title: A systematic review on the innervation of peri-implant tissues with special emphasis on the influence of implant placement and loading protocols.
abstract: OBJECTIVE
  To systematically review the available literature on the influence of dental implant placement and loading protocols on peri-implant innervation.
  
  
  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.
authors: Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.|Oral Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China.
authors: Yan
authors: Y
authors: Huang
authors: Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
authors: Reinhilde
authors: R
authors: Jacobs
authors: Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
authors: Jeroen
authors: J
authors: Van Dessel
authors: Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.|Section of Dental Radiology and Stomatology, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland.
authors: Michael M
authors: MM
authors: Bornstein
authors: Faculty of Medicine, Biomedical Research Institute, Laboratory of Morphology, University of Hasselt, Diepenbeek, Belgium.
authors: Ivo
authors: I
authors: Lambrichts
authors: Department Imaging & Pathology, Faculty of Medicine, OIC, OMFS IMPATH research group, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
authors: Constantinus
authors: C
authors: Politis
mesh_terms: D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D004848:Epithelium / Q000294:innervation*; D006801:Humans; D007568:Jaw / Q000294:innervation*; D009061:Mouth Mucosa / Q000294:innervation*; D009412:Nerve Fibers / Q000502:physiology*; D009416:Nerve Regeneration / Q000502:physiology*; D016348:Osseointegration / Q000502:physiology
chemical_list: D015921:Dental Implants
keywords: dental implants; immediate implant placement; immediate loading; innervation; osseoperception; systematic review