A histologic study of bone response to bioactive glass particles used before implant placement: A clinical report

This clinical report describes the microscopic analysis of the postextraction bone response to bioactive glass particles used prior to titanium implant placement, after a healing period of 6 months. The clinical and radiographic follow-up were performed over a 3-year period after implantation.Fil: Stvrtecky, Roberto. Universidad de Buenos Aires; ArgentinaFil: Gorustovich Alonso, Alejandro Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Guglielmotti, Maria Beatriz. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Guglielmotti, María Beatriz. Universidad de Buenos Aires; Argentin

The effect of antiresorptive drugs on implant therapy : Systematic review and meta-analysis

Objectives: A considerable portion of the adult population has received and/or is receiving treatment with antiresorptive drugs (ARDs). It is thus relevant to assess possible side effects of ARD intake in connection to various aspects of implant ther‐ apy. The aim of this study was to answer the focused question “In patients with sys‐ temic intake of ARDs, what is the outcome and complication rate of implant therapy including associated bone grafting procedures comparing to patients without sys‐ temic intake of ARDs?” Materials and Methods: Original studies fulfilled predefined inclusion criteria (e.g., case series, cohort studies, case–control studies, and controlled and/or randomized controlled clinical trials; retro‐ or prospective design; and ≥10 patients with systemic intake of ARDs). Various patient‐, medication‐, and intervention‐related parameters [i.e., implant loss, grafting procedure complication/failure, peri‐implant marginal bone levels/loss, medication‐related osteonecrosis of the jaws (MRONJ), and peri‐ implantitis] were extracted, and meta‐analyses and quality assessment were performed. Results: Twenty‐four studies with bisphosphonate (BP) intake (mainly low dose for osteoporosis treatment) and seven studies on hormone replacement therapy (HRT), including ≥10 patients, and controls not taking the medication were identified. Furthermore, seven studies on MRONJ associated with implants were included. Meta‐analyses based on four studies reporting on patient level and eight studies re‐ porting on implant level showed no significant differences in terms of implant loss between patients on BPs (mainly low dose for osteoporosis treatment) and controls. Furthermore, low‐dose BP intake did not compromise peri‐implant marginal bone levels. Based on two studies, no negative effect of HRT was observed on the implant level, while HRT appeared to exert a marginally significant negative effect regarding implant survival on the patient level and regarding peri‐implant marginal bone levels. Based on six studies reporting single‐patient data, MRONJ in patients on BP for os‐ teoporosis appeared in 70% of the cases >36 months after start of drug intake, while in patients with cancer, MRONJ appeared in 64% of the cases ≤36 months after first BP intake. Conclusion: Low‐dose oral BP intake for osteoporosis treatment, in general, does not compromise implant therapy, that is, patients on ARDs do not lose more implants nor get more implant‐related complications/failures comparing to implant patients with‐ out BP intake. There is almost no information available on the possible effect on im‐ plant therapy of high‐dose BPs or other widely used ARDs (e.g., denosumab), or on the success or safety of bone grafting procedures. Patients with high‐dose ARD in‐ take for management of malignancies, patients on oral BP over a longer period of time, and patients with comorbidities should be considered as high‐risk patients for MRONJ

Research on implants and osseointegration

Osseointegration was originally defined as a direct structural and functional connection between ordered living bone and the surface of a load-carrying implant. It is now said that an implant is regarded as osseointegrated when there is no progressive relative movement between the implant and the bone with which it is in direct contact. Although the term osseointegration was initially used with reference to titanium metallic implants, the concept is currently applied to all biomaterials that have the ability to osseointegrate. Biomaterials are closely related to the mechanism of osseointegration; these materials are designed to be implanted or incorporated into the living system with the aims to substitute for, or regenerate, tissues and tissue functions. Objective evaluation of the properties of the different biomaterials and of the factors that influence bone repair in general, and at the bone tissue?implant interface, is essential to the clinical success of an implant. The Biomaterials Laboratory of the Oral Pathology Department of the School of Dentistry at the University of Buenos Aires is devoted to the study and research of the properties and biological effects of biomaterials for dental implants and bone substitutes. This paper summarizes the research work resulting from over 25 years? experience in this field. It includes studies conducted at our laboratory on the local and systemic factors affecting the peri-implant bone healing process, using experimental models developed by our research team. The results of our research on corrosion, focusing on dental implants, as well as our experience in the evaluation of failed dental implants and bone biopsies obtained following maxillary sinus floor augmentation with bone substitutes, are also reported. Research on biomaterials and their interaction with the biological system is a continuing challenge in biomedicine, which aims to achieve optimal biocompatibility and thus contribute to patient health.Fil: Guglielmotti, Maria Beatriz. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Olmedo, Daniel Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Universidad de Buenos Aires; ArgentinaFil: Cabrini, Rómulo L.. Comisión Nacional de Energía Atómica; Argentina. Universidad de Buenos Aires; Argentin