A systematic review on the innervation of peri-implant tissues with special emphasis on the influence of implant placement and loading protocols

Authors

  • Yan Huang,

    1. Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
    2. Oral Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China
    Search for more papers by this author
  • Reinhilde Jacobs,

    Corresponding author
    1. Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
    • Corresponding author:

      Reinhilde Jacobs

      OIC, OMFS IMPATH research group, Dept. Imaging & Pathology, University of Leuven, Kapucijnenvoer 33, Leuven B3000, Belgium

      Tel.: +32 16 3 32452

      Fax: +32 16 3 32410

      e-mail: reinhilde.jacobs@med.kuleuven.be

    Search for more papers by this author
  • Jeroen Van Dessel,

    1. Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
    Search for more papers by this author
  • Michael M. Bornstein,

    1. Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
    2. Section of Dental Radiology and Stomatology, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
    Search for more papers by this author
  • Ivo Lambrichts,

    1. Faculty of Medicine, Biomedical Research Institute, Laboratory of Morphology, University of Hasselt, Diepenbeek, Belgium
    Search for more papers by this author
  • Constantinus Politis

    1. Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
    Search for more papers by this author

Abstract

Objectives

To systematically review the available literature on the influence of dental implant placement and loading protocols on peri-implant innervation.

Material and methods

The database MEDLINE, Cochrane, EMBASE, Web of Science, LILACS, OpenGrey and hand searching were used to identify the studies published up to July 2013, with a populations, exposures and outcomes (PEO) search strategy using MeSH keywords, focusing on the question: Is there, and if so, what is the effect of time between tooth extraction and implant placement or implant loading on neural fibre content in the peri-implant hard and soft tissues?

Results

Of 683 titles retrieved based on the standardized search strategy, only 10 articles fulfilled the inclusion criteria, five evaluating the innervation of peri-implant epithelium, five elucidating the sensory function in peri-implant bone. Three included studies were considered having a methodology of medium quality and the rest were at low quality. All those papers reported a sensory innervation around osseointegrated implants, either in the bone–implant interface or peri-implant epithelium, which expressed a particular innervation pattern. Compared to unloaded implants or extraction sites without implantation, a significant higher density of nerve fibres around loaded dental implants was confirmed.

Conclusions

To date, the published literature describes peri-implant innervation with a distinct pattern in hard and soft tissues. Implant loading seems to increase the density of nerve fibres in peri-implant tissues, with insufficient evidence to distinguish between the innervation patterns following immediate and delayed implant placement and loading protocols. Variability in study design and loading protocols across the literature and a high risk of bias in the studies included may contribute to this inconsistency, revealing the need for more uniformity in reporting, randomized controlled trials, longer observation periods and standardization of protocols.

Ancillary