journal of prosthodontic research 59 (2015) 79–80
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jpor
Editorial
Minimally invasive interventions for replacing missing teeth with implants: Current status and future perspective
In general, the goal of an implant-supported reconstruction is to obtain optimal esthetics and function. In order to achieve this goal, bone augmentation procedures are frequently necessary to optimize implant positioning and creating an adequate soft tissue support. The term ‘restorative-driven’ treatment planning has been used to identify these processes. However, an undesirable aspect of ‘restorative-driven’ treatments is that they are mostly invasive to the patients. The reason is that, in many cases, ‘restorative-driven’ treatments need bone and/or soft tissue augmentation procedures for optimizing implant placement. It is natural that no patient wants to have invasive treatment, therefore doctors and patients are looking for solutions that reduce the invasiveness of the procedure or increase the speed of implant treatment. In this regard, recent minimally invasive treatment procedures like graftless solutions, flapless surgery and immediate loading have found favor with the most patients, and they are now recognized as ‘patient-driven’ implant treatment procedures. However, especially graftless solutions, minimally invasive treatment procedures are sometimes questionable with regard to esthetic results of implantsupported prosthodontics. In this issue, Kaku et al. reviewed the current consensus of cell-based bone augmentation therapies with emphasis on cell sources, transplanted cell survival, endogenous stem cell recruitment and immunomodulatory function of transplanted osteoprogenitor cells [1]. If we can control the mobilization of endogenous osteoprogenitor cells in the near future, invasive surgery might no longer be necessary for bone augmentation procedures. Actually,
patients as well as clinicians are looking forward to the day when cell-based bone augmentation is available. Moreover, according to the Bra˚nemark protocol, a stressfree healing period for 3–6 months is one of the most emphasized requirements for osseointegration of dental implant. Certainly almost all patients desire restoration of their chewing ability as soon as possible after placement of dental implants, therefore many clinical investigators have tried to shorten the healing period. In this regard, surface modification of implant is a major key factor for achievement of shortening the healing period. A suggestive review series by Shibata et al. (in this and former issues) [2,3] described methods for improving fixation of dental implant. They described that the intrinsic host tissue response to titanium implants is facilitated by the chemistry or topography of a passive oxide film. But, they also stated that the extent to which the surface characteristics enable rapid osseointegration is still uncertain. They suggested that the understanding of complex mechanical bone behavior and size-dependent properties ranging from a nano- to a macroscopic level is essential in the biomechanical optimization of implants. In my opinion, our future perspective is to develop cellbased regenerative medicine and biomechanical optimization of implants, and it might realize impeccable minimally invasive implant therapies for replacing missing teeth.
references
[1] Kaku M, Akiba Y, Akiyama K, Akita D, Nishimura M. Cellbased bone regeneration for alveolar ridge augmentation – cell source, endogenous cell recruitment and immunomodulatory function. J Prosthodont Res 2015;59: 96–112. [2] Shibata Y, Tanimoto Y. A review of improved fixation methods for dental implants. Part I: surface optimization for rapid osseointegration. J Prosthodont Res 2015;59: 20–33.
80
journal of prosthodontic research 59 (2015) 79–80
[3] Shibata Y, Tanimoto Y, Maruyama N, Nagakura M. A review of improved fixation of dental implants – part II: biomechanical integrity at bone–implant interface. J Prosthodont Res 2015;59:84–95.
Ryuji Hosokawa DDS, PhD Department of Oral Rehabilitation and Reconstruction, Faculty of Dentistry, Kyushu Dental University, Kitakyushu 803-8580, Japan
E-mail address: [email protected] (R. Hosokawa) http://dx.doi.org/10.1016/j.jpor.2015.03.002 1883-1958/# 2015 Published by Elsevier Ireland on behalf of Japan Prosthodontic Society.
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jpor
Editorial
Minimally invasive interventions for replacing missing teeth with implants: Current status and future perspective
In general, the goal of an implant-supported reconstruction is to obtain optimal esthetics and function. In order to achieve this goal, bone augmentation procedures are frequently necessary to optimize implant positioning and creating an adequate soft tissue support. The term ‘restorative-driven’ treatment planning has been used to identify these processes. However, an undesirable aspect of ‘restorative-driven’ treatments is that they are mostly invasive to the patients. The reason is that, in many cases, ‘restorative-driven’ treatments need bone and/or soft tissue augmentation procedures for optimizing implant placement. It is natural that no patient wants to have invasive treatment, therefore doctors and patients are looking for solutions that reduce the invasiveness of the procedure or increase the speed of implant treatment. In this regard, recent minimally invasive treatment procedures like graftless solutions, flapless surgery and immediate loading have found favor with the most patients, and they are now recognized as ‘patient-driven’ implant treatment procedures. However, especially graftless solutions, minimally invasive treatment procedures are sometimes questionable with regard to esthetic results of implantsupported prosthodontics. In this issue, Kaku et al. reviewed the current consensus of cell-based bone augmentation therapies with emphasis on cell sources, transplanted cell survival, endogenous stem cell recruitment and immunomodulatory function of transplanted osteoprogenitor cells [1]. If we can control the mobilization of endogenous osteoprogenitor cells in the near future, invasive surgery might no longer be necessary for bone augmentation procedures. Actually,
patients as well as clinicians are looking forward to the day when cell-based bone augmentation is available. Moreover, according to the Bra˚nemark protocol, a stressfree healing period for 3–6 months is one of the most emphasized requirements for osseointegration of dental implant. Certainly almost all patients desire restoration of their chewing ability as soon as possible after placement of dental implants, therefore many clinical investigators have tried to shorten the healing period. In this regard, surface modification of implant is a major key factor for achievement of shortening the healing period. A suggestive review series by Shibata et al. (in this and former issues) [2,3] described methods for improving fixation of dental implant. They described that the intrinsic host tissue response to titanium implants is facilitated by the chemistry or topography of a passive oxide film. But, they also stated that the extent to which the surface characteristics enable rapid osseointegration is still uncertain. They suggested that the understanding of complex mechanical bone behavior and size-dependent properties ranging from a nano- to a macroscopic level is essential in the biomechanical optimization of implants. In my opinion, our future perspective is to develop cellbased regenerative medicine and biomechanical optimization of implants, and it might realize impeccable minimally invasive implant therapies for replacing missing teeth.
references
[1] Kaku M, Akiba Y, Akiyama K, Akita D, Nishimura M. Cellbased bone regeneration for alveolar ridge augmentation – cell source, endogenous cell recruitment and immunomodulatory function. J Prosthodont Res 2015;59: 96–112. [2] Shibata Y, Tanimoto Y. A review of improved fixation methods for dental implants. Part I: surface optimization for rapid osseointegration. J Prosthodont Res 2015;59: 20–33.
80
journal of prosthodontic research 59 (2015) 79–80
[3] Shibata Y, Tanimoto Y, Maruyama N, Nagakura M. A review of improved fixation of dental implants – part II: biomechanical integrity at bone–implant interface. J Prosthodont Res 2015;59:84–95.
Ryuji Hosokawa DDS, PhD Department of Oral Rehabilitation and Reconstruction, Faculty of Dentistry, Kyushu Dental University, Kitakyushu 803-8580, Japan
E-mail address: [email protected] (R. Hosokawa) http://dx.doi.org/10.1016/j.jpor.2015.03.002 1883-1958/# 2015 Published by Elsevier Ireland on behalf of Japan Prosthodontic Society.
