Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2—clinical and microbiological parameters

Clever, Kim; Schlegel, K. A.; Kniha, Heinz; Conrads, Georg; Rink, Lothar; Modabber, Ali; Hölzle, Frank; Kniha, Kristian

doi:10.1016/j.ijom.2018.10.017

Cited by 24 publications

(17 citation statements)

References 18 publications

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“…No relation was detected when putting the result in context of the clinical situation or the histology of these patients. In contrast to the present results, a recently published study reported distinct differences based on only 16 patients (Clever et al, 2019). Samples were obtained for a tooth, a titanium and a zirconia dental implant within the same patient.…”

Section: Discussioncontrasting

confidence: 99%

Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial

Bienz

Hilbe²,

Hüsler

et al. 2021

J Clinic Periodontology

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Objectives: To analyse the soft tissue morphology under healthy and experimental mucositis conditions comparing zirconia and titanium implants.Methods: Forty-two patients with two adjacent missing teeth received one zirconia (Zr) and one titanium (Ti) implant, with the mesial and distal position randomized. At 3 months, half of the patients were instructed to continue (healthy; h) and the other half to omit (experimental mucositis; m) oral hygiene around the implants for 3 weeks.Clinical parameters were evaluated before and after the experimental phase, and a soft tissue biopsy was harvested. Mixed model analyses were performed to analyse the data. Results:The plaque control record increased significantly for the two mucositis groups, reaching 68.3 ± 31.9% (mean ± SD) for Zr-m and 75.0 ± 29.4% for Ti-m (p < .0001), being also significantly lower for Zr-m than for Ti-m. Bleeding on probing remained stable in group Zr-m and amounted to 21.7 ± 23.6%, but increased significantly in group Ti-m (p = .040), measuring 32.5 ± 27.8%. The number of inflammatory cells and the length of the junctional epithelium did not significantly differ between the groups. Conclusion: Both implants rendered similar outcomes under healthy conditions.Lower plaque and bleeding scores were detected for zirconia implants under experimental mucositis conditions. Histologically, only minimal differences were observed. K E Y W O R D Shistology, histomorphometry, mucositis, peri-implant soft tissue, zirconia implant Clinical RelevanceScientific rationale for the study: Zirconia dental implants have drawn attention as a metal-free solution in implant dentistry during the last decade. Zirconium dioxide is claimed to be a material with favourable properties in terms of soft tissue integration. Currently, clinical data on a histological level are scarce, and settings comparing the material directly with titanium implants are lacking.

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Section: Discussioncontrasting

confidence: 99%

Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial

Bienz

Hilbe²,

Hüsler

et al. 2021

J Clinic Periodontology

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“…The authors assumed that in the event of a wound healing disorder or peri-implantitis in the case of bisphosphonate administration, the bacterial accumulation and thus the number of bacteria increases. With regard to the number of bacteria, studies have shown that already at the stage of peri-implant mucositis the total number of bacteria increased [ 10 , 11 ]. Thus, the total number of bacteria can be used as a marker for the degree of the individual inflammation.…”

Section: Introductionmentioning

confidence: 99%

In vivo and in vitro analysis in a rat model using zoledronate and alendronate medication: microbiological and scanning electron microscopy findings on peri-implant rat tissue

et al. 2021

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Background The aim of the present study was to assess the development of bacterial deposits and morphological parameters around dental zirconia and titanium implants compared with natural teeth during systemic bisphosphonate medication. Materials and methods Fifty-four rats were randomly allocated into one control group and two experimental groups (drug application of zoledronic and alendronic acid), with 18 animals in each group. After 4 weeks of drug delivery, either a zirconia or a titanium implant was immediately inserted. Microbiological analysis conducted 1 week, 8 weeks, and 12 weeks after surgery included total bacterial count and composition measurements. Samples were analyzed in a scanning electron microscope (SEM) equipped with energy-dispersive X-ray spectroscopy (EDX). Bone cell morphology was analyzed by transmission electron microscopy (TEM). Results One week after surgery, titanium and zirconia implants of the alendronic acid and control group showed a significantly higher bacterial count when compared to natural teeth in rats with zoledronic acid administration (p < 0.01). Less significant differences were recorded after 3 months, at which time no inter-material differences were evaluated (p > 0.05). I n the control group, TEM analysis showed that the osteoblasts had a strongly developed endoplasmic reticulum. In contrast, the endoplasmic reticulum of the osteoblasts in drug-treated animals was significantly less developed, indicating less activity. Conclusions Within the limits of this study, neither implant material was superior to the other at 3-month follow-up. With regard to the treatment and complications of patients with bisphosphonates, the implant material should not be an influencing factor. Bisphosphonates can be used in the rat model to reduce not only the activity of osteoclasts but also osteoblasts of the peri-implant bone.

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“…Recently, zirconia has been introduced as an alternative material due to its better aesthetics properties, excellent resistance to corrosion, biocompatibility and high wear resistance 11 . Recent studies also showed lower susceptibility to early biofilm colonization of zirconia abutments compared to titanium 12,13 . Differences in the microbiome profile related to zirconia and titanium abutments were also demonstrated in short clinical investigations 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Microbial communities of titanium versus zirconia abutments on implant‐supported restorations: Biodiversity composition and its impact on clinical parameters over a 3‐year longitudinal prospective study

Freitas

Rey

Santos

et al. 2021

Clin Implant Dent Rel Res

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Background Shifts in microbial communities are common over time, but they may disturb the host‐microbiome homeostasis and result in inflammation of the peri‐implant issues if a dysbiotic biofilm is established. Purpose Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single‐implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3‐years of implant loading. Materials and methods MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes. Results Microbiomes of both abutment materials presented high alpha‐diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri‐implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes. Conclusions The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.

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Experimental peri-implant mucositis around titanium and zirconia implants in comparison to a natural tooth: part 2—clinical and microbiological parameters

Cited by 24 publications

References 18 publications

Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial

Clinical and histological comparison of the soft tissue morphology between zirconia and titanium dental implants under healthy and experimental mucositis conditions—A randomized controlled clinical trial

In vivo and in vitro analysis in a rat model using zoledronate and alendronate medication: microbiological and scanning electron microscopy findings on peri-implant rat tissue

Microbial communities of titanium versus zirconia abutments on implant‐supported restorations: Biodiversity composition and its impact on clinical parameters over a 3‐year longitudinal prospective study

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