Dental endo-osseous implants have become a widely used treatment for replacing missing teeth. Dental implants are placed into a surgically created osteotomy in alveolar bone, the healing of the soft tissue lesion and the osseointegration of the implant being key elements to long-term success. Autophagy is considered the major intracellular degradation system, playing important roles in various cellular processes involved in dental implant integration. The aim of this review is an exploration of autophagy roles in the main cell types involved in the healing and remodeling of soft tissue lesions and implant osseointegration, post-implant surgery. We have focused on the autophagy pathway in macrophages, endothelial cells; osteoclasts, osteoblasts; fibroblasts, myofibroblasts and keratinocytes. In macrophages, autophagy modulates innate and adaptive immune responses playing a key role in osteo-immunity. Autophagy induction in endothelial cells promotes apoptosis resistance, cell survival, and protection against oxidative stress damage. The autophagic machinery is also involved in transporting stromal vesicles containing mineralization-related factors to the extracellular matrix and regulating osteoblasts’ functions. Alveolar bone remodeling is achieved by immune cells differentiation into osteoclasts; autophagy plays an important and active role in this process. Autophagy downregulation in fibroblasts induces apoptosis, leading to better wound healing by improving excessive deposition of extracellular matrix and inhibiting fibrosis progression. Autophagy seems to be a dual actor on the scene of dental implant surgery, imposing further research in order to completely reveal its positive features which may be essential for clinical efficacy.
The objective of this study is to evaluate food bolus properties (mass, moisture content and food comminution) in patients wearing fixed or removable dental prostheses. Methods: A cross-sectional study was conducted on a convenience sample of patients aged at least 55 years old. Patients chewed a 10 g sample of fresh raw carrot until they felt ready to swallow. The mass of the food bolus was determined as collected and after drying. Food comminution was assessed by the multiple sieve method. Results: Patients with fixed prostheses compared to those with removable prostheses registered a similar mass of food bolus as collected (4.40 g vs. 4.60 g; p = 0.856); a higher mass of dried food bolus (3.46 g vs. 0.86 g; p < 0.001); lower moister of food bolus (24.65% vs. 82.35%; p < 0.001); and better food comminution (mass of smaller particles, of size below 2 mm, represented 65.93% vs. 20% of dried food bolus). In removable denture wearers, food comminution was slightly better in partially than in completely edentulous patients, and rather similar in completely edentulous patients with either implant overdenture or complete denture in the mandible, and complete denture in the maxilla. Conclusions: The current results suggest that food bolus properties are dependent on the dentate and prosthetic status.