cell migration decreased, and proliferation was higher than other groups. Surface analysis indicated HT enhanced the formation of surface TiO2 layer without altering surface topography. Consequently, Ca-HT of Ti reduced PIE down-growth via tight epithelial attachment to the surface, which may enhance implant capability for a longer time post-implantation.

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Bone loss around oral and orthopedic implants: An immunologically based condition

Cited by 54 publications

References 88 publications

Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants?

Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants?

On the Cleanliness of Different Oral Implant Systems: A Pilot Study

Long Term Retention of Gingival Sealing around Titanium Implants with CaCl2 Hydrothermal Treatment: A Rodent Study

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