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Novel Insights into Interactions between Dental Implants and the Surrounding Tissue

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 29760

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Special Issue Editor

Prof. Yasunori Ayukawa

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Guest Editor

Section of Implant & Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
Interests: prosthodontics; dental implantology; biomaterial; bone; medication-related osteonecrosis of the jaw

Special Issue Information

Dental implants have been applied clinically for more than half a century. The first modern implant established by Professor Brånemark had a surface with machine polishing. This surface has the great characteristic of a lower risk of both plaque retention and subsequent peri-implant inflammation; however, earlier integration with bone was expected. Textured implant surfaces have been reported to have the characteristic of earlier osseointegration, but rough-surfaced implants in the early days were “too” rough, which sometimes induced peri-implantitis or other problems. From this viewpoint, a Swedish group drew a conclusion that the best surface for osseointegration is one with moderate roughness (Ra = 1–2μm).

Since peri-implantitis is known as one of main reasons for the loss of implants, the secure connection of the gingiva to the implant surface is obviously important. However, for the implant component facing the gingival soft tissue, notable innovation has scarcely been introduced. Quite recently, some surfaces/processes with an affinity to gingival tissue have been reported. The guest editor feels that there is still great room for the improvement of implant surfaces.

The current Special Issue seeks clinical studies that can contribute to the advancement of the integration between dental implants and both bone and soft tissue. As well as material/surface innovation, the enhancement of the host tissue response for the promotion of the tissue integration of implants is also encouraged.

Prof. Yasunori Ayukawa
Guest Editor

Manuscript Submission Information

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Keywords

Bone and soft tissue integration
Peri-implant tissue regeneration
Surface modification
Dental implant failure
Clinical outcome

Published Papers (7 papers)

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Research

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9 pages, 2425 KiB

Open AccessArticle

Soft Tissue Interface with Various Kinds of Implant Abutment Materials

by Akihiro Furuhashi, Yasunori Ayukawa, Ikiru Atsuta, Yunia Dwi Rakhmatia and Kiyoshi Koyano

J. Clin. Med. 2021, 10(11), 2386; https://doi.org/10.3390/jcm10112386 - 28 May 2021

Cited by 16 | Viewed by 3062

Abstract

Various materials, such as titanium, zirconia and platinum-gold (Pt-Au) alloy, have been utilized for dental implant trans-mucosal parts. However, biological understanding of soft tissue reaction toward these materials is limited. The aim of this study was to compare the response of cell lines and soft tissue to titanium, zirconia and Pt-Au substrata. The surface hydroxyl groups and protein adsorption capacities of the substrata were measured. Next, gingival epithelial-like cells (Sa3) and fibroblastic cells (NIH3T3) were cultured on the materials, and initial cell attachment was measured. Immuno-fluorescent staining of cell adhesion molecules and cytoskeletal proteins was also performed. In the rat model, experimental implants constructed from various materials were inserted into the maxillary tooth extraction socket and the soft tissue was examined histologically and immunohistochemically. No significant differences among the materials were observed regarding the amount of surface hydroxyl groups and protein adsorption capacity. Significantly fewer cells of Sa3 and NIH3T3 adhered to the Pt-Au alloy compared to the other materials. The expression of cell adhesion molecules and a well-developed cytoskeleton was observed, both Sa3 and NIH3T3 on each material. In an animal model, soft tissue with supracrestal tissue attachment was observed around each material. Laminin-5 immuno-reactivity was seen in epithelia on both titanium and zirconia, but only in the bottom of epithelia on Pt-Au alloy. In conclusion, both titanium and zirconia, but not Pt-Au alloy, displayed excellent cell adhesion properties. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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13 pages, 3343 KiB

Open AccessArticle

The Anatomical Conditions of the Alveolar Process of the Anterior Maxilla in Terms of Immediate Implantation—Radiological Retrospective Case Series Study

by Piotr Wychowański, Anna Starzyńska, Martyna Osiak, Jan Kowalski, Barbara Alicja Jereczek-Fossa, Blanka Seklecka, Tadeusz Morawiec, Paulina Adamska and Jarosław Woliński

J. Clin. Med. 2021, 10(8), 1688; https://doi.org/10.3390/jcm10081688 - 14 Apr 2021

Cited by 5 | Viewed by 2551

Abstract

The feasibility and the level of difficulty of immediate flapless implantation depend largely on the residual alveolar bone. The purpose of the study was to determine how often immediate flapless implantation in the anterior maxilla is feasible and assess the difficulty level using cone-beam computed tomography (CBCT) scans. A radiological retrospective case series study was conducted. In total, 1200 CBCT scans from 300 consecutive patients were analyzed with dedicated planning software. Immediate flapless implants were possible in 78.33% of cases. Drilling direction was either through the apex or the palatal slope. Bimodal was conducted in 9% of the cases; only through the apex in 13.08% of the cases and in 56.25% only in the slope. In 21.67%, immediate flapless implants were excluded. The feasibility and degree of difficulty differed statistically to the disadvantage of the lateral incisors compared to the central incisors. Drilling direction caused that BASE classification reflects the difficulty level of immediate implantation. CBCT is a helpful diagnostic tool for assessing the feasibility of immediate flapless implants due to the residual bone shape and volume. BASE classification helps to determine a challenge level that may also facilitate communication and result in comparison. The alveolar bone condition allows for immediate flapless implants in most cases in the aesthetic region of the maxilla, but they should be performed by an experienced specialist with regard to the bone and soft tissue quality. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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18 pages, 1747 KiB

Open AccessArticle

Clinical Performance of a Novel Two-Piece Abutment Concept: Results from a Prospective Study with a 1-Year Follow-Up

by Giacomo Fabbri, Tristan Staas, Tomas Linkevicius, Valda Valantiejiene, Oscar González-Martin and Eric Rompen

J. Clin. Med. 2021, 10(8), 1594; https://doi.org/10.3390/jcm10081594 - 9 Apr 2021

Cited by 6 | Viewed by 3612

Abstract

Development of a stable and healthy soft-tissue barrier around dental implants is key to long-term success of implant-supported prostheses. The novel two-piece abutment concept shifts the prosthetic interface to the soft-tissue level to protect bone interface/connective tissue during the healing phase and restorative procedures. This prospective study included 72 patients treated with 106 implants to support a single-tooth or a three-unit bridge restored with two-piece abutments. The evaluation included marginal bone level change (MBLC), implant and prosthetic survival, soft-tissue health including keratinized mucosa height and mucosal margin position, patient quality of life (QoL) and satisfaction, and clinician satisfaction and ease-of-use rating of the concept. Mean MBLC from implant placement to 1 year was −0.36 ± 1.26 mm (n = 89), the 1-year implant and prosthetic survival rates were 97.1 and 96.7%, respectively, while keratinized mucosa height increased from 2.9 ± 1.2 mm at prosthetic delivery to 3.2 ± 1.3 mm, and mucosal margin migrated coronally by 0.49 ± 0.61 mm by 1 year. Patient satisfaction and QoL were high. Clinicians were satisfied with the esthetic and functional results and rated the concept as easy to use. In conclusion, the novel two-piece abutment concept promotes good peri-implant tissue health, while providing an easy-to-use workflow and high treatment satisfaction to both patients and clinicians. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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14 pages, 15096 KiB

Open AccessArticle

Short (6 mm) and Regular Dental Implants in the Posterior Maxilla–7-Years Follow-up Study

by Jakub Hadzik, Paweł Kubasiewicz-Ross, Izabela Nawrot-Hadzik, Tomasz Gedrange, Artur Pitułaj and Marzena Dominiak

J. Clin. Med. 2021, 10(5), 940; https://doi.org/10.3390/jcm10050940 - 1 Mar 2021

Cited by 15 | Viewed by 3803

Abstract

Short 6 mm dental implants are considered as an alternative to the maxillary sinus elevation and bone augmentation procedure where there is a reduced alveolar ridge height. The aim of this study was to compare the implant survival rate between short dental implants (6 mm) and regular length implants (11–13 mm) when placed in combination with bone grafting and loaded with a single non splinted crown, seven years after placing the implant. It was conducted as a controlled clinical study of 30 patients with partial edentulism in the posterior maxilla. The protocol included radiological and clinical evaluation of the C/I ratio (length of the superstructure divided by the length of the implant crestal part), marginal bone level (MBL), ultrasonography measurement of soft tissue surrounding implant (STT), patient-reported outcomes, and biological and technical complications. A total number of 28 implants (93%) remained integrated during follow-up period. MBL of 0.50 and 0.52 mm was observed for short implants and regular implants, respectively. MBL was checked for correlation with STT, and a negative correlation was found between MBL: STT. Our study has demonstrated a significantly lower implant survival rate for short implants compared to regular implants (87% compared to 100%). Despite the loss of several implants, good clinical results were achieved in the remaining implants in both groups. It is, therefore, worth considering short implants as an alternative to regular implants with a sinus lift surgery. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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7 pages, 1282 KiB

Open AccessArticle

Localization of Integrin Beta-4 Subunit at Soft Tissue–Titanium or Zirconia Interface

by Yasunori Ayukawa, Ikiru Atsuta, Yasuko Moriyama, Yohei Jinno and Kiyoshi Koyano

J. Clin. Med. 2020, 9(10), 3331; https://doi.org/10.3390/jcm9103331 - 17 Oct 2020

Cited by 11 | Viewed by 2369

Abstract

Currently, along with titanium (Ti), zirconia is widely used as an abutment material for dental implants because it makes it possible to avoid gingival discoloration; however, the epithelial sealing capability of zirconia remains unknown. The purpose of the present study is to elucidate the localization of integrin β4 subunit (Inβ4), one of the main proteins in the attachment structure between gingival junctional epithelial (JE) cells and substrata. Maxillary first molars were extracted from rats, and implants were placed with Ti or zirconia transgingival parts; then, the localization of Inβ4 was observed. Morphological and functional changes in rat oral epithelial cells (OECs) cultured on a culture dish (Dish) and Ti and zirconia plates were also evaluated with Inβ4 immunofluorescence histochemistry and Western blotting. After four weeks of implant placement, the morphology of the peri-implant epithelium (PIE) and the localization of Inβ4 around the Ti and zirconia transgingival parts were similar. However, both exhibited markedly shorter Inβ4-positive bands in the PIE than in the JE around natural teeth. Decreased expression levels of Inβ4 were observed in OECs cultured on Ti and zirconia plates compared with those cultured on Dish. In conclusion, although inferior to natural teeth, zirconia implants are thought to have epithelial sealing properties comparable to those of titanium. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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12 pages, 5445 KiB

Open AccessArticle

Effect of Calcium Chloride Hydrothermal Treatment of Titanium on Protein, Cellular, and Bacterial Adhesion Properties

by Takuya Haraguchi, Yasunori Ayukawa, Yukie Shibata, Toru Takeshita, Ikiru Atsuta, Yoichiro Ogino, Noriyuki Yasunami, Yoshihisa Yamashita and Kiyoshi Koyano

J. Clin. Med. 2020, 9(8), 2627; https://doi.org/10.3390/jcm9082627 - 13 Aug 2020

Cited by 7 | Viewed by 2338

Abstract

Topographical modification of the dental implant surface is one of the main topics for the improvement of the material, however, the roughened surface has some risks for peri-implantitis. A hydrothermal treatment (HT) of titanium with calcium chloride solution was reported to improve osseointegration and soft tissue sealing without changing the surface topography; however, its mechanism is unclear. We herewith investigated the interaction between extracellular matrix (ECM) protein and HT titanium. Furthermore, we also clarified the bacterial interaction. We employed two kinds of HT, HT with water (DW-HT) and HT with calcium chloride solution (Ca-HT). As a result, the adsorptions of both laminin-332 and osteopontin onto the Ca-HT surface were enhanced. In contrast, the adsorption of albumin, which was reported to have no cell adhesion capacity, was not influenced by Ca-HT. Osteoblast adhesion onto Ca-HT was also enhanced. Although Ca-HT was reported to enhance both epithelial cell attachment strength and in vivo peri-implant epithelial bonding, the number of epithelial cell attachment was not increased even after HT. Ca-HT had no impact in the adhesion of Streptococcus gordonii. These results suggest that Ca-HT enhances cell adhesion onto titanium without increasing bacterial adhesion, and the improvement of ECM protein adsorption is supposed to contribute to cell adhesion. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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Review

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36 pages, 524 KiB

Open AccessReview

The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation

by Stefanie Kligman, Zhi Ren, Chun-Hsi Chung, Michael Angelo Perillo, Yu-Cheng Chang, Hyun Koo, Zhong Zheng and Chenshuang Li

J. Clin. Med. 2021, 10(8), 1641; https://doi.org/10.3390/jcm10081641 - 12 Apr 2021

Cited by 135 | Viewed by 11319

Abstract

Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant’s surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation. Full article

(This article belongs to the Special Issue Novel Insights into Interactions between Dental Implants and the Surrounding Tissue)

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