Clinical, histological, and nanomechanical parameters of implants placed in healthy and metabolically compromised patients

• Published in: Journal of dentistry Vol. 100; p. 103436
• Main Authors: Granato, Rodrigo, Bergamo, Edmara T.P., Witek, Lukasz, Bonfante, Estevam A., Marin, Charles, Greenberg, Michael, Kurgansky, Gregory, Coelho, Paulo G.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2020; Elsevier Limited
• Subjects: Blood pressure; Bone growth; Bone healing; Bone implants; Bones; Clinical outcomes; Clinical study; Dental Implantation, Endosseous; Dental Implants; Dentistry; Diabetes; Edentulous; Fatty acids; Female; Glucose; Healing; Histology; Humans; Lipids; Loading; Male; Males; Mandible; Mechanical properties; Metabolic disorders; Metabolic syndrome; Metabolites; Modulus of elasticity; Morphology; Nanoindentation; Occupancy; Osseointegration; Osteogenesis; Parameters; Patients; Photomicrographs; Population studies; Properties (attributes); Prostheses; Prototypes; Quotients; Risk factors; Stability analysis; Statistical analysis; Surgery; Survival; Transplants & implants; Tumor necrosis factor-TNF; Sweden; Osseointegration; Histology; Dental implants; Clinical study
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2020.103436

To evaluate the clinical outcomes, histological parameters, and bone nanomechanical properties around implants retrieved from healthy and metabolic syndrome (MS) patients. Twenty-four patients with edentulous mandibles (12/condition), received four implants between the mental foramina. An additional implant prototype was placed for retrieval histology. The following clinical outcomes were evaluated: insertion torque (IT), implant stability quotient (ISQ) values at baseline and after 60 days of healing, and implant survival. The prototype was retrieved after the healing and histologically processed for bone morphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO), and bone nanoindentation to determine the elastic modulus (Em) and hardness (H). Descriptive statistical procedures and survival tests were used to analyze the data. The final study population was comprised of 10 women and 11 men (∼64 years). A total of 105 implants were placed, 21 retrieved for histology. Implant survival rates were similar between groups (>99 %). Similarly, IT and ISQ analyses showed no significant association with systemic condition (p > 0.216). Histological micrographs depicted similar bone morphology, woven bone, for both conditions. While MS (33 ± 5.3 %) and healthy (39 ± 6.5 %) individuals showed no significant difference for %BIC (p = 0.116), significantly higher %BAFO was observed for healthy (45 ± 4.6 %) relative to MS (30 ± 3.8 %) (p < 0.001). No significant differences on bone nanomechanical properties was observed (p > 0.804). Although no significant influence on clinical parameters and bone nanomechanical properties was observed, MS significantly reduced bone formation in the peri-implant area in the short-term. A lower amount of bone formation in the peri-implant area was observed in comparison to healthy patients, although the other short-term clinical outcomes were not significantly different. Considering the escalating prevalence of MS patients in need for implant treatment, it becomes crucial to understand bone-to-implant response to determine the ideal loading time in this population.