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Plasma of argon to enhance soft tissue integration to prosthetic components: a randomized, controlled animal study


Peri-implant soft and hard tissues stability is critical for the success of an implant-supported restoration, from a functional as well as an esthetical point of view (Buser et al. 2004). It has been described how the relationship between the implant-abutment connection and surrounding hard and soft tissues plays an important role in establishing such mechanical and biological stability (Abrahamsson et al. 1996). In fact, literature demonstrated that when an implant is exposed to the oral environment after the connection of a prosthetic component, peri-implant hard tissue level changes may occur (Hermann et al. 1997), and the amount of bone remodelling, characterized by circumferential (horizontally and vertically) bone loss, should remain stable after one year (Manz 2000). Several factors and, in particular, disruptions occurring after prosthetic connections may affect peri-implant resorption (Schou et al. 2006), since the bacterial contamination of the implant-abutment junction from the oral cavity was shown to trigger hard tissue response (Cochran et al. 1997). Many strategies have been advocated to clinically minimize the effect of this contamination: mechanical improvement of the implant/abutment connection stability (Van Assche et al. 2011), implant/abutment microgap shifting from the vital bone (Degidi et al. 2008, Vigolo & Givani 2009, Canullo et al. 2010a), diminishing of theabutment dis/reconnection (Canullo et al. 2010b); nevertheless, a minimal bone resorption (0.5mm) has been observed in longitudinal analysis (Annibali et al. 2012).This event might be related to the contaminants (bacteria, wear micro-particles and pollutions coming from laboratory procedures) present on the abutment at the time of implant/abutment connection. In fact, the presence of contaminants on the abutment surface can still be verified after the steam cleaning protocol following technical laboratory procedures (Canullo et al. 2012). Abutment cleanliness appears even more important since the abutment gets in contact with both bone and connective tissue. In fact, presence of contaminants at the platform-abutment level has been suggested to cause an associated tissue-damaging inflammation; titanium wear micro-particles were also demonstrated to activate osteoclastogenesis (Mishra et al. 2011). Additionally, it has been showed how the interactions between cellular components and implant-abutment materials influence the stages of the healing process around implants and how these interactions are regulated by the state of the surface (Piattelli et al. 2011).To preserve abutments from such pollutants, recently, plasma cleaning of customized abutments was advocated (Canullo et al. 2013a). Plasma cleaning was demonstrated in vitro to have a triple effect on titanium: cleaning, corrosion protection and increasing surface energy of the cleaned surfaces (Tavares et al. 2009).However, a lack of evidence is present in literature regarding the clinical relevance of plasma cleaning procedure on dental implant abutments. This animal study is designed to histologically proof the concept of soft tissue adhesion and peri-implant bone level stabilization after insertion of plasma cleaned abutment. The described method demonstrates a complete removing of microbiologic and pollution contamination in vitro. Before a clinical study in humans is justified, an animal test has to proof the ability of this method to gain a re-osseointegration. (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
TANAKA, KAZUSHIGE; SILVA, ERICK RICARDO; KAWAKAMI, SHUNSUKE; CANULLO, LUIGI; BOTTICELLI, DANIELE; XAVIER, SAMUEL P. Effect of Plasma of Argon Treated Implants on Bone Density: A Randomized, Controlled, Histomorphometric Study in Dogs. OPEN DENTISTRY JOURNAL, v. 12, p. 937-945, 2018. Web of Science Citations: 0.

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