Abstract
Implant rejection is a relatively common issue affecting people with mouth implants following the procedure. Implant rejection can lead to adverse symptoms, including infection, inflammation, pain, and swelling (Plikrylová, Procházková, & Podzimek, 2019). Additionally, implant rejection requires removal and re-installation, leading to additional healthcare expenses. Bone integration, or osseointegration, is also an important issue that may affect the outcomes. According to studies, poor osseointegration leads to primary implant failure in 1-2% of patients who have installed a dental implant (Smeets et al., 2016). Hence, the issue of osseointegration increases the risks associated with implant installation and reduces the potential for implant survival.
The proposed study seeks to improve practice in the area of dental implantation by researching the effect of cortisone on implant rejection and osseointegration. The first aim of the study is to determine whether or not local cortisone injections decrease the risk of implant rejection. The second aim of the research is to examine whether cortisone promotes bone integration. Additionally, the study has some supporting objectives that will also be fulfilled through the selected methodology. In particular, the results will be used to determine which cortisone can be injected locally, the dose of injection, and its method. This will help to provide recommendations to clinical specialists working with dental implants and enhance practice in the area. Hence, the study could contribute to patients’ prognosis following dental implantation by reducing the rate of implant rejection and promoting osseointegration.
Materials and Methods
The study will follow an experimental, randomized controlled trial methodology with a sample size of 25-30 participants with a total of 100-130 implants. This specific design was selected because it allows manipulating the independent variable while also providing high-quality data on the cause and effect relationship between the variables (Bowling, 2014). Various types of data will be collected in clinical settings, including the participant’s demographic characteristics, implant brands, and the dose and type of cortisone used for injections. The control group will not receive any cortisone injections, which will help to evaluate the statistical significance of the effect of cortisone on osseointegration and implant rejection. The subjects will be followed for two years after the implantation to establish long-term effects of cortisone use, while the overall duration of all phases of the study is likely to be three years. Data analysis instruments to be used include SPSS software, where various statistical tests, including regression, correlation, and ANOV, will be performed.
Abbreviations
The following abbreviations will be used as part of the study and in the write-up:
- LJ – lower jaw;
- UJ – upper jaw;
- IR – implant rejection;
- OI – osseointegration;
- CI – cortisone injections.
These abbreviations will allow improving the efficiency of reporting while also making it easier to compile and disseminate information about the results of the study.
Background
The idea of using cortisone injections to reduce the risk of implant rejection and promote osseointegration stems from the successful use of cortisone in patients with pulmonary fibrosis. Pulmonary fibrosis is a disease of the lung where lung tissue becomes thickened and scarred, leading to a decline in lung function (Leuchte et al., 2015). There are various conditions that can be associated with lung fibrosis, including tuberculosis, autoimmune disorders, and infections. However, there are also cases in which fibrosis develops without any apparent cause. In this case, the condition is called idiopathic pulmonary fibrosis (Leuchte et al., 2015). The prognosis for patients with pulmonary fibrosis is generally poor, with many patients having a life expectancy of less than five years following the diagnosis (Juarez, Chan, Norris, Morrissey, & Albertson, 2015). This is mainly due to the progressive nature of fibrosis and the presence of exacerbations.
Corticosteroids showed some success in the management of pulmonary fibrosis. According to a study by Juarez et al. (2015), corticosteroids are recommended as the first line of treatment during acute exacerbations of idiopathic pulmonary fibrosis due to their anti-inflammatory properties. This allows suggesting that cortisone injections could be useful in decreasing the risk of dental implant rejection. The anti-inflammatory properties of corticosteroids also allow for them to be used in promoting bone integration (Petsinis, Kamperos, Alexandridi, & Alexandridis, 2017). Conducting a study using local injections of cortisone would help to determine if they have a positive effect on patients with dental implants.
Operational Objectives
It is expected that the study will be conducted over a period of three years. In year one, the primary aim will be to finalize the design of the study, recruit participants, and agree on a clinical site for injections and progress tracking. In year two, implants will be installed, and treatment with cortisone will be applied in the experimental group. The results will be recorded at a set frequency of one month for the first three months after the procedure, then every three months until the end of the data collection period. The goal of year three would be to finalize data collection, perform data analysis using correlation, regression, and statistical testing, and produce a report on the findings and conclusions of the research.
References
Bowling, A. (2014). Research methods in health: Investigating health and health services (4th ed.). Maidenhead, UK: Open University Press.
Juarez, M. M., Chan, A. L., Norris, A. G., Morrissey, B. M., & Albertson, T. E. (2015). Acute exacerbation of idiopathic pulmonary fibrosis—A review of current and novel pharmacotherapies. Journal of Thoracic Disease, 7(3), 499-519.
Leuchte, H. H., Mernitz, P., Baezner, C., Baumgartner, R. A., von Wulffen, W., Neurohr, C., & Behr, J. (2015). Self-report daily life activity as a prognostic marker of idiopathic pulmonary fibrosis. Respiration, 90(6), 460-467.
Petsinis, V., Kamperos, G., Alexandridi, F., & Alexandridis, K. (2017). The impact of glucocorticosteroids administered for systemic diseases on the osseointegration and survival of dental implants placed without bone grafting—A retrospective study in 31 patients. Journal of Cranio-Maxillofacial Surgery, 45(8), 1197-1200.
Přikrylová, J., Procházková, J., & Podzimek, Š. (2019). Side effects of dental metal implants: Impact on human health (metal as a risk factor of implantologic treatment). BioMed Research international, 2019(1), 1-5.
Smeets, R., Stadlinger, B., Schwarz, F., Beck-Broichsitter, B., Jung, O., Precht, C.,… Ebker, T. (2016). Impact of dental implant surface modifications on osseointegration. BioMed Research International, 2016(1), 1-16.