ABSTRACT Background Postmenopausal osteoporosis associated with cafeteria diet and bisphosphonate therapy may impair peri‐implant bone repair. Therefore, strategies to enhance osseointegration are needed. Aim This study investigated whether teriparatide‐coated implant surfaces enhance osseointegration in a rodent model of estrogen deficiency (OVX) and cafeteria diet (CD) treated with risedronate (RIS). Material and Methods In the in vitro phase, titanium discs coated with 10 or 40 ng of teriparatide were evaluated by in vitro bioassays, and drug adsorption was confirmed by UV–Vis spectroscopy. As both loading amounts produced similar biological responses, 10 ng was selected for the in vivo phase. In the in vivo phase, 48 rats were randomly assigned to SHAM (sham‐operated control), OVX/CD (ovariectomized with cafeteria diet), or OVX/CD/RIS (ovariectomized with cafeteria diet and risedronate) groups. Titanium implants either coated with teriparatide using a layer‐by‐layer topical drug delivery system or left non‐coated were placed bilaterally in the maxilla. Rats were euthanized after 28 days. Osseointegration was evaluated by removal torque testing, micro computed tomography, fluorescence microscopy, and RT‐qPCR analysis. Results In the cell culture experiment, both teriparatide amounts successfully promoted mineralized nodule formation in vitro and UV–Vis spectroscopy confirmed drug adsorption. In vivo, teriparatide significantly increased removal torque across all groups, with the greatest increase in OVX/CD/RIS. Teriparatide also increased peri‐implant bone volume in OVX/CD and OVX/CD/RIS, confirmed by micro computed tomography and fluorescence microscopy. RT‐qPCR also confirmed upregulation of osteogenic and angiogenic markers. Conclusion Topical teriparatide delivery improves peri‐implant bone repair under estrogen deficiency, cafeteria diet, and bisphosphonate therapy.
ABSTRACT Objectives This study represents the 1‐year follow‐up of a previously reported randomized controlled trial comparing chairside fully guided (FG) flapless implant placement with conventional partially guided (PG) open‐flap implant placement. We evaluated marginal bone level (MBL) change, peri‐implant clinical outcomes, and associations between placement accuracy and MBL change. Materials and Methods This study was a 1‐year follow‐up analysis of a previously reported randomized controlled trial. Fifty‐six patients were randomized into the FG ( n = 28) and PG ( n = 28) groups. Radiographic MBL changes and peri‐implant clinical indices were evaluated at baseline and 1‐year post‐loading. Deviations between the virtually planned and placed implants were quantified in three dimensions. Stepwise multiple linear regression analyses were performed to identify accuracy parameters associated with MBL changes. Results Twenty‐one FG and 22 PG patients completed follow‐up. Peri‐implant clinical parameters were comparable between groups. In unadjusted analyses, the FG group showed more positive mesial and mean ΔMBL values than the PG group. However, the treatment group was not significantly associated with mesial, distal, or mean ΔMBL in the adjusted models. Implant accuracy was higher in the FG group, with lower horizontal, three‐dimensional, and angular deviations. Adjusted regression analyses retained TPD and distal EA in the mesial ΔMBL model and VAD in the mean ΔMBL model. Conclusions Chairside, FG flapless implant placement improved positional accuracy and was associated with modest unadjusted differences in short‐term marginal bone level changes after crestal sinus augmentation. However, the between‐group differences in ΔMBL were not statistically significant after adjustment for multiple comparisons. Trial Registration Clinical Research Information Service of the National Research Institute of Health, South Korea (KCT0005465), Registered October 12, 2020. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26961&search_page=L
ABSTRACT Objectives To evaluate patient‐reported outcome (PROs) and their associated factors in patients treated with dental implants more than 5 years earlier. Materials and Methods In this cross‐sectional study, patients with implants (> 5 years) completed a self‐administered questionnaire assessing functional, aesthetic, psychosocial and economic satisfaction. The 17 satisfaction items were condensed by exploratory factor analysis, and a Global Satisfaction Score was derived. Univariable and multivariable linear regression with robust standard errors identified factors associated with satisfaction, complemented by sensitivity and subgroup analyses. Results A total of 260 patients were included (61.2% female; 91.5% aged > 50 years). Overall satisfaction was high, with 93.1% of patients satisfied or very satisfied. Factor analysis yielded four dimensions (overall satisfaction, psychosocial function, aesthetics, information). In the multivariable model, higher pre‐treatment information ( β = +6.4, p < 0.001) and the absence of patient‐reported peri‐implant inflammation ( β = −8.2, p < 0.001) were the only factors independently associated with overall satisfaction. Both remained robust across sensitivity analyses. Demographic variables, cost and extent of rehabilitation were not associated with satisfaction. A history of periodontitis was associated with higher aesthetic satisfaction ( p = 0.030). Conclusions Patient satisfaction more than 5 years after implant therapy was high and most strongly associated with patient‐reported pre‐treatment information and the absence of reported complications than with demographic factors. These findings should be interpreted cautiously as the cross‐sectional design and retrospective self‐reporting preclude causal inference.
ABSTRACT Aim To evaluate the diagnostic accuracy of host‐derived and microbiological biomarkers, alone and in combination with clinical parameters, for the detection of peri‐implant bone loss (BL). Methods A university‐based cohort of subjects with dental implants was examined at baseline and after a mean follow‐up of 3.9 years. Peri‐implant BL served as the reference standard, defined as > 1 mm between baseline and follow‐up radiographs; implants with < 0.5 mm BL served as controls. At follow‐up, peri‐implant crevicular fluid and submarginal‐microbiological samples were collected. Bone metabolism and inflammatory biomarkers were quantified using Luminex technology. Bacterial loads were quantified by qPCR. Associations of biomarkers with BL were evaluated using multilevel logistic regression models. Diagnostic accuracy was assessed using ROC curves, with AUC, sensitivity, specificity, and predictive values reported. Results Seventy‐one subjects with 273 implants were included. Twenty‐eight exhibited peri‐implant‐BL > 1.0 mm over the follow‐up period. Increased levels of IL‐1β, T. denticola, Fusobacterium spp., and T. forsythia were associated with BL in unadjusted analyses. However, these associations were no longer statistically significant after adjustment for clinical parameters. Individual biomarkers demonstrated limited diagnostic accuracy (maximum AUC = 0.68). In contrast, biomarker combinations with clinical parameters exhibited excellent discriminative performance (AUC > 0.95). The combination of IL‐1β and BoP‐or‐PPD achieved the highest accuracy (AUC = 0.97). Conclusions While individual biomarkers showed limited diagnostic utility, combining multiple predictors significantly improved the ability to detect peri‐implant BL. Combining IL‐1β with either BoP or PPD significantly outperformed individual clinical measures but did not outperform the combination of clinical parameters, highlighting the potential of integrated biomarker and clinical parameter approaches as screening tools for detecting BL.
