Two-piece implant systems are mainly used in oral implantology involving an osseointegrated implant connected to an abutment, which supports prosthetic structures. It is well documented that the presence of microgaps, biofilms and oral fluids at the implant-abutment connection can cause mechanical and biological complications. The aim of this review paper was to report the degradation at the implant-abutment connection by wear and corrosion processes taking place in the oral cavity. Most of the retrieved studies evaluated the wear and corrosion (tribocorrosion) of titanium-based materials used for implants and abutments in artificial saliva. Electrochemical and wear tests together with microscopic techniques were applied to validate the tribocorrosion behavior of the surfaces. A few studies inspected the wear on the inner surfaces of the implant connection as a result of fatigue or removal of abutments. The studies reported increased microgaps after fatigue tests. In addition, data suggest that micromovements occurring at the contacting surfaces can increase the wear of the inner surfaces of the connection. Biofilms and/or glycoproteins act as lubricants, although they can also amplify the corrosion of the surfaces. Consequently, loosening of the implant-abutment connection can take place during mastication. In addition, wear and corrosion debris such as ions and micro- and nanoparticles released into the surrounding tissues can stimulate peri-implant inflammation that can lead to pathologic bone resorption.
Aim The aim of this article was to evaluate the accuracy of buccal bone thickness measurements around implants on CBCT. Material and methods Forty‐four Osseospeed EV implants (3.6 in Ø) were placed guided and flapless in five fresh frozen human cadaver heads. The buccal peri‐implant bone was measured clinically via guided bone sounding. Post‐op CBCTs were taken with two different CBCT scanners (NewTom® and Accuitomo®) on which the buccal bone was measured. Consequently, after implant removal, a new CBCT was made without implant artefacts (image reference standard) on which the real buccal bone thickness was scored. Results Due to an average blooming (artificial increase of implant diameter) percentage of 12%–15%, the buccal peri‐implant bone thickness was underestimated by 0.3 mm on both CBCT devices. Immediately adjacent to the implant blooming area, a doubtful zone of about 0.45 mm was observed in which the buccal bone was not always visible. Buccal bone that was thick enough to fall outside this doubtful zone could always be visualized. Conclusion The findings in this study may help the clinician in the decision‐making process whether or not to intervene surgically in areas with ambiguous CBCT results.
background: The main objective of regenerative periodontal therapy is to completely restore the periodontal tissues lost. This review summarizes the most recent evidence in support of scaffold-and cell-based tissue engineering, which are expected to play a relevant role in next-generation periodontal regenerative therapy. Methods: A literature search (PubMed database) was performed to analyze more recently updated articles regarding periodontal regeneration, scaffolds and cell-based technologies. Results: Evidence supports the importance of scaffold physical cues to promote periodontal regeneration, including scaffold multicompartmentalization and micropatterning. The in situ delivery of biological mediators and/or cell populations, both stem cells and already differentiated cells, has shown promising in vivo efficacy. Conclusions: Porous scaffolds are pivotal for clot stabilization, wound compartmentalization, cell homing and cell nutrients delivery. Given the revolutionary introduction of rapid prototyping technique and cell-based therapies, the fabrication of custom-made scaffolds is not far from being achieved.
Objective The objective of this review was to assess the accuracy of available means of determining the BBT (buccal bone thickness) and/or BBL (buccal bone level). This was translated into the following research question: What is the accuracy of the available means of visualizing the BBP (buccal bone plate) to establish the BBT and/or the BBL, when compared to control measurements? As control measurements histomorphometric measurements, direct measurements and cone‐beam computed tomography (CBCT) measurements in the absence of metal are accepted. Background Data: Methods The literary search was performed by searching the databases of MEDLINE, Embase, and Web of Science, up to July 13, 2021. Types of studies included were clinical, in vitro and animal trials, specifically looking into the bone level and/or bone thickness of the buccal bone plate at oral implants. Reference lists were hand searched for relevant articles. Two reviewers performed the data extraction and analysis. Only studies using reliable control measurements to evaluate the accuracy of the tested means of visualizing BBT and/or BBL were included for analysis. The QUADAS‐2 tool was used to perform bias analysis on the relevant studies. Extracted data was tabulated to show the differences between test and control measurements for BBT and BBL. For in vitro studies on CBCT measurements of BBT meta‐analysis could be performed. Results A total of 1176 papers were identified in the search. Twenty‐two articles were used for data extraction and qualitative analysis. Of these studies nine were animal studies, 9 were in vitro studies and four were human studies. Six animal studies and three human studies provided data on probing. CBCT and sonography as techniques for visualizing the buccal bone plate. Probing at implant sites seems to provide data that correlates with a consistent distance from the BBP. Meta‐analysis for probing studies could not be performed due to heterogeneity in the setups of these studies. Eleven studies on CBCT were eligible for inclusion. Of these three were animal studies, the remaining 8 studies were all in vitro studies. Meta‐analysis was performed on the accuracy of CBCT for in vitro studies, finding a significant underestimation of the BBT when compared to control measurements by a mean difference of −0.15 mm with 95%CI [−0.26,−0.03]. Three studies were identified on measurement of BBT and/or BBL by sonography. This included one human study and two in vitro studies. The identified studies show a low error when determining the buccal bone level or thickness using sonography. All included studies possess a high risk of bias according to risk of bias analysis, mostly due to selection of the patient. Conclusion A strong limitation of this systematic review is the inclusion of different studies with heterogeneous designs. Within the limits of this analysis it cannot be concluded that probing is an accurate way of visualizing the BBP. CBCT cannot yet be recommended as a standard diagnostic tool for follow‐up of the BBP at oral...
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