Dynamic analyses of a soft tissue–implant interface: Biological responses to immediate versus delayed dental implants

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2024-05-06 DOI:10.1111/jcpe.13980

Fabiana Aellos, Joseph A. Grauer, Kasidy G. Harder, Julia S. Dworan, Giacomo Fabbri, Pedro L. Cuevas, Xue Yuan, Bo Liu, John B. Brunski, Jill A. Helms

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Abstract

Aim

To qualitatively and quantitatively evaluate the formation and maturation of peri-implant soft tissues around ‘immediate’ and ‘delayed’ implants.

Materials and Methods

Miniaturized titanium implants were placed in either maxillary first molar (mxM1) fresh extraction sockets or healed mxM1 sites in mice. Peri-implant soft tissues were evaluated at multiple timepoints to assess the molecular mechanisms of attachment and the efficacy of the soft tissue as a barrier. A healthy junctional epithelium (JE) served as positive control.

Results

No differences were observed in the rate of soft-tissue integration of immediate versus delayed implants; however, overall, mucosal integration took at least twice as long as osseointegration in this model. Qualitative assessment of Vimentin expression over the time course of soft-tissue integration indicated an initially disorganized peri-implant connective tissue envelope that gradually matured with time. Quantitative analyses showed significantly less total collagen in peri-implant connective tissues compared to connective tissue around teeth around implants. Quantitative analyses also showed a gradual increase in expression of hemidesmosomal attachment proteins in the peri-implant epithelium (PIE), which was accompanied by a significant inflammatory marker reduction.

Conclusions

Within the timeframe examined, quantitative analyses showed that connective tissue maturation never reached that observed around teeth. Hemidesmosomal attachment protein expression levels were also significantly reduced compared to those in an intact JE, although quantitative analyses indicated that macrophage density in the peri-implant environment was reduced over time, suggesting an improvement in PIE barrier functions. Perhaps most unexpectedly, maturation of the peri-implant soft tissues was a significantly slower process than osseointegration.

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软组织-种植体界面的动态分析：即刻种植体与延迟种植体的生物反应

目的定性和定量评估 "即刻 "和 "延迟 "种植体周围种植体软组织的形成和成熟。在多个时间点对种植体周围软组织进行评估，以评估附着的分子机制以及软组织作为屏障的功效。结果在即刻种植体与延迟种植体的软组织结合率上没有观察到差异；但总体而言，在该模型中，粘膜结合所需的时间至少是骨结合时间的两倍。对软组织整合过程中波形蛋白表达的定性评估表明，种植体周围结缔组织包膜最初比较混乱，随着时间的推移逐渐成熟。定量分析显示，与种植体周围牙齿周围的结缔组织相比，种植体周围结缔组织中的胶原蛋白总量明显较少。定量分析还显示，种植体周围上皮（PIE）中半脂质体附着蛋白的表达量逐渐增加，同时炎症标记物也明显减少。虽然定量分析显示随着时间的推移，种植体周围环境中的巨噬细胞密度有所降低，表明 PIE 的屏障功能有所改善，但与完整的 JE 相比，半膜附着蛋白的表达水平也明显降低。也许最出乎意料的是，种植体周围软组织的成熟过程明显慢于骨结合过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.