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Open Access 01-12-2023 | Laser | Research

Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials

Authors: Giulia Gaggi, Andrea Di Credico, Gianmaria D’Addazio, Barbara Ghinassi, Giulio Argentieri, Sergio Caputi, Angela Di Baldassarre, Bruna Sinjari

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

Dental implant is the principal treatment for edentulism and the healthiness of the peri-implant tissue has a pivotal role for its longterm success. In addition, it has been shown that also the topography of the healing abutment can influence the outcome of the restoration. The objective of this human clinical trial was to assess the impact of a novel laser-treated healing abutment on peri-implant connective tissue and extracellular matrix proteins compared to the conventional machined surface, which served as the control group.

Methods

During second surgical stage a customized healing abutment were inserted on 30 single dental implants. Healing abutments were realized with two alternated different surface (two side laser-treated surfaces and two side machined surfaces) in order to be considered both as test and control on the same implant and reduce positioning bias. Following the soft tissue healing period (30 ± 7 days) a 5 mm circular biopsy was retrieved. Immuno-histochemical and quantitative real-time PCR (qPCR) analyses were performed on Collagen, Tenascin C, Fibrillin I, Metalloproteinases (MMPs) and their inhibitor (TIMPs). 15 were processed for qPCR, while the other 15 were processed for immunohistochemical analysis. Paired t-test between the two groups were performed. A value of p < 0.05 was considered statistically significant.

Results

Results revealed that the connective tissue facing the laser-treated surface expressed statistically significant lower amount of MMPs (p < 0.05) and higher level of TIMPs 3 (p < 0.05), compared to the tissue surrounding the machined implant, which, in turn expressed also altered level of extracellular matrix protein (Tenascin C, Fibrillin I (p < 0.05)) and Collagen V, that are known to be altered also in peri-implantitis.

Conclusions

In conclusion, the laser-treated surface holds promise in positively influencing wound healing of peri-implant connective tissue. Results demonstrated that topographic nature of the healing abutments can positively influence mucosal wound healing and molecular expression. Previous studies have been demonstrated how laser treatment can rightly influence integrity and functionality of the gingiva epithelium and cell adhesion. Regarding connective tissue different molecular expression demonstrated a different inflammatory pattern between laser treated or machined surfaces where laser treated showed better response. Targeted interventions and preventive measures on peri- implant topography could effectively minimize the risk of peri-implant diseases contributing to the long-term success and durability of restoration. However, new studies are mandatory to better understand this phenomenon and the role of this surface in the peri-implantitis process.

Trial registration

This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970). Registered 06/03/2023, retrospectively registered.

Zheng Z, Ao X, Xie P, Jiang F, Chen W. The biological width around implant. J Prosthodont Res. 2021;65(1):11–8. https://doi.org/10.2186/jpr.JPOR_2019_356.CrossRefPubMed

Chavrier C, Couble ML, Magloire H, Grimaud JA. Connective tissue organization of healthy human gingiva: ultrastructural localization of collagen types I-III-IV. J Periodontal Res. 1984;19(3):221–9. https://doi.org/10.1111/j.1600-0765.1984.tb00813.x.CrossRefPubMed

Nikoloudaki G. Functions of matricellular proteins in dental tissues and their emerging roles in orofacial tissue development, maintenance, and disease. Int J Mol Sci. 2021;22(19):6626. https://doi.org/10.3390/ijms22126626.CrossRefPubMedPubMedCentral

Marzeda AM, Midwood KS. Internal affairs: tenascin-c as a clinically relevant, endogenous driver of innate immunity. J Histochem Cytochem. 2018;66(4):289–304. https://doi.org/10.1369/0022155418757443.CrossRefPubMedPubMedCentral

Mane DR, Rahman SU, Desai KM, Kale AD, Bhat KG, Arany PR. Roles of the matricellular protein tenascin-C in T-Lymphocyte trafficking and etiopathogenesis of oral lichen planus. Arch Oral Biol. 2020;110:104622. https://doi.org/10.1016/j.archoralbio.2019.104622.CrossRefPubMed

de Jong T, Bakker AD, Everts V, Smit TH. The intricate anatomy of the periodontal ligament and its development: lessons for periodontal regeneration. J Periodontal Res. 2017;52(6):965–74. https://doi.org/10.1111/jre.12477.CrossRefPubMed

Chaudhry SS, Cain SA, Morgan A, Dallas SL, Shuttleworth CA, Kielty CM. Fibrillin-1 regulates the bioavailability of TGFβ1. J Cell Biol. 2007;176(3):355–67. https://doi.org/10.1083/jcb.200608167.CrossRefPubMedPubMedCentral

Yoshiba N, Yoshiba K, Ohkura N, Takei E, Edanami N, Oda Y, Hosoya A, Nakamura H, Okiji T. Correlation between Fibrillin-1 Degradation and MRNA downregulation and myofibroblast differentiation in cultured human dental pulp tissue. J Histochem Cytochem. 2015;63(6):438–48. https://doi.org/10.1369/0022155415580622.CrossRefPubMedPubMedCentral

Abraham D, Ponticos M, Nagase H. Connective tissue remodeling: cross-talk between endothelins and matrix metalloproteinases. Curr Vasc Pharmacol. 2005;3(4):369–79. https://doi.org/10.2174/157016105774329480.CrossRefPubMed

10.

Borsani E, Salgarello S, Mensi M, Boninsegna R, Stacchiotti A, Rezzani R, Sapelli P, Bianchi R, Rodella LF. Histochemical and Immunohistochemical Evaluation of Gingival Collagen and Metalloproteinases in Peri-Implantitis. Acta Histochem. 2005;107(3):231–40. https://doi.org/10.1016/j.acthis.2005.06.002.CrossRefPubMed

11.

Tomasi C, Tessarolo F, Caola I, Piccoli F, Wennström JL, Nollo G, Berglundh T. Early healing of peri-implant mucosa in man. J Clin Periodontol. 2016;43(9):816–24. https://doi.org/10.1111/jcpe.12600. PubMed PMID: 27367527.CrossRefPubMed

12.

D’Ercole S, D’Addazio G, Di Lodovico S, Traini T, Di Giulio M, Sinjari B. Porphyromonas gingivalis load is balanced by 0.20% Chlorhexidine Gel. A randomized, double-blind, controlled, microbiological and immunohistochemical human study. J Clin Med. 2020;9(1):284. https://doi.org/10.3390/jcm9010284. PubMed PMID: 31947818.CrossRefPubMedPubMedCentral

13.

Di Mauro M, Izzicupo P, Santarelli F, Falone S, Pennelli A, Amicarelli F, Calafiore AM, Di Baldassarre A, Gallina S. ACE and AGTR1 polymorphisms and left ventricular hypertrophy in endurance athletes. Med Sci Sports Exerc. 2010;42(5):915–21. https://doi.org/10.1249/MSS.0b013e3181c1a0b2. PubMed PMID: 19997016.CrossRefPubMed

14.

Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol. 2018;45(Suppl 20):S246–66. https://doi.org/10.1111/jcpe.12962.CrossRefPubMed

15.

Koldsland OC, Scheie A, Aass AM. Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss. J Periodontol. 2010;81(2):231–8. https://doi.org/10.1902/jop.2009.090317.CrossRefPubMed

16.

Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015;42:158–71.CrossRef

17.

Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CH, Heitz-Mayfield LJ, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N, Zucchelli G. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol. 2018;45(20):S286–91.CrossRefPubMed

18.

Diaz P, Gonzalo E, Villagra LJG, et al. What is the prevalence of peri-implantitis? A systematic review and meta-analysis. BMC Oral Health. 2022;22:449. https://doi.org/10.1186/s12903-022-02493-8.CrossRefPubMedPubMedCentral

19.

De Avila ED, de Molon RS, Vergani CE, de Assis Mollo F Jr, Salih V. The relationship between biofilm and physical-chemical properties of implant abutment materials for successful dental implants. Materials (Basel). 2014;7(5):3651–62. https://doi.org/10.3390/ma7053651. PMID: 28788510; PMCID: PMC5502731.CrossRefPubMed

20.

Belibasakis GN. Microbiological and immuno-pathological aspects of peri-implant diseases. Arch Oral Biol. 2014;59(1):66–72. https://doi.org/10.1016/j.archoralbio.2013.09.013.CrossRefPubMed

21.

Narimatsu I, Atsuta I, Ayukawa Y, Oshiro W, Yasunami N, Furuhashi A, Koyano K. Epithelial and connective tissue sealing around titanium implants with various typical surface finishes. ACS Biomater Sci Eng. 2019;5:4976–84. https://doi.org/10.1021/acsbiomaterials.9b00499.CrossRefPubMed

22.

de Souza VZ, Manfro R, Joly JC, Elias CN, Peruzzo DC, Napimoga MH, Martinez EF. Viability and collagen secretion by fibroblasts on titanium surfaces with different acid-etching protocols. Int J Implant Dent. 2019;5:41. https://doi.org/10.1186/s40729-019-0192-4.CrossRefPubMedPubMedCentral

23.

Araujo MG, Lindhe J. Peri-Implant Health. J Periodontol. 2018;89:S249–56. https://doi.org/10.1002/JPER.16-0424.CrossRefPubMed

24.

Ghinassi B, Di Baldassarre A, D’Addazio G, Traini T, Andrisani M, Di Vincenzo G, Gaggi G, Piattelli M, Caputi S, Sinjari B. Gingival response to dental implant: comparison study on the effects of new nanopored laser-treated vs. traditional healing abutments. Int J Mol Sci. 2020;21(17):6056. https://doi.org/10.3390/ijms21176056.CrossRefPubMedPubMedCentral

25.

Ghinassi B, D’Addazio G, Di Baldassarre A, Femminella B, Di Vincenzo G, Piattelli M, Gaggi G, Sinjari B. Immunohistochemical results of soft tissues around a new implant healing-abutment surface: a human study. J Clin Med. 2020;9(4):1009. https://doi.org/10.3390/jcm9041009.CrossRefPubMedPubMedCentral

26.

Sinjari B, Guarnieri S, Diomede F, Merciaro I, Mariggio MA, Caputi S, Trubiani O. Influence of titanium laser surface geometry on proliferation and on morphological features of human mandibular primary osteoblasts. J Biol Regul Homeost Agents. 2012;26(3):505–13.PubMed

27.

Sinjari B, Traini T, Caputi S, Mortellaro C, Scarano A. Evaluation of fibrin clot attachment on titanium laser-conditioned surface using scanning electron microscopy. J Craniofac Surg. 2018;29(8):2277–81. https://doi.org/10.1097/SCS.0000000000004983. PubMed PMID: 30234808.CrossRefPubMed

28.

Di Giulio M, Traini T, Sinjari B, Nostro A, Caputi S, Cellini L. Porphyromonas gingivalis biofilm formation in different titanium surfaces, an in vitro study. Clin Oral Implants Res. 2016;27(8):918–25. https://doi.org/10.1111/clr.12716. PubMed PMID: 26123247.CrossRefPubMed

29.

Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: Anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19:43–61.PubMed

30.

Ravidà A, Arena C, Tattan M, Caponio VCA, Saleh MHA, Wang HL, Troiano G. The role of keratinized mucosa width as a risk factor for peri-implant disease: a systematic review, meta-analysis, and trial sequential analysis. Clin Implant Dent Relat Res. 2022;24(3):287–300. https://doi.org/10.1111/cid.13080. Epub 2022 Mar 17. PMID: 35298862; PMCID: PMC9311272.CrossRefPubMedPubMedCentral

31.

Gaggi G, Di Credico A, Guarnieri S, Mariggiò MA, Di Baldassarre A, Ghinassi B. Human mesenchymal amniotic fluid stem cells reveal an unexpected neuronal potential differentiating into functional spinal motor neurons. Front Cell Dev Biol. 2022;10:936990. https://doi.org/10.3389/fcell.2022.936990.CrossRefPubMedPubMedCentral

32.

Gaggi G, Di Credico A, Izzicupo P, Alviano F, Di Mauro M, Di Baldassarre A, Ghinassi B. Human mesenchymal stromal cells unveil an unexpected differentiation potential toward the dopaminergic neuronal lineage. Int J Mol Sci. 2020;21(18):6589. https://doi.org/10.3390/ijms21186589.CrossRefPubMedPubMedCentral

33.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRefPubMed

34.

Leong A, De Kok I, Mendonça D, Cooper LF. Molecular assessment of human peri-implant mucosal healing at laser-modified and machined titanium abutments. Int J Oral Maxillofac Implants. 2018;33(4):895–904. https://doi.org/10.11607/jomi.6367.CrossRefPubMed

35.

Asensio JJ, Vázquez-Lasa B, Rojo L. Achievements in the topographic design of commercial titanium dental implants: towards anti-peri-implantitis surfaces. J Clin Med. 2019;8(11):1982. https://doi.org/10.3390/jcm8111982.CrossRefPubMedPubMedCentral

36.

Traini T, Pecora G, Iezzi G, Piattelli A. Preferred collagen fiber orientation in human peri-implant bone after a short- and long-term loading period: a case report. J Oral Implantol. 2006;32(4):177–81. https://doi.org/10.1563/285.1.CrossRefPubMed

37.

Traini T, Degidi M, Caputi S, Strocchi R, Di Iorio D, Piattelli A. Collagen fiber orientation in human peri-implant bone around immediately loaded and unloaded titanium dental implants. J Periodontol. 2005;76(1):83–9. https://doi.org/10.1902/jop.2005.76.1.83.CrossRefPubMed

38.

Midwood KS, Orend G. The role of tenascin-C in tissue injury and tumorigenesis. J Cell Commun Signal. 2009;3(3–4):287–310. https://doi.org/10.1007/s12079-009-0075-1.CrossRefPubMedPubMedCentral

39.

Häkkinen L, Hildebrand HC, Berndt A, Kosmehl H, Larjava H. Immunolocalization of tenascin-C, α9 integrin subunit, and αvβ6 integrin during wound healing in human oral mucosa. J Histochem Cytochem. 2000;48(7):985–98. https://doi.org/10.1177/002215540004800712.CrossRefPubMed

40.

Wang Y, Wang G, Liu H. Tenascin-C: a key regulator in angiogenesis during wound healing. Biomolecules. 2022;12(11):1689. https://doi.org/10.3390/biom12111689.CrossRefPubMedPubMedCentral

41.

Handa K, Abe S, Suresh VV, Fujieda Y, Ishikawa M, Orimoto A, Kobayashi Y, Yamada S, Yamaba S, Murakami S, et al. Fibrillin-1 insufficiency alters periodontal wound healing failure in a mouse model of Marfan syndrome. Arch Oral Biol. 2018;90:53–60. https://doi.org/10.1016/j.archoralbio.2018.02.017.CrossRefPubMed

42.

Cornelini R, Rubini C, Fioroni M, Favero GA, Strocchi R, Piattelli A. Transforming growth factor-beta 1 expression in the peri-implant soft tissues of healthy and failing dental implants. J Periodontol. 2003;74(4):446–50. https://doi.org/10.1902/jop.2003.74.4.446.CrossRefPubMed

43.

Mogi M, Otogoto J, Ota N, Inagaki H, Minami M, Kojima K. Interleukin 1β, Interleukin 6, Β2-Microglobulin, and transforming growth factor-α in gingival crevicular fluid from human periodontal disease. Arch Oral Biol. 1999;44(7):535–9. https://doi.org/10.1016/S0003-9969(99)00020-5.CrossRefPubMed

Title: Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials
Authors: Giulia Gaggi
Andrea Di Credico
Gianmaria D’Addazio
Barbara Ghinassi
Giulio Argentieri
Sergio Caputi
Angela Di Baldassarre
Bruna Sinjari
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Laser
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03148-y

2024 ASCO Annual Meeting

Springer Medicine

Impact on peri-implant connective tissue of laser treated versus traditional healing abutments: a human clinical trials

Abstract

Background

Methods

Results

Conclusions

Trial registration

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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