Peri-implant Soft Tissues Reaction to Healing Abutments Made from Different Materials

Peri-implant Soft Tissues Reaction to Healing Abutments Made from Different Materials
Author: Sasa Jankovic
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Introduction: Single-stage implant placement protocol involves healing abutmentsu2019 (HA) insertion to allow non-submerged dental implant healing. In addition to osseointegration process, healing of peri-implant soft tissues, as well as soft tissue stability are of a great importance, for the long-term implant success. Routinely, HA made of titanium (Ti) are used. Due to some material related limitations, the aim is to find novel materials that would have the same mechanical properties, but show less biofilm-adhesion affinity and lower local inflammatory soft tissue response. Polyetheretherketone (PEEK) is a thermoplastic polymer that has favorable mechanical characteristics, high biocompatibility and low submissiveness to microorganism adhesion. It has been introduced in implant dentistry as a material for various prosthetic components. The Aim: To compare the formation of dental plaque on PEEK and Ti HA and examine the local inflammatory response of peri-implant soft tissues.Materials and Methods: The study included 11 patients with at least two missing teeth in the posterior regions. In each patient, 2 implants were installed, with PEEK abutment (test group) placed on one implant, while on the other implant, Ti abutment (control group) was placed. 6 months after implant placement, both HA were replaced with new ones and a thin layer of peri-implant soft tissue was sent to histological analysis. For microscopic histological evaluation, biopsies were fixed in 10% neutral-buffered formalin. Three 5-u03bcm-thick paraffin-embedded horizontal sections were cut, dyed with a haematoxylinu2013eosin (HE) stain and analyzed by light microscopy and microscope Nikon Eclipse Ci with control unit DS-L3 and pre-installed software. Following morphological changes were analyzed: presence, localization and intensity of the inflammation. Presence in epithelial and subepithelial tissue was categorized qualitatively (yes/no) and intensity semi-qualitatively (light, medium, intensive).Results: All 11 patients successfully completed the study, without implant loss or implant related complications. Histological immunohistochemical analysis of samples of peri-implant soft tissues showed that all the samples had inflammation in subepithelial tissue. However, inflammatory cells in epithelium were present only in the test group. Semiquantitative analysis showed wary similar distribution of inflammation intensity. Inflammatory responses were classified as u201cintensiveu201d, u201cmediumu201d or u201clightu201d. Intensive inflammatory infiltration in subepithelial tissue in the test group was observed in 90.9% of the specimens, while in the control group it was classified as moderate or weak in 63.3% and 36.4%, respectively. Correlation between intensity, localization and inflammatory cell phenotype showed predominant T-cell proliferation in massive inflammation, with lymphoepithelial lesion in the test group.Conclusion: Both types of HA have been shown to be successful in single-stage implantation protocol. However, contrary to the expectations and preliminary findings from the literature, PEEK healing abutments showed a more pronounced inflammatory response of the surrounding soft tissues compared to Titanium abutments.

Peri-implant Inflammatory Response to Different Abutment Materials - Zirconia, Acrylic and Titaniumu00a0

Peri-implant Inflammatory Response to Different Abutment Materials - Zirconia, Acrylic and Titaniumu00a0
Author: Chen Andru00e9
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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BackgroundInformation on the molecular events occurring during early peri-implant wound healing, that is, during dynamic tissue conditions is scarce.Inflammatory perimplant wound healing express in regulatory cytokines may contribute to early events such as marginal bone remodeling. Different biomaterials are known to evoke different tissue reactionsI.Zirconia. titanium and acrylic are materials regularly used in implant dentistry but little is know about the quantification of cytokines expression that each one has.Aim/HypothesisWhen placing titanium dental implants, does the abutment material (titanium (T) compared to zirconia (Z) and(A) acrylic) have the same inflammatory/cytokine response to perimplant tissues, measured in IL1b and IL6 concentrations at different time frames ?Materials and methodsEight adult male sheep, receive 6 mandibular titanium, platform-switch implants (Biomet-Zimmeru00ae 4.1/3.5x8,5 mm height), three on each side, placed in the diastema, between incisors and premolars.Peri-implant crevicular fluid (PICF) was analyzed for cytokines expression.At the time of surgery each implant was randomly assigned, a two-piece healing abutment made from milled T, milled Z or milled A.PICF samples were take, at the day of surgery (1 hour after surgery was finished - baseline- BL), at 1 month (T1) and at three month (T3) with adsorbent paper (Periopaperu00ae).Samples were placed in eppendorf tubes, transported in dry ice and stored at -80.Interleukins (IL) 1b (IL1b) and 6 (IL6) were measured from validated ELISA kits (Raybiotechu00ae)Calibration Curve for IL6 and IL1b and spectrophotometry at 450 nm readings were made. We randomly duplicate and triplicate each sample for accuracyFor control group we measure the amount of IL1b and IL6 from periodontal crevicular fluid (PCF) sulcus of adjacent teeth (at BL and T3), and the amount of IL from blood samples immediately taken after first incision at BL. p values0.05 were considered statistically significant.ResultsFor IL6 at BL (p=0,597), T1 (p=0,497 ) and T3 (p=0,481), and forIL1b at BL (p=0,857), T1 (p=0, 357) and T3 (p=0,237) there were no statistically differences between T, Z and A, regarding changes in IL expression (p values0.05).For each material there were no statistical differences (Mann-Whitney) between BL and T3 for IL6, T (p=1,000); Z (p=0,857); A (p=0,095) andfor IL1b, T (p=1,000); Z (p=0,905); A (p=0,286) respectively (p values>0.05)There were no statistical differences between (PCF) and (PICF), at baseline (p=0.688) and at day 3 (p=1.000) for IL6 (p values>0.05)There were no statistical differences between (PCF) and (PICF), at baseline (T p=0.688, Zp=0.688,A p=1.000) and at day 3 (Tp=1.000, Zp=1.000,A p=0,125) for IL1b (p values>0.05)For T, Z and A there was significantly less expression of IL6 (p=0.0310.05) in PICF, at BL (1hour after), than the IL present in blood, at the time of incision.For IL1B there was significantly less expression for Z (p=0.0310.05) in PICF at BL (1 hour after), than IL present in blood, but not for A (p=0,3750,05) or T (p=0,2190,05)Conclusion and clinical implicationsRegarding expression of IL6 and IL1b from Bl to T3, T, Z and A have a similar behavior throw time, expressing the same amount of IL, than PIC of adjacent teeth, at similar time frame.For IL6 at BL, T, Z and A express less amount of IL, than the same IL present in blood.Z abutment have a significant inferior IL1b and IL6 expression than the IL present in the blood at BL. The inferior reaction triggered by Z abutments (measured in osteoclastic inducer IL1B) but not by A or T, may be the key to understand, if different materials have different marginal bone remodeling patterns in the first days of healing.

Clinical and Laboratory Manual of Dental Implant Abutments

Clinical and Laboratory Manual of Dental Implant Abutments
Author: Hamid R. Shafie
Publisher: John Wiley & Sons
Total Pages: 200
Release: 2014-07-09
Genre: Medical
ISBN: 1118928539

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To fulfill the vision for his latest book, Dr. Hamid Shafie compiled technical information from a vast variety of sources, including implant manufacturers and designers, master dental technicians, implant researchers, and expert clinicians leading the field of implant dentistry worldwide. He and his expert contributors meticulously assembled each chapter to include only the most relevant and up-to-date content and procedures in a concise and simple format. Dr. Shafie follows the same easy-to-read, easy-to-understand format as his best-selling textbook Clinical and Laboratory Manual of Implant Overdentures.Starting with the material science behind implant abutments, the text then describes all of the relevant abutment solutions, providing a step-by-step guide to design and manufacturing of the CAD/CAM abutments and explaining how to adjust prefabricated abutments and one-piece titanium and zirconia implants. In addition to offering the ultimate procedural guide for clinical and laboratory preparation of dental implant abutments, this textbook is filled with useful tips on clinical practice management such as sterilization, instrumentation and trouble-shooting related to implant abutments. Clinical and Laboratory Manual of Dental Implant Abutmentsis the only text devoted exclusively to an in-depth look at implant abutments. Every dental implant clinician, technician, student, and implant industry insider needs this vital work in their library.

Effect of Different Healing Abutment Materials on Parameters of Peri-implant Infections

Effect of Different Healing Abutment Materials on Parameters of Peri-implant Infections
Author: martin lorenzoni
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Research is increasingly being conducted on polymethylmethacrylate (PMMA) as a material for fixed dentures and/or healing abutments. In this prospective study, the effects of different healing abutment materials (Ti, Zr, PMMA) on parameters of peri-implant infections were investigated.30 subjects with two-piece Ti implants received healing abutments made of Ti, Zr or PMMA. Subsequently, different parameters of peri-implant infections were assessed at placement of healing abutments and follow-ups (after 2 weeks, 2, 3, 6, 12, and 15 months):Inflammatory response mediated by u03b1MMP-8 level in peri-implant sulcus fluidClinical and radiographic periodontal status: pocket probing depths (PPD), bleeding on probing (BOP), plaque index (PI), marginal bone loss (MBL)No significant differences for preliminary results in u03b1MMP-8 level and in clinical parameters (PPD, BOP, PI, MBL) between the three groups were found. Compared to other studies (e.g. [1], [2]) no signs of peri-implant diseases were observed.

Dental Implant Materials 2019

Dental Implant Materials 2019
Author: In-Sung Yeo
Publisher: MDPI
Total Pages: 196
Release: 2021-03-17
Genre: Science
ISBN: 3036504168

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Dental implant materials are advancing in the fusion of various scientific fields. Surface modification technologies for implants have been applied to titanium at the micro-level for about four decades. Now, implant surfaces are being topographically and chemically modified at both the micro- and nano-level. The modification techniques are altering other metals and ceramics, making these materials more biocompatible. Materials for abutments in dental implant systems appear to depend on implant–abutment connection structures. Biomechanical factors, such as friction and preload, influence the development of the abutment materials. Additionally, the surfaces of the abutment materials are important in the soft-tissue attachment, which is being actively investigated. As dental implants have to be functional in human bodies for a long time, numerous materials are being clinically tested as implant-supported restorations. The Special Issue, “Dental Implant Materials 2019”, introduces the creative works of scientists on the current advancements in the field of materials for implant dentistry.

Healing Abutment and Abutment of Different Materials - a Randomized Pilot Study

Healing Abutment and Abutment of Different Materials - a Randomized Pilot Study
Author: martin lorenzoni
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Research is increasingly being conducted on polymethylmethacrylate (PMMA) as a material for fixed dentures and/or healing abutments. In this prospective study, the effects of different healing abutment materials (Ti, Zr, PMMA) on marginal bone loss (MBL) as parameter of peri-implant infections was investigated.30 subjects with two-piece Ti implants received healing abutments made of Ti, Zr or PMMA. Subsequently, marginal bone levels were assessed at placement of healing abutments (3 months after implant exposure) and at follow-up (15 months).No significant differences for results in MBL between the three groups were found. Compared to other studies, which assessed Ti and PMMA abutments only ([1], [2]), similar results for these materials were observed. In addition, observed MBL for PMMA abutments is in the same order of magnitude.Thus, all materials seem appropriate as healing abutments and abutments concerning MBL. Further long-term investigations are necessary prior to application of PMMA as abutment material.

Preliminary Results of Human Soft Tissues Adhesion Around Different Treated Healing Abutments

Preliminary Results of Human Soft Tissues Adhesion Around Different Treated Healing Abutments
Author: Gianmaria D'Addazio
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Long-term implant success has been shown to be related to the presence of a soft tissue barrier, which prevents bacterial penetration. The quality of this mucosal attachment is influenced by the properties of the implant components that are placed in contact with the soft tissue. Although, different study has been performed there is still lack of information on which is the implant surface that better promote the soft tissue cells adhesion. The aim of the present study is to evaluate the adhesion of human soft tissues surrounding a custom-made healing abutments. A total of 21 healing abutments with alternate laser-conditioned and machined surfaces with attached the gingival biopsies have been collected after 4 weeks of healing. The u201cG.du2019Annunziou201d Chieti-Pescara University Ethic Committee has approved this clinical trial Nu00b0 22 of 18.10.2018. Paraffin sections of human gingiva surrounding the healing abutments were prepared from 10 subjects. Hematossilin Eosin and Tricrome staining and image analysis were performed to measure and compare the morphological differences among junctional epithelium, sulcular epithelium and the subepithelial connective tissue of the gingiva touching the smooth and the laser-conditioned surface of the healing abutment. Maygrunwald Giemsa staining and immunofluorescence for CD63 were performed to identify inflammation area. The region of the gingiva adherent to the laser-conditioned showed a regular morphology in all its parts (junctional epithelium, sulcular epithelium and subepithelial connective tissue). By contrast, the region of the gingiva adherent to the machined surfaces showed several stress hallmarks:u2028a) disruption and discontinuities in the basal membrane associated with areas of increased inflammation evident both in the epithelium and, in a larger extent, in the subepithelial connective (abundant presence of CD63 positive area that is surface marker specific for neuthrophils present in inflamed tissue and it is not expressed by neutrophils present in healthy tissue). b) The correct keratinization process is defective or absent since the corneum status present still nucleated cells or a very thin enucleated cells layer compared to the regular corneal layer of the epithelium of the part of gingiva facing the laser-conditioned surface These data suggest that the use of laser treated surface on healing abutment could positively influence the healing. A better distribution and cell morphology on test surface could encourage the clinical use of this treatment. The laser treated surface seems to influence the cell adhesion and the inflammatory infiltrate of the soft tissue. However, further study will be necessary to better understand biological aspects related to soft tissue adhesion on abutment and prosthetic materials.

Soft Tissue Healing Around Immediate Implants with Standard Versus Customized Healing Abutment. One-year Outcomes of an Ongoing Randomized Clinical Trial

Soft Tissue Healing Around Immediate Implants with Standard Versus Customized Healing Abutment. One-year Outcomes of an Ongoing Randomized Clinical Trial
Author: Alfonso Caiazzo
Publisher:
Total Pages:
Release: 2017
Genre:
ISBN:

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Abstract Objectives: Following tooth extraction, soft and hard tissue alterations occur. This randomized clinical trial aimed at evaluating the soft and hard tissues changes in the esthetic region around immediate implants placed in fresh extraction sockets that received u2013 during the first 4 months of healing - a customized (test) or a standard (control) healing abutment without restoration.Materials and Methods: Patients, who required a single tooth extraction and who received an immediate implant with an alloplastic graft (in situ hardening biphasic calcium phosphate), were randomly assigned to two groups: test group (n=18) that received a customized healing abutment or control group (n=18) that received a standard healing abutment. Clinical and intraoral radiographic examinations were taken immediately after implant placement (baseline) and at 4 and 12 months after implant placement, to assess the peri-implant tissues changes. Results:41 patients were preliminary enrolled, after tooth extractions 5 out of 41 extraction sockets sites were evaluated as not suitable for an immediate implant placement and were excluded from the study. In total 36 patients were randomized in the 2 experimental groups. There were 17 females and 19 males (ranging in age from 23.4 to 77.9), with a mean age of 58 years at the time of implant placement. In total, 28 (77.7%) patients reported to be non-smokers and 8 patients (32,3%) reported to be light smokers (less than 10 cigarettes/day). The two study groups were not balanced for confounding factors, even though at baseline no significant differences were observed between the two groups. No prosthetic or implant failure were registered during the study period with a 100% of survival rate. The test group presented better value of Pink Esthetic Score (PES) at distal papilla sites at 12 months when compared to the control group (p = 0.0002). The mesial and distal Papilla Index (PI) in the customized group were significantly higher than in the standard group at 3 and 12 months (p 0.0002). Regarding the bone tissue, the marginal bone loss at mesial sites was significantly higher in the control group than in the test group (p 0.0014).Conclusion: The use of customized healing abutment demonstrated the most favorable results regarding soft and hard tissue in case of immediate implant in addition to peri-implant bone grafting.

Peri-Implant Soft Tissue Management

Peri-Implant Soft Tissue Management
Author: Mohamed Hassan
Publisher: Springer Nature
Total Pages: 165
Release:
Genre:
ISBN: 3031455169

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Zero Bone Loss Concepts

Zero Bone Loss Concepts
Author: Tomas Linkevic̆ius
Publisher:
Total Pages:
Release: 2019
Genre:
ISBN: 9780867158342

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