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Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans.

ABSTRACT: The goal of the current study is to assess the difference in connective tissue adherence to laser microtextured versus machined titanium abutments.Six patients were selected and each of them received 2 implants, one combined with a laser treated abutment and one with a machined abutment. After three months, the abutments were retrieved together with their surrounding gingival tissue for histological analysis. Qualitative and quantitative evaluation of microscopical images was performed to assess the presence or absence of adherence between the soft tissues and the abutment, and the percentage of soft tissue adhered to the two different surfaces.Intimate adherence between connective tissue and the laser treated abutments, while on machined abutments no adherence was detected. A significant difference was found in the percentage of surface in contact with soft tissue between both implant abutments p=0.03.Within the limitation of the current study, it can be concluded that connective tissues show enhanced adherence to microtextured abutments compared to machined abutments.

SUBMITTER: Blazquez-Hinarejos M

PROVIDER: S-EPMC5813997 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans.

Blázquez-Hinarejos M M Ayuso-Montero R R Álvarez-López J-M JM Manzanares-Céspedes M-C MC López-López J J

Medicina oral, patologia oral y cirugia bucal 20171101 6

<h4>Background</h4>The goal of the current study is to assess the difference in connective tissue adherence to laser microtextured versus machined titanium abutments.<h4>Material and methods</h4>Six patients were selected and each of them received 2 implants, one combined with a laser treated abutment and one with a machined abutment. After three months, the abutments were retrieved together with their surrounding gingival tissue for histological analysis. Qualitative and quantitative evaluation ...[more]

PMID: 29053657

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Project description:BackgroundOne of the main factors for the osseointegration of dental implants is the development of an adequate soft tissue barrier, mainly composed by collagen, which protects the implant from bacterial development. The structural features of the peri-implant collagen are influenced by the implant components and, in particular, by the type of the surface. In the clinical practice, healing abutments are characterized by smooth surfaces, named machined. Recently, a new laser technique, Synthegra, has been developed to obtain a topography-controlled surface with micrometric regular pores that seems reducing the risk of peri-implantitis. Based on this background, this study aims investigating the structural organization and spatial distribution of collagen surrounding healing abutments characterized by laser-treated and machined surfaces.MethodsGingiva portions surrounding custom-made healing abutments (HA), characterized by alternated laser-treated and machined surfaces, were collected and analyzed by combining Fourier Transform InfraRed Imaging (FTIRI) spectroscopy, a non-invasive and high-resolution bidimensional analytical technique, with histological and multivariate analyses.ResultsMasson's trichrome staining, specific for collagen, highlighted a massive presence of collagen in all the analyzed samples, evidencing a surface-related spatial distribution. The nature of collagen, investigated by the FTIRI spectroscopy, appeared more abundant close to the laser-treated surface, with a perpendicular disposition of the bundles respect to the HA; conversely, a parallel distribution was observed around the machined surface. A different secondary structure was also found, with a higher amount of triple helices and a lower quantity of random coils in collagen close to the laser treated surfaces.ConclusionsFTIRI spectroscopy demonstrates that the use of a laser treated transmucosal surface can improve the morphological organization of the peri-implant collagen, which presents a distribution more similar to that of natural teeth.Trial registrationThis trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970). Registered 06/03/2023, retrospectively registered, https://clinicaltrials.gov/show/NCT05754970 .

Project description:Statement of the problemThe gingival configuration around implant abutments is of paramount importance for preserving the underlying marginal bone, and hence for the long-term success of dental implants.ObjectiveThe objective was to study, clinically and histologically, the effects of the change in the morphology of abutments connected to the endosseous implant, and of their surface treatment. In particular, the objective was to ascertain the effect of changing the shape of the transepithelial pillar and the treatment of its surface on the dimensions, quality and health of the components of the peri-implant biological space, such as the dimensions of the epithelial and connective tissues of the biological space, the concentration of inflammatory cells and the density of collagen fibers.MethodsA clinical trial of 10 patients with a totally edentulous maxilla, who had four implants (IPX4010_GALIMPLANT®, Sarria, Spain) inserted in the area of the first and second molars on both sides with computer-guided implant surgery, was conducted with the final purpose of assessing the quality of the peri-implant soft tissue attachment around the transepithelial abutments which were employed (aesthetic machined (RM), aesthetic anodized (RA), slim machined (SM) and slim anodized (SA)). At 8 weeks and following the collection of the samples (removal of the implant-abutment assembly with its surrounding hard and soft tissue) and their processing for subsequent histological and histomorphometric analysis in order to study the dimensions, quality and health of the peri-implant soft tissue area, the variables previously mentioned were determined according to the aims of the study. By using appropriate diameter trephine in order to obtain a useful fringe of soft tissue around the transepithelial pillars, ANOVA and chi-square tests were performed.ResultsThe SPSS statistical analysis ANOVA results revealed that the machined slim abutments have a better performance considering the variables analyzed with epithelial and connective attachment heights of 1.52 mm and 2.3 mm, respectively, and that connective density (density of collagen fibers) was high at 85.7% of the sample size affected by the design for the slim abutments and 92.9% of the high-density sample size affected by the surface treatment for the machined surface.ConclusionsAll variables studied, despite the small sample size, showed the superiority of the slim machined abutment among the four groups.

Project description:Currently, selective laser melting (SLM) has been thriving in implant dentistry for on-demand fabricating dental implants. Based on the coarse microtopography of SLM titanium surfaces, constructing nanostructure to form the hierarchical micro-nano topography is effective in enhancing osseointegration. Given that current nanomodification techniques of SLM implants, such as anodization and hydrothermal treatment, are facing the inadequacy in costly specific apparatus and reagents, there has been no recognized nanomodified SLM dental implants. The present study aimed to construct hierarchical micro-nano topography on self-made SLM dental implants by a simple and safe inorganic chemical oxidation, and to evaluate its contribution on osteoblastic cells bioactivity and osseointegration. The surface chemical and physical parameters were characterized by FE-SEM, EDS, profilometer, AFM, and contact angle meter. The alteration on bioactivity of MG-63 human osteoblastic cells were detected by qRT-PCR. Then the osseointegration was assessed by implanting implants on the femur condyle of New Zealand Rabbits. The hierarchical micro-nano topography was constituted by the microrough surface of SLM implants and nanoneedles (diameter: 20∼50 nm, height: 150∼250 nm), after nanomodifying SLM implants in 30% hydrogen peroxide and 30% hydrochloride acid (volume ratio 1:2.5) at room temperature for 36 h. Low chemical impurities content and high hydrophilicity were observed in the nanomodified group. Cell experiments on the nanomodified group showed higher expression of mitophagy related gene (PINK1, PARKIN, LC3B, and LAMP1) at 5 days and higher expression of osteogenesis related gene (Runx2 and OCN) at 14 days. In the early stage of bone formation, the nanomodified SLM implants demonstrated higher bone-to-implant contact. Intriguingly, the initial bone-to-implant contact of nanomodified SLM implants consisted of more mineralized bone with less immature osteoid. After the cessation of bone formation, the bone-to-implant contact of nanomodified SLM implants was equal to untreated SLM implants and marketable TixOs implants. The overall findings indicated that the inorganic chemical oxidized hierarchical micro-nano topography could enhance the bioactivity of osteoblastic cells, and consequently promote the peri-implant bone formation and mineralization of SLM dental implants. This study sheds some light on improvements in additive manufactured dental implants.

Project description:Proper horizontal and vertical thickness of the gingival connective tissue has been proven to be one of the success criteria in dental implant and reconstructive surgery. When thin tissue is found, gingiva augmentation methods can be used to increase the quality and volume of the tissue. Many methods have been described, among them pedicle soft-tissue flaps or autogenic tissue grafts. As an alternative to patients' own tissue, xenogenic materials can be used for grafting. The fundamental issue is to choose a material that will ensure the maximum therapeutic effect, while also minimizing the negative influence on the patient's health. The aim of this study was to compare gingival augmentation procedures using a palatal connective tissue graft (CTG) and an xenogenic soft-tissue substitute, Geistlich Mucograft (xenogeneic collagen matrix; CMX), and assess whether the timing of the graft surgery influences the clinical outcomes. The original study was a randomized control trial with a total of 75 implants placed. The patients received the soft-tissue thickening 3 months before the implant placement or 3 months after the implant placement (depending on the group). A connective tissue graft (CTG) or Geistlich Mucograft were used (depending on the group). For both the CTG and Geistlich Mucograft, better clinical outcomes were observed for maintaining the alveolar bone level and the thickness of the attached gingiva compared to the control group with no gingival augmentation. The Geistlich Mucograft showed good clinical performance in comparison to the control. Soft-tissue augmentation with the CTG before the implant placement was found to be most efficient method in terms of a stable increase of the tissue thickness since, throughout the entire observation period, the greatest increase of 1.035 mm (SD = 0.73 mm) in thickness was observed. Statistically important differences in the tissue thickness baseline compared after 5 years were observed for groups G1 vs. G2b (no augmentation vs. CTG before), G1 vs. G3b (no augmentation vs. CTG after) and for groups G2b vs. G3a (CTG before vs. CMX after).

Project description:IntroductionAwareness about dental implants is increasing among dental patients, which demands a higher level of competence for dental students. So, the objective of this study was to assess the knowledge and perception of undergraduate dental students about dental implants.Materials and methodsThis cross-sectional questionnaire-based survey was conducted after taking ethical clearance and approval from the Institutional Review Committee of B.P. Koirala Institute of Health Sciences and informed consent from each dental college of Nepal. The sample included all those students who were present at the time of survey. Data collection were carried out during the academic schedules of the colleges, supervised, and monitored by the investigators themselves. Collected data were coded, entered in Microsoft excel 2013 and descriptive analysis was carried out.ResultsA majority of the total (54.6%) and 59.2% of 5th year respondents perceived to be moderately well-informed about dental implants. The main advantage of dental implants was thought to be longevity by 53.1% of total and 48.4% of 5th year students; only 27.6% of the total and 42.2% of 5th year students said the main advantage of dental implants is they are more conservative than other tooth-replacement modalities. Highest percentage of the total respondents (31.9%) said most important factor for implant success to be implant type and material, whereas 59.8% of 5th year students said case selection. Those who felt dental implants require additional oral hygiene maintenance and care by the patient and dentist were 58.4% of total and 75.1% of 5th year students. Over two-thirds (67.5%) of total thought that economic feasibility will limit use of dental implants in Nepal. The difficulty encountered to place implants was perceived to be average by 56.8% of total and 58.1% of 5th year. There were differences in the perception and knowledge at different academic levels, but not as expected.ConclusionsIt could not be concluded that knowledge about dental implants increased with increase in academic level. Even at the late-clinical year a majority of students gave unsatisfactory responses.

Dataset Information

Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans.

Publications

Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans.

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