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Nanostructured Zn-Substituted Monetite Based Material Induces Higher Bone Regeneration Than Anorganic Bovine Bone and β-Tricalcium Phosphate in Vertical Augmentation Model in Rabbit Calvaria. NANOMATERIALS 2021; 12:nano12010143. [PMID: 35010093 PMCID: PMC8746457 DOI: 10.3390/nano12010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
The capacity of a nanostructured multicomponent material composed of Zn-substituted monetite, amorphous calcium phosphate, hydroxyapatite and silica gel (MSi) to promote vertical bone augmentation was compared with anorganic bovine bone (ABB) and synthetic β-tricalcium phosphate (β-TCP). The relation between biological behavior and physicochemical properties of the materials was also studied. The in vivo study was conducted in a vertical bone augmentation model in rabbit calvaria for 10 weeks. Significant differences in the biological behavior of the materials were observed. MSi showed significantly higher bone regeneration (39%) than ABB and β-TCP (24%). The filled cylinder volume was similar in MSi (92%) and ABB (91%) and significantly lower in β-TCP (81%) implants. In addition, β-TCP showed the highest amount of non-osteointegrated particles (17%). MSi was superior to the control materials because it maintains the volume of the defect almost full, with the highest bone formation, the lowest number of remaining particles, which are almost fully osteointegrated and having the lowest amount of connective tissue. Besides, the bone formed was mature, with broad trabeculae, high vascularization and osteogenic activity. MSi resorbs gradually over time with an evident increment of the porosity and simultaneous colonization for vascularized new bone. In addition, the osteoinductive behavior of MSi material was evidenced.
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The Effect of Bone Density Measured by Cone Beam Computed Tomography and Implant Dimensions on the Stability of Dental Implants. J Craniofac Surg 2021; 33:e553-e557. [PMID: 34930876 DOI: 10.1097/scs.0000000000008429] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/26/2021] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The aim of this study was to evaluate the effect of bone density value in Hounsfield unit derived from cone beam computed tomography (CBCT), and implant dimensions in relation to implant stability parameters namely the resonance frequency analysis and the insertion torque (IT) value. It included 24 patients who received 42 dental implants (DI). The bone density of the planned implant site was preoperatively measured using cone beam computed tomography. The implant stability was measured using Osstell implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. The IT value was categorized as 35 N/cm or > 35 N/cm. The mean (standard deviation) primary stability was 79.58 (5.27) ISQ, which was significantly higher than the secondary stability 74.31 (6.34) ISQ (P < 0.0001). There was a significant moderate positive correlation of bone density with primary stability (r = 0.4, P = 0.0099) and no correlation with secondary stability (r = 0.003, P = 0.9867). The bone density of DI with 35 N/cm IT was significantly lower than with > 35 N/cm IT (P = 0.0390). Better stability was recorded with wider implants. Whereas the length of the DI showed a nonsignificant correlation with primary and secondary stability (P = 0.7633 and 0.4670, respectively). The DI dimensions showed a nonsignificant correlation with the IT. Cone beam computed tomography may be considered as a reliable method to assess bone density and predict the implant stability. The diameter of DI affected the implant stability favorably, whereas DI length showed no effect.
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Sharaf MY, Eskander AE, Elbakery AI. Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial. Eur J Dent 2021; 16:414-423. [PMID: 34863083 PMCID: PMC9339942 DOI: 10.1055/s-0041-1736292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective
This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically.
Materials and Methods
Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired
t
-tests at a significance level of 5%.
Results
All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference (
p
< 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference (
p
< 0.0001). Minor prosthetic and surgical complications were reported.
Conclusion
The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.
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Affiliation(s)
- Mohamed Y Sharaf
- Department of Prosthodontics, Faculty of Dentistry, University of Menoufia, Menoufia, Egypt
| | - Asharf Email Eskander
- Department of Prosthodontics, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Ahmed Ibrahim Elbakery
- Department of Prosthodontics, Faculty of Dentistry, University of Ahram Canadian, Cairo, Egypt
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Osborne MS, Child-Hymas A, McDermott AL. Clinical evaluation and resonance frequency analysis of laser-ablated titanium bone-anchored hearing implant system in children with Down Syndrome. Int J Pediatr Otorhinolaryngol 2021; 151:110981. [PMID: 34781113 DOI: 10.1016/j.ijporl.2021.110981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/03/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate complication rates and resonance frequency analysis (RFA) of the stability of a new laser-ablated titanium Bone Anchored hearing Implant system in children with Down syndrome. METHODS A prospective, single-subject, repeat measure, cohort study in which each participant served as their own control. Consecutive paediatric patients 4yrs- 15 years old, with a primary diagnosis of Down syndrome (trisomy 21) were implanted between January 2015-January 2020 with BHX Oticon wide implants. Evaluation of soft tissue reactions, fixture failure rates and post implantation Implant stability Quotient (ISQ) at both fixtures and abutment levels were studied over a 12-month period. Data was analysed for statistical significance through mixed effect modelling with significance set at p = 0.01. RESULTS 31 consecutive paediatric patients with a diagnosis of Down syndrome were implanted with 43 Ponto BHX Oticon™ implant system. Twelve children had bilateral implants and nineteen were unilateral. Over the 12 month follow up 2 fixtures (4.6%) were lost, and adverse skin reactions (Holgers >2) were recorded in 3.2% of all clinical reviews. Implant level stability quotient showed no statically significant change between first and second stage 71.1-71.7. Abutment level ISQ increased from 46.2 to 56.7 p = 0.0001 at the 12-month review point as compared to that recorded at loading. CONCLUSION Implant survival and adverse skin reactions were found to be in keeping with those in published literature and much improved compared to previous implant systems placed at this centre. Although abutment level ISQ showed an increase over the review period no correlation between this and implant loss can be concluded.
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Affiliation(s)
- Max Sallis Osborne
- ST8 ENT Registrar Birmingham Children's Hospital, Steelhouse Ln, Birmingham B4 6NH, UK.
| | - Anne Child-Hymas
- Lead Audiologist, Birmingham Children's Hospital, Steelhouse Ln, Birmingham B4 6NH, UK.
| | - Ann Louise McDermott
- Consultant ENT Surgeon, Birmingham Children's Hospital, Steelhouse Ln, Birmingham B4 6NH, UK.
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Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review. MATERIALS 2021; 14:ma14237183. [PMID: 34885335 PMCID: PMC8658728 DOI: 10.3390/ma14237183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022]
Abstract
Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
- Private Practitioner, 20132 Milan, Italy
| | | | - Paolo Capparè
- Department of Dentistry, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-0226433619
| | - Silvia Barbon
- Section of Human Anatomy, Department of Neurosciences, Padua University, 35121 Padua, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
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Mikami K, Nemoto M, Nagura T, Nakamura M, Matsumoto M, Nakashima D. Machine Learning-Based Diagnosis in Laser Resonance Frequency Analysis for Implant Stability of Orthopedic Pedicle Screws. SENSORS 2021; 21:s21227553. [PMID: 34833628 PMCID: PMC8623959 DOI: 10.3390/s21227553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
Evaluation of the initial stability of implants is essential to reduce the number of implant failures of pedicle screws after orthopedic surgeries. Laser resonance frequency analysis (L-RFA) has been recently proposed as a viable diagnostic scheme in this regard. In a previous study, L-RFA was used to demonstrate the diagnosis of implant stability of monoaxial screws with a fixed head. However, polyaxial screws with movable heads are also frequently used in practice. In this paper, we clarify the characteristics of the laser-induced vibrational spectra of polyaxial screws which are required for making L-RFA diagnoses of implant stability. In addition, a novel analysis scheme of a vibrational spectrum using L-RFA based on machine learning is demonstrated and proposed. The proposed machine learning-based diagnosis method demonstrates a highly accurate prediction of implant stability (peak torque) for polyaxial pedicle screws. This achievement will contribute an important analytical method for implant stability diagnosis using L-RFA for implants with moving parts and shapes used in various clinical situations.
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Affiliation(s)
- Katsuhiro Mikami
- Faculty of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan;
- Correspondence:
| | - Mitsutaka Nemoto
- Faculty of Biology-Oriented Science and Technology, Kindai University, Wakayama 649-6493, Japan;
| | - Takeo Nagura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (T.N.); (M.N.); (M.M.); (D.N.)
- Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (T.N.); (M.N.); (M.M.); (D.N.)
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (T.N.); (M.N.); (M.M.); (D.N.)
| | - Daisuke Nakashima
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (T.N.); (M.N.); (M.M.); (D.N.)
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Qu C, Luo F, Hong G, Wan Q. Effects of platelet concentrates on implant stability and marginal bone loss: a systematic review and meta-analysis. BMC Oral Health 2021; 21:579. [PMID: 34772376 PMCID: PMC8588658 DOI: 10.1186/s12903-021-01929-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023] Open
Abstract
Background Osseointegration is essential for the success and stability of implants. Platelet concentrates were reported to enhance osseointegration and improve implant stability. The purpose of this review is to systematically analyze the effects of platelet concentrates on implant stability and marginal bone loss. Methods Two researchers independently performed searches in the following databases (last searched on 21 July 2021): MEDLINE (PubMed), Cochrane Library, EMBASE, and Web of Science. In addition, a manual search was carried out on references of relevant reviews and initially included studies. All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on the application of platelet concentrates in the implant surgery procedure were included. The risk of bias of RCTs and CCTs were assessed with a revised Cochrane risk of bias tool for randomized trials (RoB 2.0) and the risk of bias in non-randomized studies—of interventions (ROBINS-I) tool, respectively. Meta-analyses on implant stability and marginal bone loss were conducted. Researchers used mean difference or standardized mean difference as the effect size and calculated the 95% confidence interval. In addition, subgroup analysis was performed based on the following factors: type of platelet concentrates, method of application, and study design. Results Fourteen studies with 284 participants and 588 implants were included in the final analysis. 11 studies reported implant stability and 5 studies reported marginal bone level or marginal bone loss. 3 studies had high risk of bias. The meta-analysis results showed that platelet concentrates can significantly increase implant stability at 1 week (6 studies, 302 implants, MD 4.26, 95% CI 2.03–6.49, P < 0.001) and 4 weeks (8 studies, 373 implants, MD 0.67, 95% CI 0.46–0.88, P < 0.001) after insertion, significantly reduced marginal bone loss at 3 months after insertion (4 studies, 95 implants, mesial: MD − 0.33, 95% CI − 0.46 to − 0.20, P < 0.001; distal: MD − 0.38, 95% CI − 0.54 to − 0.22, P < 0.001). However, the improvement of implant stability at 12 weeks after insertion was limited (P = 0.10). Subgroup analysis showed that PRP did not significantly improve implant stability at 1 week and 4 weeks after insertion (P = 0.38, P = 0.17). Platelet concentrates only placed in the implant sites did not significantly improve implant stability at 1 week after insertion (P = 0.20). Conclusions Platelet concentrates can significantly improve implant stability and reduce marginal bone loss in the short term. Large-scale studies with long follow‐up periods are required to explore their long-term effects and compare effects of different types. Trial registration This study was registered on PROSPERO, with the Registration Number being CRD42021270214. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01929-x.
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Affiliation(s)
- Changxing Qu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China.
| | - Guang Hong
- Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan.,Department of Prosthetic Dentistry, Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, 610041, China
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Nakashima D, Mikami K, Kikuchi S, Nishikino M, Kitamura T, Hasegawa N, Matsumoto M, Nakamura M, Nagura T. Laser resonance frequency analysis of pedicle screw stability: A cadaveric model bone study. J Orthop Res 2021; 39:2474-2484. [PMID: 33458845 PMCID: PMC8596623 DOI: 10.1002/jor.24983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 02/04/2023]
Abstract
There is no evaluation method currently available to assess intraoperative pedicle screw fixation (PSF) strength. In this study, we established a laser-based resonance frequency analysis (RFA) system with high-speed, noncontact, quantitative measurements of PSF. Clinical investigations in the future can assess surgical failure risk of implants. We investigated the characteristics of the laser RFA and compared them with the conventional methods. We inserted a pedicle screw in the vertebral pedicle of human cadaver or model bone, followed by screw pull-out, peak torque, implant stability quotient (ISQ) value obtained by the magnetic dental RFA system, and fixation force of laser RFA. We compared the outcomes using best-fit linear or logarithmic approximations. For the model bone study, the resonance frequency (RF) versus peak torque/pull-out force (POF) demonstrated strong correlations using logarithmic approximation (vs. peak torque: R = 0.931, p < .001, vs. POF: R = 0.931, p < .001). RF strongly correlated with the ISQ value using linear approximation (R = 0.981, p < .001). For the cadaveric vertebrae study, the correlation coefficients between RF and the peak torque/POF were significant regardless of approximation method (peak torque: logarithmic: R = 0.716 vs. linear: R = 0.811; p < .001) (POF: logarithmic: R = 0.644 vs. linear: R = 0.548; p < .05). Thus, the results of this study revealed a constant correlation between RFA and conventional methods as a measurement validation, predicting favorable support for intraoperative PSF. RFA has the potential to be a new index for evaluating the implant fixation force.
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Affiliation(s)
- Daisuke Nakashima
- Department of Orthopedic SurgeryKeio University School of Medicine, ShinjukuTokyoJapan
| | - Katsuhiro Mikami
- Faculty of Biology‐Oriented Science and Technology, Kindai UniversityKinokawaWakayamaJapan
| | - Shunsuke Kikuchi
- Department of Orthopedic SurgeryKeio University School of Medicine, ShinjukuTokyoJapan
| | - Masaharu Nishikino
- The National Institutes for Quantum and Radiological Science and Technology Quantum Beam Science Research Directorate Kansai Photon Science InstituteKyotoJapan
| | - Toshiyuki Kitamura
- The National Institutes for Quantum and Radiological Science and Technology Quantum Beam Science Research Directorate Kansai Photon Science InstituteKyotoJapan
| | - Noboru Hasegawa
- The National Institutes for Quantum and Radiological Science and Technology Quantum Beam Science Research Directorate Kansai Photon Science InstituteKyotoJapan
| | - Morio Matsumoto
- Department of Orthopedic SurgeryKeio University School of Medicine, ShinjukuTokyoJapan
| | - Masaya Nakamura
- Department of Orthopedic SurgeryKeio University School of Medicine, ShinjukuTokyoJapan
| | - Takeo Nagura
- Department of Orthopedic SurgeryKeio University School of Medicine, ShinjukuTokyoJapan,Department of Clinical BiomechanicsKeio University School of Medicine, ShinjukuTokyoJapan
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59
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Implant Stability Changes for Nonsubmerged and Submerged Protocols for a Single Implant Mandibular Overdenture Using Ball Attachment. Int J Dent 2021; 2021:8269197. [PMID: 34594381 PMCID: PMC8478597 DOI: 10.1155/2021/8269197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/08/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives To compare the changes in implant stability for the nonsubmerged (NS) and submerged (S) protocols for the single implant retained mandibular overdenture using ball attachment throughout a 24-month follow-up. Materials and Methods Eighty completely edentulous patients were seeking to improve retention of their lower complete denture by installing a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into 2 groups using sealed envelopes: the nonsubmerged (NS) and submerged (S) group. After a 3-month healing period, all patients were randomized using sealed envelopes into ball attachment and CM-LOC attachment. The Periotest readings (PTV) was recorded using the Periotest M device and was recorded every 3 months for the first year and then annually in the second year. The scope of this clinical trial focused only on results of the ball attachment. The Mann–Whitney U test was used for comparison between study groups for independent samples. Two-sided p values less than 0.05 was considered statistically significant. Results There was no statistically significant difference in the mean change in PTV reading between the NS and S group at the different follow-up intervals. Initially, at the day of pickup (baseline) and 3-month follow-up, the mean PTV reading for the NS was greater than that of the S group (−4.471 ± 1.489, −4.391 ± 1.4727 (p=0.913)), while the S group has shown a greater improvement in PTV than the NS group after 6-month follow-up and continued throughout the 24-month follow-up (−5.730 ± 1.7804, −50855 ± 1.2581 (p=1)). Conclusion Both the nonsubmerged and the submerged healing protocol have shown reliable Periotest readings using ball attachment for a single implant retained overdenture. The submerged group has resulted in a greater improvement in Periotest readings after the 12- and 24-month follow-up period when compared to the nonsubmerged group although this improvement was not statistically significant.
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60
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Raz P, Meir H, Levartovsky S, Peleg M, Sebaoun A, Beitlitum I. Reliability and Correlation of Different Devices for the Evaluation of Primary Implant Stability: An In Vitro Study. MATERIALS 2021; 14:ma14195537. [PMID: 34639933 PMCID: PMC8509803 DOI: 10.3390/ma14195537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022]
Abstract
Our aim was to analyze the correlation between the IT evaluated by a surgical motor and the primary implant stability (ISQ) measured by two RFA devices, Osstell and Penguin, in an in vitro model. This study examines the effect of bone type (soft or dense), implant length (13 mm or 8 mm), and implant design (CC: conical connection; IH: internal hexagon), on this correlation. Ninety-six implants were inserted using a surgical motor (IT) into two types of synthetic foam blocks. Initial measurements for both the peak IT and ISQ were recorded at the point when implant insertion was stopped by the surgical motor, and the final measurements were recorded when the implant was completely inserted into the synthetic blocks using only the RFA devices. Our null hypothesis was that there is a good correlation between the devices, independent of the implant length, design, or bone type. We found a positive, significant correlation between the IT, and the Osstell and Penguin devices. Implant length and bone type did not affect this correlation. The correlation between the devices in the CC design was maintained; however, in the IH design it was maintained only between the RFA devices. We concluded that there is a high positive correlation between the IT and ISQ from a mechanical perspective, which was not affected by bone type or implant length but was affected by the implant design.
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Affiliation(s)
- Perry Raz
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
- Correspondence:
| | - Haya Meir
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Maia Peleg
- The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Alon Sebaoun
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
| | - Ilan Beitlitum
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
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Murakami K, Yamamoto K, Ishida J, Tsutsumi S, Kirita T. Analysis of implant stability changes in immediate loading using a laser displacement sensor in vivo and comparison of its sensitivity with that of resonance frequency analysis. Clin Oral Implants Res 2021; 32:1341-1356. [PMID: 34403162 DOI: 10.1111/clr.13835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/07/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the stability changes in immediately loaded implants by using an in vivo quantitative measurement of micromotion under functional dynamic loading and to verify the sensitivity of Resonance Frequency Analysis (RFA) as compared to that of actual micromotion. MATERIALS AND METHODS The micromotions of immediately loaded implants placed in the tibia of 11 rabbits were monitored using a laser displacement sensor. Functional dynamic loading forces were applied 5 days a week for 6 weeks. The implant stability quotient (ISQ) was monitored using RFA. RESULTS The micromotion of the almost-loaded implants increased to peak values the day after loading was started and subsequently reached a plateau gradually. The ISQ changes in the loaded implants closely correlated with the alterations of the actual micromotion (r = -0.98, p < .01). Although the ISQ value itself correlated with the measured micromotion at the time of initial fixation (r = 0.73, p < .05), it did not correlate with the micromotion of the implant that acquired integration. No close correlation was observed between the ISQ and the histomorphometrical data. CONCLUSION The immediately loaded implants showed the lowest stability immediately after the start of loading, which gradually increased thereafter. RFA is considered a useful method for examining stability changes and initial stability; however, it cannot determine the absolute magnitude of the stability after integration.
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Affiliation(s)
- Kazuhiro Murakami
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara City, Nara, Japan
| | - Kazuhiko Yamamoto
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara City, Nara, Japan
| | - Junichi Ishida
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara City, Nara, Japan
| | - Sadami Tsutsumi
- Applied Electronics Laboratory, Kanazawa Institute of Technology, Ishikawa, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara City, Nara, Japan
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62
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Brouwers JEIG, Buis S, de Groot PG, de Laat B, Remijn JA. Resonance frequency analysis with two different devices after conventional implant placement with ridge preservation: A prospective pilot cohort study. Clin Implant Dent Relat Res 2021; 23:789-799. [PMID: 34312973 DOI: 10.1111/cid.13031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Primary and secondary implant stability is of high importance for survival and success of dental implants in the short and long term. Measurements of implant stability during healing provide the opportunity to monitor the course of the osseointegration process. PURPOSE To compare implant stability quotient (ISQ) by resonance frequency analysis (RFA), recorded with two different devices after implant placement. MATERIALS AND METHODS Patients with the need of single tooth extraction in posterior sites of the maxilla and the mandible were treated in a surgical center. All patients received additional augmentation with a bovine bone substitute and platelet-rich fibrin (PRF) after atraumatic tooth extraction. After a healing period of 10 weeks, 28 self-tapping titanium-implants were placed. Implant stability was recorded with two different devices (Osstell and Penguin) at the time of implant insertion (T0), 10 days later (T1), and after 7 (T2), or 17 weeks (T3). RESULTS No implant was lost, and no postoperative complication occurred during follow-up. Patient cohort comprised 9 female (32.1%) and 19 male patients (67.9%), with a mean age of 52.8 years, 64.3 years, respectively. Mean overall insertion torque was 43.6 Ncm at implant placement with no significant difference between implant location, age, or gender. No patient dropped out. During observation period, a significant increase in mean ISQ was recorded with both devices. Significant positive correlations between insertion torque and ISQ were recorded with both devices at T0, T2, and T3. No significant differences were observed in ISQ-values between both devices, and measuring directions at any point of measurement. CONCLUSIONS Within the limitations of this cohort study, both devices were suitable for RFA-measurement and revealed comparable results. Due to the cordless design, handling of the Penquin device was more comfortable. Reusability of the Penguin MultiPeg-transducers may offer an additional benefit with regard on ecological aspects.
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Affiliation(s)
| | - Sharon Buis
- Institute for Dental Implantology, Amersfoort, the Netherlands
| | - Philip G de Groot
- Synapse Research Institute, Maastricht, the Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bas de Laat
- Synapse Research Institute, Maastricht, the Netherlands.,Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jasper A Remijn
- Synapse Research Institute, Maastricht, the Netherlands.,Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht, Meander Medical Center, Amersfoort, the Netherlands.,Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, the Netherlands
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63
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Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study. J Clin Med 2021; 10:jcm10153220. [PMID: 34362004 PMCID: PMC8347999 DOI: 10.3390/jcm10153220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
Implant stability is one of the main indicators of successful osseointegration. Although it has been measured in numerous studies, there has been little research on implant stability in regenerated bone. The study compares primary and secondary stability between implants placed in regenerated versus native bone and evaluates the influence of bone quality on the results. Sixty implants were placed in 31 patients: 30 implants inserted in native bone (non-regenerated) after a healing period of at least 6 months post-exodontia and 30 inserted in regenerated bone at 6 months after grafting with xenograft. Resonance frequency analysis (RFA) was used to obtain implant stability quotient (ISQ) values at baseline (implant placement), 8 weeks, and 12 weeks. Statistically significant differences were found between implants placed in regenerated bone and those placed in native bone at all measurement time points (p < 0.05). ISQ values were significantly influenced by bone quality at baseline (p < 0.05) but not at 8 or 12 weeks. Greater stability was obtained in implants placed in native bone; however, those placed in regenerated bone showed adequate primary and secondary stability for prosthetic loading. Bone quality influences the primary but not secondary stability of the implants in both native and regenerated bone.
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64
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Ko SY, Hong JY, Lee W, Chang YY, Park KB, Yun JH. Osteoconductivity of Porous Titanium Structure on Implants in Osteoporosis. J Dent Res 2021; 100:1178-1185. [PMID: 34235985 DOI: 10.1177/00220345211023724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In compromised bone conditions such as osteoporosis, developments of the implant surface are necessary to secure the stability of implants. This study investigated the effect of the surface porous titanium structure (PS) on the osseointegration of implants in osteoporotic bone. Bilateral ovariectomy (OVX) was performed in 4 female beagle dogs to induce osteoporosis for 32 wk. Success of induction was based on the evaluation of bone mineral density by Hounsfield units (HU) in computed tomography images. Posterior teeth in both mandibles were extracted 1 wk after OVX, and a total of 30 implants (15 implants in each group) were placed after 32 wk of osteoporosis induction. The control group implant underwent resorbable blast media (RBM) surface treatment, whereas the test group underwent RBM surface treatment in the coronal two-thirds and a PS added to the apical 3-mm portion. HU values in the mandibular trabecular bone, lumbar, and femoral head significantly decreased 32 wk after OVX, confirming osteoporotic condition after induction. Resonance frequency analysis and removal torque test showed comparable values between the 2 groups at 4 wk after implant placement. The surface topography of the implant after removal showed hard tissue integration at the PS in the test group. Bone-to-implant contact length was greater in the apical portion of the test group, although statistical significance was not found between the groups. Interthread bone area in the apical portion of the test group showed a significant increase compared to the control group (control: 0.059 ± 0.041 mm2, test: 0.121 ± 0.060 mm2, P = 0.028) with the histological feature of bone ingrowth at the PS. The findings of the study demonstrated that the surface PS could improve osteoconductivity in the osteoporotic trabecular bone by bone ingrowth at the pore space, thereby enhancing the osseointegration and stability of the implants.
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Affiliation(s)
- S Y Ko
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - J Y Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - W Lee
- Advanced Process and Materials R&D Group, Korea Institute of Industrial Technology, Incheon, Republic of Korea
| | - Y Y Chang
- Department of Dentistry, Inha International Medical Center, Incheon, Republic of Korea
| | - K B Park
- MIR Dental Hospital and MegaGen, Daegu, Republic of Korea
| | - J H Yun
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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65
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A Mathematical Model for Biomechanical Evaluation of Micro-motion in Dental Prosthetics using Vibroacoustic RFA. J Med Biol Eng 2021. [DOI: 10.1007/s40846-021-00636-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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66
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Mohamed M, Pisavadia H, Westover L. A finite element model for evaluating the effectiveness of the Advanced System for Implant Stability Testing (ASIST). J Biomech 2021; 124:110570. [PMID: 34171676 DOI: 10.1016/j.jbiomech.2021.110570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022]
Abstract
The Advanced system for Implant Stability Testing (ASIST) was developed to evaluate the stability of osseointegrated implants. ASIST matches the physical response with an analytical model's prediction to determine the stiffness of the bone implant interface (BII) which is then used to calculate the ASIST Stability Coefficient (ASC). In this investigation, a 3D dynamic finite element (FE) model of the ASIST experimental impact technique for bone anchored hearing aids was created. The objectives were to evaluate the analytical model's ability to capture the behavior of the implant system and to assess its effectiveness in minimising the effects of the system's geometry on the ASC scores. The models were developed on ABAQUS®, they consisted of the implant, abutment, screw, base support and impact rod. The models relied on frictional contact definitions between the system's components. The simplified "three-part" model had the implant, abutment and screw merged as one part while the "five-part" model treated them as separate components. Different interface conditions were simulated (friction coefficient range: 0-0.9) for three abutment lengths (6, 9 and 12 mm). The simulation output was the average nodal acceleration response of the rod, which was imported to the custom ASIST program in Mathematica® to obtain the ASC scores. The overall quality of the curve fits indicate that the analytical model is capable of representing the system's behavior. Moreover,ASC scores provide a reliable assessment of implant stability as they are sensitive to interface conditions and are minimally influenced by the system's geometry.
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67
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Kinalski MDA, Agostini BA, Bergoli CD, Dos Santos MBF. Influence of low-level laser therapy on implant stability in implants placed in healed sites: a randomized controlled trial. Int J Implant Dent 2021; 7:49. [PMID: 34059974 PMCID: PMC8166992 DOI: 10.1186/s40729-021-00331-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background The present study aims to assess the influence of low-level laser therapy (LLLT) on stability in implants placed in healed sites. Material and methods The present study followed the SPIRIT statement and is reported according to CONSORT. Patients were randomly allocated to LLLT or control groups. LLLT consisted in the application of 808-nm GaAlA laser applied before the preparation of the implant bed and after suturing (80 seconds; 11J/cm2). Implant stability quotient (ISQ) and the distance between the implant platform to the alveolar bone crest (millimeters) were assessed at implant placement (T0) and the abutment selection phase (4–6 months, Ta). Results A total of 64 implants were placed in 33 patients. The insertion torque ranged from 10 to 70 N.cm (mean 43.23; SD ±16.82). The T0 ISQ ranged from 18 to 95.5 (mean 61.7; SD ±18.23) and the crestal bone radiographic distance was 2.03 mm (SD±1.27). At Ta, the ISQ ranged from 39 to 90 (mean 64.2; SD±9.84), and the mean crestal bone radiographic loss was 1.70mm (SD±1.65). However, no differences were observed when LLLT and control groups were compared with ISQ difference (Ta–T0; p=0.598) or radiographical peri-implant alterations (p=0.531). Conclusion LLLT did not influence the implant stability in implants placed in healed sites compared to a control group. Trial registration ReBEC, RBR-35TNJ7. Registered May 23, 2018
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Affiliation(s)
| | | | - Cesar Dalmolin Bergoli
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande, Brazil
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Nenen F, Garnica N, Rojas V, Oyonarte R. Comparison of the primary stability of orthodontic miniscrews after repeated insertion cycles. Angle Orthod 2021; 91:336-342. [PMID: 33378455 DOI: 10.2319/050120-375.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To compare the primary stability of miniscrews after repeated cycles of insertion through insertion torque (IT) measurements and resonance frequency analysis (RFA). MATERIALS AND METHODS Sixty titanium miniscrews were divided into two groups according to the insertion protocol: one with predrilled sites and the other self-drilled into porcine iliac crest bone specimens. Each group had three cycles of reinsertion. After each insertion, the IT and RFA were measured. The IT was measured by using a torque meter, and the RFA was measured using the Osstell ISQ device. A total of five miniscrews of each group were selected for sequential assessment of the morphology of their tip and threads using scanning electron microscopy after each insertion cycle. RESULTS No statistically significant differences were found in the IT values of miniscrews reinserted up to three times in the group with predrilled surgical sites. The IT value increased significantly with the number of reinsertions in the self-drilled group. The RFA value decreased as the number of insertions increased in both groups. CONCLUSIONS Under the conditions of this in vitro study, reinserting miniscrews deteriorates the integrity of their tip and thread. Reinsertion should be discouraged particularly when insertion sites are not predrilled.
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69
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Chen S, Rittel D, Shemtov Yona K. The normal stiffness of the edentulous alveolar process. Bone Rep 2021; 14:101066. [PMID: 33898661 PMCID: PMC8060551 DOI: 10.1016/j.bonr.2021.101066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
The normal stiffness of the jawbone is seldom considered, as opposed to the mechanical properties of its individual cortical and trabecular components. Our standpoint is essentially structural, rather than purely material-oriented, as the jawbone is considered as a natural load-bearing structure. Throughout the work, 3 representative sections in the mandible and the maxilla are modelled and compared. Specifically, we evaluate the sections' elastic structural stiffness numerically, according to the recent geometrical classification proposed by Shemtov Yona (2021). Each case is modelled using two extreme configurations for the cortical-trabecular interaction, namely bonded and unbonded. Those two configurations reflect extreme interfacial conditions, though the bonded one is more physical. For the unbonded cases, the structural stiffness is the sum of the individual stiffnesses of the components. By sharp contrast, the bonded case results in a much larger stiffness than that obtained by the simple sum of the individual stiffnesses, indicating a strong synergistic stiffening effect between the components through their interface. We also investigate the role of the elastic moduli, whose reported values vary widely in the literature, emphasizing the role of the trabecular Poisson's coefficient, whose stiffening effect is evidenced when it exceeds about 0.3. The bone's structural stiffness shown here complements the geometrical classification of the jawbone types with a fundamental mechanical/structural property delineating the coupling between the mechanical properties and the geometry. The adopted approach is not limited to the jawbone and applies in principle to other bone types. From a clinical standpoint, the results presented here complement not only the basic mechanical aspects of the geometrical characterization, but also provide a starting point for future studies on dental implant placement and stability, the latter being directly related to the structural stiffness.
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Affiliation(s)
- S Chen
- Mechanical Engineering Faculty, Technion, Israel Institute of Technology, Haifa, Israel
| | - D Rittel
- Mechanical Engineering Faculty, Technion, Israel Institute of Technology, Haifa, Israel
| | - K Shemtov Yona
- Mechanical Engineering Faculty, Technion, Israel Institute of Technology, Haifa, Israel.,The Maurice and Gabriela Goldschleger School of Dental Medicine, Department of Oral Biology, Tel Aviv University, Tel Aviv, Israel
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70
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Kligman S, Ren Z, Chung CH, Perillo MA, Chang YC, Koo H, Zheng Z, Li C. The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation. J Clin Med 2021; 10:1641. [PMID: 33921531 PMCID: PMC8070594 DOI: 10.3390/jcm10081641] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.
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Affiliation(s)
- Stefanie Kligman
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhi Ren
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Michael Angelo Perillo
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
| | - Yu-Cheng Chang
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Hyun Koo
- Biofilm Research Laboratories, Department of Orthodontics, Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (Z.R.); (H.K.)
- Center for Innovation & Precision Dentistry, School of Dental Medicine and School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.-H.C.); (M.A.P.)
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71
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Impact of renin-angiotensin system inhibitors and beta-blockers on dental implant stability. Int J Implant Dent 2021; 7:31. [PMID: 33829330 PMCID: PMC8026804 DOI: 10.1186/s40729-021-00309-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Current experimental research suggests antihypertensive medication reduces the failure risk of dental implants due to enhanced bone remodeling. However, evidence from clinical studies evaluating the impact of antihypertensive medication on implant stability is lacking. METHODS We retrospectively analyzed 377 implants in 196 patients (46 implants inserted in antihypertensive drug users (AH) and 331 implants in non-users (NAH)) for implant stability measured by radiofrequency analysis, and we determined the implant stability quotient (ISQ). AH subgroups were stratified by the use of beta-blockers, renin-angiotensin system (RAS) inhibitors, and both of the aforementioned. The impact of antihypertensive medication on ISQ values at implant insertion (primary stability) and implant exposure (secondary stability) was analyzed by a linear regression model with a regression coefficient and its 95% confidence interval (95% CI), adjusted for potential confounders. RESULTS Time between implant insertion and implant exposure was 117.1 ± 56.6 days. ISQ values at insertion were 71.8 ± 8.7 for NAH and 74.1 ± 5.6 for AH, respectively. ISQ at exposure was 73.7 ± 8.1 for NAH and 75.7 ± 5.9 for AH. Regression analysis revealed that none of the AH subgroups were significantly related to ISQ at implant insertion. However, renin-angiotensin system inhibitors (RAS) were significantly associated with higher ISQ values at exposure (reg. coeff. 3.59, 95% CI 0.46-6.71 (p=0.025)). CONCLUSIONS Outcome of the present study indicates enhanced bone remodeling and osseointegration following dental implant insertion in patients taking RAS inhibitors than in non-users. Future randomized prospective studies must confirm these indicative results.
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72
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Evaluation of the Histomorphometric and Micromorphometric Performance of a Serum Albumin-Coated Bone Allograft Combined with A-PRF for Early and Conventional Healing Protocols after Maxillary Sinus Augmentation: A Randomized Clinical Trial. MATERIALS 2021; 14:ma14071810. [PMID: 33917513 PMCID: PMC8038833 DOI: 10.3390/ma14071810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to compare the microarchitecture of augmented bone following maxillary sinus augmentation (MSA) after healing periods of 3 (test) and 6 (control) months using the combination of advanced platelet-rich fibrin (A-PRF) and a serum albumin-coated bone allograft (SACBA). Twenty-six patients with 30 surgical sites who required two-stage MSA were enrolled and grafted with the combination of A-PRF and SACBAs. The surgical sites were randomly allocated to the test or control group. During implant site preparation, 17 bone core biopsy samples were collected from each study group for histological, histomorphometric and micromorphometric analysis. Resonance frequency analysis was performed at the time of implant placement and 6, 8, 10, and 12 weeks postoperatively. The percentage of newly formed bone was 44.89 ± 9.49% in the test group and 39.75 ± 8.15% in the control group (p = 0.100). The results of the µCT analysis showed no significant differences in morphometric parameters between the study groups. The implant stability quotient was not significantly different between the two groups at 10 and 12 weeks postoperatively. Based on these findings, the total treatment time may be reduced by 3 months with the use of A-PRF and SACBAs for two-stage MSA.
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73
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Jinno Y, Stocchero M, Galli S, Toia M, Becktor JP. Impact of a Hydrophilic Dental Implant Surface on Osseointegration: Biomechanical Results in Rabbit. J ORAL IMPLANTOL 2021; 47:163-168. [PMID: 32663272 DOI: 10.1563/aaid-joi-d-19-00217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the effect of surface hydrophilicity on the biomechanical aspects of osseointegration of dental implants in the tibia and femur of rabbits. Forty-eight mature female New Zealand White rabbits were included, and 96 commercially pure, Grade 4, titanium dental implants (control group), and 96 implants of same macro geometry with the hydrophilic surface (test group) were used in this study. One osteotomy was performed in each tibia and femur on both sides of the rabbit, and four implants were placed in each rabbit. Control and test groups were randomly allocated on the left and right sides. During surgery, insertion torque (ITQ) value of the complete implant placement was recorded. After healing periods of 0, 2, 4, and 8 weeks after surgery, implant stability quotient (ISQ) value, and removal torque (RTQ) values were measured. No statistical difference was observed for ITQ, for ISQ and for RTQ between the control group and test group in tibia/femur for all time periods. The effect of hydrophilic properties on moderately roughened surfaces has no impact in terms of biomechanical outcomes (ISQ values and RTQ values) after a healing period of 2 to 8 weeks in rabbit tibias /femurs.
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Affiliation(s)
- Yohei Jinno
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Michele Stocchero
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Silvia Galli
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Marco Toia
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Jonas P Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
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74
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Badenes-Catalán J, Pallarés-Sabater A. Influence of Smoking on Dental Implant Osseointegration: A Radiofrequency Analysis of 194 Implants. J ORAL IMPLANTOL 2021; 47:110-117. [PMID: 32699886 DOI: 10.1563/aaid-joi-d-19-00223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although many studies have related smoking to peri-implantitis and marginal bone loss, little is known of its potential impact on dental implant osseointegration. The present clinical study explores the influence of smoking on secondary stabilization based in radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and at a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between 2 groups: smokers and nonsmokers. The following variables were also analyzed: implant brand and model, length, diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking did not affect the primary stability of the implant, although it was associated with a marked decrease in secondary stability. The nonsmokers showed a gain of 2.69 points (95% confidence interval [CI]: 1.529-3.865; P < .001) in the osseointegration process. However, in the smokers group, implant stability was seen to decrease 0.91 points (95% CI: -3.424 to 1.600; P < .004), generating a difference of 3.61 points between smokers and nonsmokers. Smoking is thus concluded to be an important factor that must be taken into account when seeking good implant osseointegration outcomes.
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75
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Chao YL, Wang TM, Chang HH, Lin LD. Effects of low-dose rhBMP-2 on peri-implant ridge augmentation in a canine model. J Clin Periodontol 2021; 48:734-744. [PMID: 33544419 DOI: 10.1111/jcpe.13440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/16/2020] [Accepted: 01/22/2021] [Indexed: 12/17/2022]
Abstract
AIMS The aim of this study was to investigate the potential of low-dose rhBMP-2 combined with Hydroxyapatite (HAp)/β-tricalcium phosphate (TCP)/ Collagen (Col) composite in repairing the peri-implant critical size defect and to determine the optimal rhBMP-2 concentration. MATERIALS AND METHODS Fifty saddle-type alveolar defects (10 mm mesiodistally and 4 mm apicocoronally) were surgically prepared on edentulous ridges in ten beagle dogs. Following implant placement, the defects with vertically exposed implant fixtures either received (a) no graft, (b) HAp/TCP/Col composite, (c) HAp/TCP/Col +0.02 mg/ml rhBMP-2, (d) HAp/TCP/Col +0.08 mg/ml rhBMP-2 or (e) HAp/TCP/Col +0.2 mg/ml rhBMP-2. After healing for 4 or 8 weeks, bone regeneration and mineralization were assessed through radiography, micro-CT, fluorescence labelling and histologic analyses. Implant stability was measured through resonance frequency analysis. RESULTS It was evident HAp/TCP/Col with 0.2 mg/ml rhBMP-2 manifested strong osteogenic potential in this large animal model, as significantly more and faster new bone formation with better implant stability was identified compared to the HAp/TCP/Col-alone control group (adjusted p < .05). CONCLUSIONS Our results highlight the constructs of HAp/TCP/Col +0.2 mg/ml rhBMP-2 without barrier membranes as a promising tool for peri-implant ridge augmentation.
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Affiliation(s)
- Yueh-Ling Chao
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tong-Mei Wang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Hao-Hueng Chang
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Li-Deh Lin
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,School of Dentistry, National Taiwan University, Taipei, Taiwan
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Meijndert CM, Raghoebar GM, Vissink A, Meijer HJA. Alveolar ridge preservation in defect sockets in the maxillary aesthetic zone followed by single-tooth bone level tapered implants with immediate provisionalization: a 1-year prospective case series. Int J Implant Dent 2021; 7:18. [PMID: 33604747 PMCID: PMC7892651 DOI: 10.1186/s40729-021-00292-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background Clinical studies of single-tooth replacement in compromised bone using bone level tapered implants in the aesthetic zone are scarce. Aim To assess clinically, radiographically and aesthetically over 1 year the performance of a bone level tapered implant in the maxillary aesthetic zone in sites after alveolar ridge preservation. Material and methods Thirty patients (16 male, 14 female) with a failing tooth and large bone defect after removal received alveolar ridge preservation. After 3 months, implants were placed with immediate provisionalization. Definitive restorations were placed after 3 months. The treatment was evaluated 1 year following the definitive restoration. Results All the patients attended the 1-year follow-up. One implant was lost (96.7% implant survival rate). The mean implant stability quotient value was 68.9 ± 8.74 at implant placement. The mean marginal bone level change was minor (− 0.07 ± 0.12 mm). The mean mid-buccal mucosa changed with + 0.01 ± 0.45 mm. The median Pink Esthetic Score and White Esthetic Score after 1 year were 6 [4; 7] and 8 [7; 9], respectively. The patients’ mean overall satisfaction (0–100 VAS scale) was 86.6 ± 10.3. Conclusion Bone level tapered implants with immediate provisionalization perform well after alveolar ridge preservation in the maxillary aesthetic zone, according to implant stability, clinical, radiographic, aesthetic and patient-centred outcomes. Trial registration NTR, NL8755. Registered on 1 January 2016
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Affiliation(s)
- Caroliene M Meijndert
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, NL-9700, RB, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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A Radiographic and Clinical Comparison of Immediate vs. Early Loading (4 Weeks) of Implants with a New Thermo-Chemically Treated Surface: A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031223. [PMID: 33572988 PMCID: PMC7908367 DOI: 10.3390/ijerph18031223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/11/2021] [Accepted: 01/26/2021] [Indexed: 01/18/2023]
Abstract
Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner® VEGA® implants with a ContacTi® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level—not the osseointegration rate, clinical conditions, or PROMs.
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Daher FI, Abi-Aad HL, Dimassi HI, Baba NZ, Majzoub ZA. Factors Affecting Implant Stability Quotients at Immediately and Conventionally Loaded Implants in the Posterior Maxilla: A Split-Mouth Randomized Controlled Trial. J Prosthodont 2021; 30:590-603. [PMID: 33215755 DOI: 10.1111/jopr.13296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess primary and secondary stability of variable-thread tapered implants in the posterior maxilla and analyze the impact of various factors on implant stability quotients (ISQs). MATERIALS AND METHODS Twenty-six subjects received 3-4 adjacent implants in the maxillary premolar-molar sextants to replace bilateral tooth loss. The implants on one side were immediately loaded with a provisional fixed prosthesis regardless of their primary stability. The contralateral control implants were conventionally loaded. Bone quality was subjectively recorded and primary stability was assessed by means of insertion torque values (ITVs) and ISQs in 4 directions. Secondary stability was measured by ISQ at definitive prosthesis delivery (3-3.5 months postoperatively), and 12 months after definitive loading. The impact of measurement direction, loading protocol, time, site-related (bone quality, implant position, crestal buccal bone thickness, apical cortical anchorage), and implant-related (implant dimensions, abutment height) variables on ISQs was assessed. RESULTS For logistic reasons, ISQs were obtained for only 18 patients with 60 test and 60 control implants. Most of the implants (82%) at baseline had their lowest ISQ on the buccal aspect. There were no significant differences between ISQs measured in the buccal and palatal directions, or between ISQs in the mesial and distal directions. The mean of buccal and palatal ISQs was significantly lower than the mean of the 2 interproximal measurements at all evaluation periods. ISQs were not significantly different between the 2 loading groups at any time point. All implants showed a time-dependent increase in ISQs. Baseline ISQ correlated weakly with bone quality and ITV. None of the variables had a significant impact on baseline ISQs, except for implants in second molar sites which showed poorer primary stability than first premolars. CONCLUSION Measurement direction and time are the most significant parameters affecting ISQs of variable-thread tapered implants in the posterior maxilla.
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Affiliation(s)
- Fadi I Daher
- Department of Periodontics, Lebanese University, Faculty of Dental Medicine, Hadath, Lebanon
| | - Habib L Abi-Aad
- Department of Periodontics, Lebanese University, Faculty of Dental Medicine, Hadath, Lebanon
| | - Hani I Dimassi
- School of Pharmacy, Department of Pharmaceutical Sciences, Lebanese American University, Byblos, Lebanon
| | - Nadim Z Baba
- Advanced Dental Education Program in Implant Dentistry, Loma Linda University, School of Dentistry, Loma Linda, CA
| | - Zeina Ak Majzoub
- Department of Periodontics, Lebanese University, Faculty of Dental Medicine, Hadath, Lebanon
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79
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An In Vitro Evaluation of Primary Stability Values for Two Differently Designed Implants to Suit Immediate Loading in Very Soft Bone. Dent J (Basel) 2021; 9:dj9010005. [PMID: 33430004 PMCID: PMC7827002 DOI: 10.3390/dj9010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
The achievement of sufficient implant stability in poor quality bone seems to be a challenge. Most manufacturers develop special dental implants, which are claimed to show higher stability even in very soft bone. The aim of this experimental study was to compare two recently introduced dental implants with differing thread designs. A total of 11 implants of each group were inserted in the part of the fresh bovine ribs, corresponding to very soft bone. The primary stability was measured with resonance frequency analysis (RFA) and Periotest; the average of two measurements for each method and for each implant was taken and statistical analysis was applied. The highest stability values were obtained with the ICX Active Master implants, followed by the Conelog® Progressive-Line implants placed with the very soft bone protocol. The primary stability values of the Conelog® Progressive-Line implants inserted by the very soft bone protocol and the ICX Active Master implants placed with the standard protocol showed sufficient stability for immediate loading in low-density bone. Within the limitations of this study, the thread design of the implants and underdimensioned implant bed preparation seem to be effective for better primary stability in cancellous bone.
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Preliminary evaluation of BMP-2-derived peptide in repairing a peri-implant critical size defect: A canine model. J Formos Med Assoc 2020; 120:1212-1220. [PMID: 33358040 DOI: 10.1016/j.jfma.2020.07.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/10/2020] [Accepted: 07/17/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND/PURPOSE A synthetic bone morphogenetic protein (BMP)-2-derived peptide has been discovered to promote bone regeneration. The present study investigated the potential of the BMP-2 peptide combined with hydroxyapatite (HAp)/β-tricalcium phosphate (TCP)/collagen (Col) composite in repairing a peri-implant critical size defect. METHODS Twenty-four saddle-type alveolar defects (10 mm mesiodistally and 4 mm apicocoronally) were surgically prepared in edentulous ridges in four male beagle dogs. Following implant placement, the defects with vertically exposed implant fixtures received (a) HAp/TCP/Col composite, (b) HAp/TCP/Col + 4 mg/mL BMP-2 peptide, (c) HAp/TCP/Col + 20 mg/mL BMP-2 peptide, or (d) HAp/TCP/Col + 0.2 mg/mL recombinant human BMP-2 (rhBMP-2). Bone regeneration and mineralization were assessed using radiography, micro-computed tomography (micro-CT), fluorescence labeling, and histologic analyses after healing for 4 or 8 weeks. Implant stability was measured using resonance frequency analysis. RESULTS The 20 mg/mL BMP-2 peptide groups demonstrated a distinguishable advantage in bone regeneration potential over the control groups, as observed on radiographic imaging and histologic examination, although no significant difference was found in implant stability and histomorphometric analysis of mineralization levels. However, the performance of the 20 mg/mL BMP-2 peptide groups were inferior to that of the 0.2 mg/mL rhBMP-2 groups. CONCLUSION The BMP-2 peptide may accelerate peri-implant bone regeneration. The BMP-2 peptide at 20 mg/mL still cannot complete bone repair of peri-implant critical size defect. The BMP-2 peptide at 20 mg/mL has similar osteoinductive performance to the rhBMP-2 at 0.02 mg/mL.
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Chavarri-Prado D, Brizuela-Velasco A, Álvarez-Arenal Á, Dieguez-Pereira M, Pérez-Pevida E, Viteri-Agustín I, Estrada-Martínez A. The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants. BIOLOGY 2020; 10:biology10010012. [PMID: 33379218 PMCID: PMC7823772 DOI: 10.3390/biology10010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022]
Abstract
Simple Summary The bone, as a vertebrate support tissue, is capable of adapting its structure and function to the mechanical demands resulting from the loads that are produced during the performance of its activity. This regulatory action also occurs during the healing processes of a fracture. The purpose of this study was to determine to what extent a dynamic load was capable of modulating the bone healing response around a titanium implant. The study was carried out on experimental rabbits, to which dental implants were placed in the tibiae and there were two test groups, one in which they did not undergo exercise during healing period and another that ran daily during this process on a treadmill. The trail results showed an improvement in the osseointegration process of the implant in the group in which it was subjected to load. The importance of these results is that it opens the door to a better understanding of the mechanisms that can modulate bone healing, especially around dental implants, supporting implant loading protocols that are based on efficiency. Abstract Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.
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Affiliation(s)
- David Chavarri-Prado
- Department of Surgery and Surgical Specialties, School of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain; (A.B.-V.); (Á.Á.-A.); (M.D.-P.); (A.E.-M.)
- Correspondence:
| | - Aritza Brizuela-Velasco
- Department of Surgery and Surgical Specialties, School of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain; (A.B.-V.); (Á.Á.-A.); (M.D.-P.); (A.E.-M.)
| | - Ángel Álvarez-Arenal
- Department of Surgery and Surgical Specialties, School of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain; (A.B.-V.); (Á.Á.-A.); (M.D.-P.); (A.E.-M.)
| | - Markel Dieguez-Pereira
- Department of Surgery and Surgical Specialties, School of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain; (A.B.-V.); (Á.Á.-A.); (M.D.-P.); (A.E.-M.)
| | - Esteban Pérez-Pevida
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain
| | - Iratxe Viteri-Agustín
- Department of Pharmacology and Physiology, School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Alejandro Estrada-Martínez
- Department of Surgery and Surgical Specialties, School of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain; (A.B.-V.); (Á.Á.-A.); (M.D.-P.); (A.E.-M.)
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de Matos R, Mesquita AMM, Giovani EM. Cone Morse Implant Placement in Patients With Aids Who Use Highly Active Antiretroviral Therapy Report of Clinical Cases. Open Dent J 2020. [DOI: 10.2174/1874210602014010650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
The Acquired Immune Deficiency Syndrome (AIDS) is a condition that manifests itself after the infection of the human organism by the Human Immunodeficiency Virus (HIV). In 1996, the Highly Active Antiretroviral Therapy (HAART) was introduced, with the aim of slowing down the immunodeficiency and restoring the immunity of these patients, extending their life expectancy. Consequently, the need for rehabilitating dental treatments arose, aiming to improve oral health, self-esteem and the quality of life of these patients. This current study was designed to assess vertical dimensional changes in the peri-implant bone level around the placement of dental implants in AIDS patients using HAART.
Materials and Methods:
For the bone level evaluation, at first cone-beam computed tomography, panoramic radiography and periapical radiographs were used during the periods at baseline, 2, 4 and 6 months after the implant installation. The images were digitized and analyzed on programs Adobe Photoshop CS5 and Digimizer 3.1.1.0.
Results:
Were installed 13 implants that presented a peri-implant bone loss average of 0.26 mm in the first bimester, 0.13 mm in the second and 0.18 mm in the third, totalizing a peri-implant bone loss average of 0.57 mm in the semester.
Conclusion:
Despite the several metabolic changes that can affect these patients due to infection, drug therapy, immune response and the absence of an adequate stability quotient and insertion torque, all implants showed osseointegration, as well as the parameters of clinical success after the installation of the implant, and the degree of bone loss in this period is within the expected according to the research.
Clinical Relevance:
Oral health professionals should be aware of the possible complications that future HIV patients may have due to their systemic and drug-related condition in association with osseointegration.
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The Effects of Smoking Cigarettes on Immediate Dental Implant Stability—A Prospective Case Series Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Smoking tobacco significantly affects the biology of periodontal tissues and contributes to the increased risk of peri-implant diseases. The aim of the study was to investigate whether smoking cigarettes affects the primary and secondary stability of maxillary dental implants, inserted into fresh sockets immediately after extraction. Methods: The study was conducted on 164 patients between the ages of 27–71 years old. 67 individuals smoked more than 20 cigarettes daily and 97 were non-smokers. 190 immediate implants were inserted in the maxilla. Immediate implantations were performed with simultaneous augmentation of the socket with xenogenic bone grafting material. In the posterior region, implants were inserted into the palatal alveolus. The stability of the implants was measured using Insertion Torque Value (ITV) and two types of devices: Periotest (PT) and Osstell (ISQ). Marginal bone loss was evaluated on cone beam computed tomography scans. Results: In an aesthetic area, the PT values at 6 months post-implantation were higher for smokers than non-smokers (p < 0.05), respectively. The ISQ values were significantly lower in smokers compared to non-smokers at 6 months post-implantation (p = 0.0226), respectively. In the posterior region PT values were higher in smokers both on the day of implantation (p = 0.0179), 6 months after surgery (p = 0.0003) as well as 24 months after surgery (p < 0.0001), as compared to non-smokers, respectively. Smokers revealed lower ISQ values than non-smokers (p = 0.0047) on the day of implantation, as well as 6 months after implantation (p = 0.0002), respectively. There were no significant differences in marginal bone loss after 18 months of loading between smokers and non-smokers in the aesthetic, as well as posterior regions (p > 0.05). ITV measurements were lower in smokers than non-smokers in the aesthetic (16.3 vs. 17.5 Ncm) and posterior area (16.8 vs. 17.9 Ncm). Conclusions: This study indicate that smoking cigarettes has a negative effect on the stability of immediate implants in the maxilla. Primary stability of immediate implants may be lower in the posterior area of the maxilla in smokers when compared to non-smokers, which may eliminate smokers from immediate implants in this region. Secondary stability of immediate implants may be lower in both the aesthetic and posterior areas in smokers compared to non-smokers, which may encourage the postponement of final crowns delivery at 6 months post op and the extension of the occlusaly temporary crowns use in some smoker cases.
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Grzeskowiak RM, Schumacher J, Dhar MS, Harper DP, Mulon PY, Anderson DE. Bone and Cartilage Interfaces With Orthopedic Implants: A Literature Review. Front Surg 2020; 7:601244. [PMID: 33409291 PMCID: PMC7779634 DOI: 10.3389/fsurg.2020.601244] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
The interface between a surgical implant and tissue consists of a complex and dynamic environment characterized by mechanical and biological interactions between the implant and surrounding tissue. The implantation process leads to injury which needs to heal over time and the rapidity of this process as well as the property of restored tissue impact directly the strength of the interface. Bleeding is the first and most relevant step of the healing process because blood provides growth factors and cellular material necessary for tissue repair. Integration of the implants placed in poorly vascularized tissue such as articular cartilage is, therefore, more challenging than compared with the implants placed in well-vascularized tissues such as bone. Bleeding is followed by the establishment of a provisional matrix that is gradually transformed into the native tissue. The ultimate goal of implantation is to obtain a complete integration between the implant and tissue resulting in long-term stability. The stability of the implant has been defined as primary (mechanical) and secondary (biological integration) stability. Successful integration of an implant within the tissue depends on both stabilities and is vital for short- and long-term surgical outcomes. Advances in research aim to improve implant integration resulting in enhanced implant and tissue interface. Numerous methods have been employed to improve the process of modifying both stability types. This review provides a comprehensive discussion of current knowledge regarding implant-tissue interfaces within bone and cartilage as well as novel approaches to strengthen the implant-tissue interface. Furthermore, it gives an insight into the current state-of-art biomechanical testing of the stability of the implants. Current knowledge reveals that the design of the implants closely mimicking the native structure is more likely to become well integrated. The literature provides however several other techniques such as coating with a bioactive compound that will stimulate the integration and successful outcome for the patient.
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Affiliation(s)
- Remigiusz M. Grzeskowiak
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Jim Schumacher
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - Madhu S. Dhar
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - David P. Harper
- The Center for Renewable Carbon, Institute of Agriculture, University of Tennessee, Knoxville, TN, United States
| | - Pierre-Yves Mulon
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
| | - David E. Anderson
- Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, United States
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Ríos-Santos JV, Tello-González G, Lázaro-Calvo P, Gil Mur FJ, Ríos-Carrasco B, Fernández-Palacín A, Herrero-Climent M. One Abutment One Time: A Multicenter, Prospective, Controlled, Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249453. [PMID: 33348644 PMCID: PMC7765846 DOI: 10.3390/ijerph17249453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
Aim: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). Results: After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group (p = 0.02). No differences were observed in implant stability between groups. Conclusions: The “One Abutment—One Time” concept does not reduce peri-implant bone loss compared to the connection–disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss.
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Affiliation(s)
- José Vicente Ríos-Santos
- Advanced Periodontics, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Seville, Spain; (G.T.-G.); (P.L.-C.); (B.R.-C.)
- Correspondence: ; Tel.: +34-954481121; Fax: +34-954481157
| | - Gregorio Tello-González
- Advanced Periodontics, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Seville, Spain; (G.T.-G.); (P.L.-C.); (B.R.-C.)
| | - Pedro Lázaro-Calvo
- Advanced Periodontics, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Seville, Spain; (G.T.-G.); (P.L.-C.); (B.R.-C.)
| | - Francisco Javier Gil Mur
- Technological Health Research Center, Biomaterials of the Faculties of Medicine and Dentistry, International University of Cataluña, 08034 Barcelona, Spain;
| | - Blanca Ríos-Carrasco
- Advanced Periodontics, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Seville, Spain; (G.T.-G.); (P.L.-C.); (B.R.-C.)
| | - Ana Fernández-Palacín
- Department of Biostatistic, Dental School, Universidad de Sevilla, 41009 Sevilla, Spain;
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Effects of Different Undersizing Site Preparations on Implant Stability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238965. [PMID: 33276529 PMCID: PMC7731014 DOI: 10.3390/ijerph17238965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 11/17/2022]
Abstract
As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.
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Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238623] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. While the PIT and ISQ values obtained are similar, the PRT values suggest different physical responses from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of BC protocol in several clinical settings.
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88
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Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The success rate of dental implants depends on primary and secondary stability. We investigate predictive factors for future risk stratification models. We retrospectively analyze 272 patients with a total of 582 implants. Implant stability is measured with resonance frequency analysis and evaluated based on the implant stability quotient (ISQ). A linear regression model with regression coefficients (reg. coeff.) and its 95% confidence interval (95% CI) is applied to assess predictive factors for implant stability. Implant diameter (reg. coeff.: 3.28; 95% CI: 1.89–4.66, p < 0.001), implant length (reg. coeff.: 0.67, 95% CI: 0.26–1.08, p < 0.001), and implant localization (maxillary vs. mandibular, reg. coeff.: −7.45, 95% CI: −8.70–(−6.20), p < 0.001) are significant prognostic factors for primary implant stability. An increase in ISQ between insertion and exposure is significantly correlated with healing time (reg. coeff.: 0.11, 95% CI: 0.04–0.19). Patients with maxillary implants have lower ISQ at insertion but show a higher increase in ISQ after insertion than patients with mandibular implants. We observe positive associations between primary implant stability and implant diameter, implant length, and localization (mandibular vs. maxillary). An increase in implant stability between insertion and exposure is significantly correlated with healing time and is higher for maxillary implants. These predictive factors should be further evaluated in prospective cohort studies to develop future preoperative risk-stratification models.
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89
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Schnutenhaus S, Götz W, Dreyhaupt J, Rudolph H, Luthardt RG, Edelmann C. Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge Preservation with a Collagen Cone. Dent J (Basel) 2020; 8:E112. [PMID: 33023224 PMCID: PMC7712570 DOI: 10.3390/dj8040112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/22/2020] [Accepted: 09/27/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The objective of this investigation was to examine whether determination of bone density (BD) with a cone beam computed tomography (CBCT) scan could help predict the primary stability (PS) of the implants and to investigate whether associations between the histomorphometric findings and the CBCT scan could be observed. MATERIALS AND METHODS In this randomized clinical study, the efficacy of alveolar ridge preservation (ARP) with a combination of a collagen cone and a collagen membrane procedure after tooth extraction was investigated. CBCT scans were obtained after a healing period of 8 (±1) weeks. Subsequently, the CBCT scans were evaluated in terms of BD at different heights of the former socket. Eleven (±1) weeks after tooth extraction, implant placement was performed and PS was measured with resonance frequency analysis. Potential associations among the radiologically measured BD, the histomorphometric results, and the PS were analyzed. RESULTS No direct association was observed between the radiologically determined BD and the histomorphometric findings. No significant associations could be found between the BD and the PS. CONCLUSION No significant associations were observed among the BD determined by the CBCT, the histomorphometric findings, and the PS.
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Affiliation(s)
- Sigmar Schnutenhaus
- Center of Dentistry, Dr. Schnutenhaus MVZ GmbH, 78247 Hilzingen, Germany
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Werner Götz
- Oral Biology Laboratory, Department of Orthodontics, University of Bonn, 53113 Bonn, Germany;
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, 89081 Ulm, Germany;
| | - Heike Rudolph
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Ralph G. Luthardt
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
| | - Cornelia Edelmann
- Center of Dentistry, Department of Prosthetic Dentistry, Ulm University, 89081 Ulm, Germany; (H.R.); (R.G.L.); (C.E.)
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90
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Guerrero-González M, Monticelli F, Saura García-Martín D, Herrero-Climent M, Ríos-Carrasco B, Ríos-Santos JV, Fernández-Palacín A. Reliability of the Resonance Frequency Analysis Values in New Prototype Transepithelial Abutments: A Prospective Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186733. [PMID: 32947802 PMCID: PMC7559410 DOI: 10.3390/ijerph17186733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
Resonance frequency analysis (RFA) requires abutment disconnection to monitor implant stability. To overcome this limitation, an experimental transepithelial abutment was designed to allow a SmartPeg to be screwed onto it, in order to determine the prototype abutments repeatability and reproducibility using Osstell ISQ and to assess whether implant length and diameter have an influence on the reliability of these measurements. RFA was conducted with a SmartPeg screwed directly into the implant and onto experimental abutments of different heights of 2, 3.5 and 5 mm. A total of 32 patients (116 implants) were tested. RFA measurements were taken twice for each group from mesial, distal, buccal and palatal/lingual surfaces. Mean values and SD were calculated and Intraclass Correlation Coefficients (ICC) (p < 0.05, IC 95%). The implant stability quotient (ISQ) mean values were 72.581 measured directly to implant and 72.899 (2 mm), 72.391 (3.5 mm) and 71.458 (5 mm) measured from the prototypes. ICC between measurements made directly to implant and through 2-, 3.5- and 5-mm abutments were 0.908, 0.919 and 0.939, respectively. RFA values registered through the experimental transepithelial abutments achieved a high reliability. Neither the implant length nor the diameter had any influence on the measurements' reliability.
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Affiliation(s)
- María Guerrero-González
- Periodontics, Faculty of Health and Sport Sciences, Universidad de Zaragoza, C/Velódromo S/N, 22006 Huesca, Spain; (M.G.-G.); (F.M.); (D.S.G.-M.)
| | - Francesca Monticelli
- Periodontics, Faculty of Health and Sport Sciences, Universidad de Zaragoza, C/Velódromo S/N, 22006 Huesca, Spain; (M.G.-G.); (F.M.); (D.S.G.-M.)
| | - David Saura García-Martín
- Periodontics, Faculty of Health and Sport Sciences, Universidad de Zaragoza, C/Velódromo S/N, 22006 Huesca, Spain; (M.G.-G.); (F.M.); (D.S.G.-M.)
| | | | - Blanca Ríos-Carrasco
- Advanced Periodontics, School of Dentistry, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain;
| | - José-Vicente Ríos-Santos
- Advanced Periodontics, School of Dentistry, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain;
| | - Ana Fernández-Palacín
- Department of Social and Health Sciences, Universidad de Sevilla, 41009 Sevilla, Spain;
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91
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Koyuncuoglu CZ, Demir B. Comparison of Measurements of Implant Stability by Two Different Radio Frequency Analysis Systems: An In Vitro Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820923251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To compare and evaluate the implant stability quotient (ISQ) measurements by two different radio frequency analysis (RFA) machines, Osstell Mentor and PenguinRFA. Materials and Methods: Twenty bone-level implants (3.7 × 10 mm2) were placed on a bovine bone in this in vitro study. The ISQ measurements were performed with the PenguinRFA and Osstell Mentor machines using the multipeg of the Penguin system. The measurements were repeated three times for each direction and an average ISQ value was calculated. The results were averaged (mean ± SD) and the intraclass correlation coefficient (ICC) was calculated to assess the relationship between the measurements. Result: The mean ISQ values for the Osstell and Penguin machines were 77.60 + 2.11 and 78.05 + 2.04, respectively. The ICC was 0.958. The ISQ values obtained from the Osstell and Penguin machines were significantly compatible ( P < .05). Conclusion: Both of the RFA devices provided similar and reliable ISQ measurements.
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Affiliation(s)
- Cenker Zeki Koyuncuoglu
- Faculty of Dentistry, Department of Periodontology, Istanbul Aydin University, Istanbul, Turkey
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92
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Enhancement of Bone Ingrowth into a Porous Titanium Structure to Improve Osseointegration of Dental Implants: A Pilot Study in the Canine Model. MATERIALS 2020; 13:ma13143061. [PMID: 32650581 PMCID: PMC7412235 DOI: 10.3390/ma13143061] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022]
Abstract
A porous titanium structure was suggested to improve implant stability in the early healing period or in poor bone quality. This study investigated the effect of a porous structure on the osseointegration of dental implants. A total of 28 implants (14 implants in each group) were placed in the posterior mandibles of four beagle dogs at 3 months after extraction. The control group included machined surface implants with an external implant–abutment connection, whereas test group implants had a porous titanium structure added to the apical portion. Resonance frequency analysis (RFA); removal torque values (RTV); and surface topographic and histometric parameters including bone-to-implant contact length and ratio, inter-thread bone area and ratio in total, and the coronal and apical parts of the implants were measured after 4 weeks of healing. RTV showed a significant difference between the groups after 4 weeks of healing (p = 0.032), whereas no difference was observed in RFA. In the test group, surface topography showed bone tissue integrated into the porous structures. In the apical part of the test group, all the histometric parameters exhibited significant increases compared to the control group. Within the limitations of this study, enhanced bone growth into the porous structure was achieved, which consequently improved osseointegration of the implant.
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93
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Schickert SDL, Jansen JA, Bronkhorst EM, van den Beucken JJJP, Leeuwenburgh SCG. Stabilizing dental implants with a fiber-reinforced calcium phosphate cement: An in vitro and in vivo study. Acta Biomater 2020; 110:280-288. [PMID: 32330608 DOI: 10.1016/j.actbio.2020.03.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 01/30/2023]
Abstract
Stabilization of dental implants by means of biomaterials such as bioceramic granules and cements is currently compromised by the poor mechanical properties of these bioceramics. Recently, our group developed a calcium phosphate cement reinforced with poly(vinyl alcohol) fibers with improved flexural strength and toughness. Herein we evaluated the capacity of these fiber-reinforced calcium phosphate cements to stabilize dental implants in vitro and in vivo using a range of mechanical and biological test methods. In vitro, filling of circumferential crestal peri‑implant bone defects with synthetic bone analogues with fiber-reinforced calcium phosphate cement demonstrated superior implant stability as compared to fiber-free calcium phosphate cement over a 12-week period. Similarly, filling of circumferential crestal peri‑implant bone defects with fiber-reinforced calcium phosphate cement effectively stabilized dental implants installed in a rabbit femoral condyle defect as assessed via both Implant Stability Quotient (ISQ) and torque-out measurements. Moreover, histological and histomorphometric evaluation demonstrated the osteocompatibility of fiber-reinforced calcium phosphate cement, as evidenced by absence of soft tissue ingrowth, direct contact between the bone and cement, and gradual degradation of the biomaterial and replacement by newly-formed bone. These data demonstrate that fiber-reinforced calcium phosphate cement stabilize dental implants during osseointegration. STATEMENT OF SIGNIFICANCE: Dental implants can be placed immediately after a tooth is removed. However, in some cases the implant might not have enough bone surrounding it and becomes loose. To solve this, bioceramics have been used to fill the implant-bone gap. However, these materials have poor mechanical properties and are often not capable to stabilize the implant. Recently, our research group developed a new bone cement that is reinforced with fibers and has, therefore, enhanced mechanical properties. In this study, we have proven that by molding this cement into the implant-bone gap, we stabilize the implant and allow for a direct connection between the implant and the surrounding bone. Using this innovative cement is therefore a safe and efficient way of stabilizing dental implants.
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94
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Farronato D, Manfredini M, Stocchero M, Caccia M, Azzi L, Farronato M. Influence of Bone Quality, Drilling Protocol, Implant Diameter/Length on Primary Stability: An In Vitro Comparative Study on Insertion Torque and Resonance Frequency Analysis. J ORAL IMPLANTOL 2020; 46:182-189. [PMID: 32582919 DOI: 10.1563/aaid-joi-d-19-00145] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the influence of bone quality, drilling technique, implant diameter, and implant length on insertion torque (IT) and resonance frequency analysis (RFA) of a prototype-tapered implant with knife-edge threads. The investigators hypothesized that IT would be affected by variations in bone quality and drilling protocol, whereas RFA would be less influenced by such variables. The investigators implemented an in vitro experiment in which a prototype implant was inserted with different testing conditions into rigid polyurethane foam blocks. The independent variables were: bone quality, drilling protocol, implant diameter, and implant length. Group A implants were inserted with a conventional drilling protocol, whereas Group B implants were inserted with an undersized drilling protocol. Values of IT and RFA were measured at implant installation. IT and RFA values were significantly correlated (Pearson correlation coefficient: 0.54). A multivariable analysis showed a strong model. Higher IT values were associated with drilling protocol B vs A (mean difference: 71.7 Ncm), implant length (3.6 Ncm increase per mm in length), and substrate density (0.199 Ncm increase per mg/cm3 in density). Higher RFA values were associated with drilling protocol B vs A (mean difference: 3.9), implant length (1.0 increase per mm in length), and substrate density (0.032 increase per mg/cm3 in density). Implant diameter was not associated with RFA or IT. Within the limitations of an in vitro study, the results of this study suggest that the studied implant can achieve good level of primary stability in terms of IT and RFA. A strong correlation was found between values of IT and RFA. Both parameters are influenced by the drilling protocol, implant length, and substrate density. Further studies are required to investigate the clinical response in primary stability and marginal bone response.
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Affiliation(s)
- Davide Farronato
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Michele Stocchero
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Neurosciences, Section of Dentistry, University of Padova, Padova, Italy
| | | | - Lorenzo Azzi
- Department of Medicine and Surgery, Unit of Oral Pathology, University of Insubria, Varese, Italy
| | - Marco Farronato
- IRCCS Fondazione Cà Granda, University of Milan, Milan, Italy
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95
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Su YH, Peng BY, Wang PD, Feng SW. Evaluation of the implant stability and the marginal bone level changes during the first three months of dental implant healing process: A prospective clinical study. J Mech Behav Biomed Mater 2020; 110:103899. [PMID: 32957204 DOI: 10.1016/j.jmbbm.2020.103899] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 11/16/2022]
Abstract
Achievement of adequate implant stability is one of the determinants for long-term successful osseointegration. Resonance frequency analysis was developed to monitor implant stability and is now a well-recognized, non-invasive tool for determining the appropriate time for functional loading. However, there have been few studies with continuous evaluation and comparison of implant stability and marginal bone level changes between two different macro designs and clinical situations during the implant healing process. Thus, the purpose of this clinical trial is to evaluate the implant stability and marginal bone level changes of straight and conical implants during the implant healing process. In this prospective clinical trial, 25 participants were randomized to either straight or conical implants. A total of 32 titanium dental implants with a length of 9 mm or 11 mm were installed in the maxilla and the mandible according to the manufacturer's instructions. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the time of implant placement and after 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, and 12 weeks of healing. The changes in the peri-implant marginal bone level were evaluated from digital radiographic films taken at the time of implant placement and after 4 weeks, 8 weeks, and 12 weeks of healing. The preliminary results of this study revealed higher ISQ values and better healing tendency for conical implants in comparison with straight implants in the maxilla. Similar ISQ values and healing tendency were observed for straight and conical implants in the mandible. No significant differences in marginal bone loss were found between the straight and conical implants. However, in the mandible, slightly more marginal bone loss was found with the conical implants than straight implants after 12 weeks of healing. In conclusion, ISQ healing tendency and marginal bone loss are influenced by implant macro-design and jaw regions. Straight implants revealed similar ISQ healing tendency and marginal bone loss in both the mandible and maxilla. Conical implants were confirmed more beneficial for maintenance of implant stability and marginal bone level in the maxilla.
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Affiliation(s)
- Yi-Han Su
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Peter-D Wang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Periodontics, College of Dental Medicine, Columbia University, New York, USA
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.
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96
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Morphological Evaluation of Bone by CT to Determine Primary Stability-Clinical Study. MATERIALS 2020; 13:ma13112605. [PMID: 32521622 PMCID: PMC7321591 DOI: 10.3390/ma13112605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022]
Abstract
Background: Primary stability is an important prognostic factor for dental implant therapy. In the present study, we evaluate the relationship between implant stability evaluation findings by the use of an implant stability quotient (ISQ), an index for primary stability, and a morphological evaluation of bone by preoperative computed tomography (CT). Subjects and methods: We analyzed 98 patients who underwent implant placement surgery in this retrospective study. For all 247 implants, the correlations of the ISQ value with cortical bone thickness, cortical bone CT value, cancellous bone CT value, insertion torque value, implant diameter, and implant length were examined. Results: 1. Factors affecting ISQ values in all cases: It was revealed that there were significant associations between the cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis. 2. It was revealed that there was a significant correlation between cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis in the upper jaw. 3. It was indicated that there was a significant association between cortical bone thickness and implant diameter with ISQ by multiple regression analysis in the lower jaw. Conclusion: We concluded that analysis of the correlation of the ISQ value with cortical bone thickness and values obtained in preoperative CT imaging were useful preoperative evaluations for obtaining implant stability.
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97
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Is It Possible to Monitor Implant Stability on a Prosthetic Abutment? An In Vitro Resonance Frequency Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114073. [PMID: 32521612 PMCID: PMC7313046 DOI: 10.3390/ijerph17114073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022]
Abstract
In order to apply the “one-abutment–one-time” concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the PenguinRFA when screwing the transducer onto the implant or onto abutments with different heights and angulations. Eighty implants (VEGA®, Klockner Implant System, SOADCO, Les Escaldes, Andorra) were inserted into fresh bovine ribs. The groups were composed of 20 implants, 12 mm in length, with two diameters (3.5 and 4 mm). Five different abutments for screwed retained restorations (Permanent®) were placed as follows: straight with 1, 2, and 3 mm heights, and angulated at 18° with 2 and 3 mm heights. The mean value of the ISQ measured directly on the implant was 75.72 ± 4.37. The mean value of the ISQ registered over straight abutments was 79.5 ± 8.50, 76.12 ± 6.63, and 71.42 ± 6.86 for 1, 2, and 3 mm height abutments. The mean ISQ over angled abutments of 2 and 3 mm heights were 68.74 ± 4.68 and 64.51 ± 4.53 respectively. The present study demonstrates that, when the ISQ is registered over the straight abutments of 2 and 3 mm heights, the values decrease, and values are lower for angled, 3 mm height abutments.
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98
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Arosio P, Arosio F, Di Stefano DA. Implant Diameter, Length, and the Insertion Torque/Depth Integral: A Study Using Polyurethane Foam Blocks. Dent J (Basel) 2020; 8:dj8020056. [PMID: 32512762 PMCID: PMC7345030 DOI: 10.3390/dj8020056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/21/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
The amount of energy necessary to place an implant in its seat, described as the integral of the torque-depth curve at insertion (I), has been validated as a reliable measure of primary stability. This study aimed to investigate whether (I) may detect the variations in primary stability caused by changes in the implant length or diameter better than the insertion torque (IT). Cylindric implants featuring a double-etched, sandblasted surface with different diameters or lengths were placed into monolithic polyurethane foam blocks with different densities that mimicked human bone. (I)-, (I)*-, IT-, IT*-diameter and -length plots ((I)* and IT* were the derived values corrected for undersizing) were drawn and the relation between (I), (I)*, IT, and IT* and the fixture diameter or length was investigated with correlation analysis. (I)* and IT* correlated better than (I) and IT with the fixture diameter; (I), (I)*, IT, and IT* correlated equally well with the fixture length. In all cases, the slopes of the lines best fitting the experimental data were greater for (I) or (I)* than IT or IT*, respectively. (I) or (I)* were better detectors than IT or IT* of the changes in primary stability that can be achieved by increasing the fixture diameter or length.
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Affiliation(s)
- Paolo Arosio
- Private Practitioner, Vimercate, 20871 Monza-Brianza, Italy;
| | | | - Danilo Alessio Di Stefano
- Adjunct Professor, Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Private Practitioner, 20148 Milan, Italy
- Correspondence: ; Tel.: +39-02-48705703
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99
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Relationship between Implant Length and Implant Stability of Single-Implant Restorations: A 12-Month Follow-Up Clinical Study. ACTA ACUST UNITED AC 2020; 56:medicina56060263. [PMID: 32471305 PMCID: PMC7353855 DOI: 10.3390/medicina56060263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Implant stability in vivo is contingent on multiple factors, such as bone structure, instrument positioning and implant surface modifications, implant diameter, and implant length. Resonance-frequency analysis is considered a non-invasive, reliable, predictable, and objective method by which to evaluate implant stability, due to its correlation with bone-to-implant contact. The purpose of this study was to evaluate the effect of implant length on the primary and secondary stability of single-implant crown rehabilitations, as measured by resonance-frequency analysis at different times. Materials and Methods: Implants of 10 and 11.5 mm were placed, and the resonance frequency was measured at the time of surgery (T0), as well as at 3 (T1), 6 (T2), and 12 (T3) months post-surgery. Results: A total of 559 implants were placed in 195 patients. Significant differences were observed when comparing the implant stability quotient (ISQ) values at T1, with values for 10-mm implants being greater than those for 11.5-mm implants (p = 0.035). These differences were also observed when comparing ISQ values for buccal and lingual areas. At T0, T2, and T3, no significant differences in ISQ values were observed. The use of 10-mm implants in the anterior maxilla yielded significantly greater values at T0 (p = 0.018) and T1 (p = 0.031) when compared with 11.5-mm implants. Significant differences in measurements were observed only for buccal areas (p = 0.005; p = 0.018). When comparing the sample lengths and sex, women with 11.5-mm implants showed significantly lower results than those with 10-mm implants (p < 0.001). Conclusions: There is a direct relationship between implants of a smaller length and greater ISQ values, with this relationship being most evident in the maxilla and in women.
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100
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Salvage of Dental Implant Located in Mandibular Odontogenic Cyst. A Conservative Surgical Treatment Proposal. Dent J (Basel) 2020; 8:dj8020049. [PMID: 32403226 PMCID: PMC7344506 DOI: 10.3390/dj8020049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/21/2022] Open
Abstract
The aim of this case report was to evaluate the use of Partsch I cystotomy in order to preserve a dental implant located in an odontogenic cyst extended from 3.2 to 4.4. A 50 year-old woman showed a circular, well-defined unilocular radiolucent area, Ø2.5 cm, in the right mandibular region with an oral implant intruding inside it. The overdenture in the mandibular right site showed no clinical mobility. The authors decided to perform a surgical treatment aimed to preserve the implant. The patient underwent Partsch I surgery followed by iodoform gauze insertion replaced weekly for one month, revision of the previous orthograde endodontic treatments, and an acrylic resin obturator prosthesis application for the following two months. The twelve month follow-up showed no clinical mobility of the right lateral mandibular implant prostheses. Radiographical analysis revealed cystic lesion healing and perimplant bone regeneration. This report highlights the opportunity to apply cystotomy when the cyst involves a dental implant and undermines its stability. This possibility is offered by the peculiar clinical scenario where the implant was stabilized by the presence of a previous prosthetic fixation. Our study led to the application of an operative protocol that allowed for the preservation of the implant.
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