PDF(Pubmed)
Abstract：
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.
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 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.
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.
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 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.
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.
摘要：
背景：牙种植体是治疗无牙症的主要方法，种植体周围组织的健康对其长期成功具有关键作用。此外,已经表明，愈合基台的地形也会影响修复的结果。这项人体临床试验的目的是评估与常规加工表面相比，新型激光治疗的愈合基台对种植体周围结缔组织和细胞外基质蛋白的影响。作为对照组。
方法：在第二个手术阶段，在30个单个牙科植入物上插入定制的愈合基台。使用两个交替的不同表面（两个侧面激光处理的表面和两个侧面加工的表面）实现了修复基台，以便将其视为同一植入物上的测试和控制，并减少定位偏差。在软组织愈合期(30±7天)之后,取回5mm圆形活检。在胶原蛋白上进行免疫组织化学和定量实时PCR（qPCR）分析，生腱蛋白C,纤溶蛋白I,金属蛋白酶(MMPs)及其抑制剂(TIMPs)。15进行qPCR处理，而其他15例进行了免疫组化分析。两组间进行配对t检验。p<0.05的值被认为是统计学上显著的。
结果：结果显示，面对激光治疗表面的结缔组织表达了统计学上显著较低的MMPs量（p<0.05）和较高水平的TIMPs3（p<0.05），与加工植入物周围的组织相比，which,反过来也表达了细胞外基质蛋白(TenascinC，纤溶蛋白I（p<0.05））和胶原蛋白V，已知在种植体周围炎也会发生改变。
结论：结论：激光治疗的表面有望积极影响植入物周围结缔组织的伤口愈合。结果表明，愈合基台的地形性质可以积极影响粘膜伤口的愈合和分子表达。先前的研究已经证明了激光治疗如何正确地影响牙龈上皮和细胞粘附的完整性和功能。关于结缔组织,不同的分子表达在激光处理或机械加工的表面之间证明了不同的炎症模式,其中激光处理显示出更好的响应。对种植体周围地形采取有针对性的干预措施和预防措施可以有效降低种植体周围疾病的风险，有助于修复的长期成功和持久性。然而,新的研究是强制性的,以更好地理解这一现象以及该表面在种植体周围炎过程中的作用.试验注册：该试验已在ClinicalTrials.gov标识符注册：（注册编号：NCT05754970）。注册06/03/2023，追溯注册。
方法：在第二个手术阶段，在30个单个牙科植入物上插入定制的愈合基台。使用两个交替的不同表面（两个侧面激光处理的表面和两个侧面加工的表面）实现了修复基台，以便将其视为同一植入物上的测试和控制，并减少定位偏差。在软组织愈合期(30±7天)之后,取回5mm圆形活检。在胶原蛋白上进行免疫组织化学和定量实时PCR（qPCR）分析，生腱蛋白C,纤溶蛋白I,金属蛋白酶(MMPs)及其抑制剂(TIMPs)。15进行qPCR处理，而其他15例进行了免疫组化分析。两组间进行配对t检验。p<0.05的值被认为是统计学上显著的。
结果：结果显示，面对激光治疗表面的结缔组织表达了统计学上显著较低的MMPs量（p<0.05）和较高水平的TIMPs3（p<0.05），与加工植入物周围的组织相比，which,反过来也表达了细胞外基质蛋白(TenascinC，纤溶蛋白I（p<0.05））和胶原蛋白V，已知在种植体周围炎也会发生改变。
结论：结论：激光治疗的表面有望积极影响植入物周围结缔组织的伤口愈合。结果表明，愈合基台的地形性质可以积极影响粘膜伤口的愈合和分子表达。先前的研究已经证明了激光治疗如何正确地影响牙龈上皮和细胞粘附的完整性和功能。关于结缔组织,不同的分子表达在激光处理或机械加工的表面之间证明了不同的炎症模式,其中激光处理显示出更好的响应。对种植体周围地形采取有针对性的干预措施和预防措施可以有效降低种植体周围疾病的风险，有助于修复的长期成功和持久性。然而,新的研究是强制性的,以更好地理解这一现象以及该表面在种植体周围炎过程中的作用.试验注册：该试验已在ClinicalTrials.gov标识符注册：（注册编号：NCT05754970）。注册06/03/2023，追溯注册。
