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Cunningham BW, Brooks DM, Rolle NP, Weiner DA, Wang W. An investigational time course study of titanium plasma spray on osseointegration of PEEK and titanium implants: an in vivo ovine model. Spine J 2024; 24:721-729. [PMID: 37875243 DOI: 10.1016/j.spinee.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/13/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND CONTEXT Methods to improve osseointegration of orthopedic spinal implants remains a clinical challenge. Materials composed of poly-ether-ether-ketone (PEEK) and titanium are commonly used in orthopedic applications due to their inherent properties of biocompatibility. Titanium has a clinical reputation for durability and osseous affinity, and PEEK offers advantages of a modulus that approximates osseous structures and is radiolucent. The hypothesis for the current investigation was that a titanium plasma spray (TPS) coating may increase the rate and magnitude of circumferential and appositional trabecular osseointegration of PEEK and titanium implants versus uncoated controls. PURPOSE Using an in vivo ovine model, the current investigation compared titanium plasma-sprayed PEEK and titanium dowels versus nonplasma-sprayed dowels. Using a time course study of 6 and 12 weeks postoperatively, experimental assays to quantify osseointegration included micro-computed tomography (microCT), biomechanical testing, and histomorphometry. STUDY DESIGN/SETTING In-vivo ovine model. METHODS Twelve skeletally mature crossbred sheep were equally randomized into postoperative periods of 6 and 12 weeks. Four types of dowel implants-PEEK, titanium plasma-sprayed PEEK (TPS PEEK), titanium, and titanium plasma-sprayed titanium (TPS titanium) were implanted into cylindrical metaphyseal defects in the distal femurs and proximal humeri (one defect per limb, n=48 sites). Sixteen nonoperative specimens (eight femurs and eight humeri) served as zero time-point controls. Half of the specimens underwent destructive biomechanical pullout testing and the remaining half quantitative microCT to quantify circumferential bone volume within 1 mm and 2 mm of the implant surface and histomorphometry to compute direct trabecular apposition. RESULTS There were no intra- or perioperative complications. The TPS-coated implants demonstrated significantly higher peak loads at dowel pullout at 6 and 12 weeks compared with uncoated controls (p<.05). No differences were observed across dowel treatments at the zero time-point (p>.05). MicroCT results exhibited no significant differences in circumferential osseointegration between implants within 1 mm or 2 mm of the dowel surface (p>.05). Direct appositional osseointegration of trabecular bone based on histomorphometry was higher for TPS-coated groups, regardless of base material, compared with uncoated treatments at both time intervals (p<.05). CONCLUSIONS The current in vivo study demonstrated the biological and mechanical advantages of plasma spray coatings. TPS improved histological incorporation and peak force required for implant extraction. CLINICAL SIGNIFICANCE Plasma spray coatings may offer clinical benefit by improving biological fixation and osseointegration within the first 6 to 12 weeks postoperatively- the critical healing period for implant-based arthrodesis procedures.
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Affiliation(s)
- Bryan W Cunningham
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, USA
| | - Daina M Brooks
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, 201 E University Pkwy, Baltimore, MD 21218, USA.
| | - Nicholas P Rolle
- Department of Surgery, Inova Fairfax Medical Campus, 3300 Gallows Rd., Falls Church, VA 22042, USA
| | - David A Weiner
- Department of Orthopaedic Surgery, MedStar Southern Maryland Hospital Center, 7503 Surratts Rd, Clinton, MD 20735, USA
| | - Wenhai Wang
- Musculoskeletal Education and Research Center, A Division of Globus Medical, Inc. 2560 General Armistead Ave, Audubon, PA 19403, USA
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Verdecchia A, Suárez-Fernández C, Miquel A, Bardini G, Spinas E. Biological Effects of Orthodontic Tooth Movement on the Periodontium in Regenerated Bone Defects: A Scoping Review. Dent J (Basel) 2024; 12:50. [PMID: 38534275 DOI: 10.3390/dj12030050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
The aim of this scoping review is to analyse the biological effects of the orthodontic tooth movement (OTM) in areas with bone defects that are undergoing regeneration using different types of regenerative materials and techniques. The electronic research was performed on four databases as follows: PubMed, Scopus, EMBASE, and Web of Science. Data were extracted according to publication information, study design, sample characteristics, parameters of OTM, biological repercussions on the periodontium complex, methods of analysis, and conclusions. A total of thirty studies were included in the final review. In twenty-two studies, the most widely adopted grafting materials were alloplastics. In most studies, the orthodontic force used was 10 or 100 g, and the timing of application ranged from immediate to 6 months after grafting surgery. Twenty-four studies showed an increase in osteogenesis; in five studies, the clinical attachment level (CAL) increased; in five others, the probing pocket depth (PPD) decreased; in sixteen studies, there was root resorption of a different magnitude. Though the effects of OTM on the periodontium in the grafted areas were positive, the outcomes should be interpreted with caution as future preclinical and clinical studies are needed to extrapolate more valid conclusions.
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Affiliation(s)
- Alessio Verdecchia
- Department of Surgery and Medical-Surgical Specialities, School of Medicine and Health Sciences, University of Oviedo, 33003 Oviedo, Spain
| | - Carlota Suárez-Fernández
- Department of Surgery and Medical-Surgical Specialities, School of Medicine and Health Sciences, University of Oviedo, 33003 Oviedo, Spain
| | - Andrea Miquel
- Department of Surgical Sciences, School of Periodontology and Implantology, Mississippi Institution, 28010 Madrid, Spain
| | - Giulia Bardini
- Department of Surgical Sciences, Division of Conservative Dentistry and Endodontics, University of Cagliari, 09124 Cagliari, Italy
| | - Enrico Spinas
- Department of Surgical Sciences, Postgraduate School in Orthodontics, University of Cagliari, 09124 Cagliari, Italy
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Báskay J, Pénzes D, Kontsek E, Pesti A, Kiss A, Guimarães Carvalho BK, Szócska M, Szabó BT, Dobó-Nagy C, Csete D, Mócsai A, Németh O, Pollner P, Mijiritsky E, Kivovics M. Are Artificial Intelligence-Assisted Three-Dimensional Histological Reconstructions Reliable for the Assessment of Trabecular Microarchitecture? J Clin Med 2024; 13:1106. [PMID: 38398417 PMCID: PMC10889719 DOI: 10.3390/jcm13041106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Objectives: This study aimed to create a three-dimensional histological reconstruction through the AI-assisted classification of tissues and the alignment of serial sections. The secondary aim was to evaluate if the novel technique for histological reconstruction accurately replicated the trabecular microarchitecture of bone. This was performed by conducting micromorphometric measurements on the reconstruction and comparing the results obtained with those of microCT reconstructions. Methods: A bone biopsy sample was harvested upon re-entry following sinus floor augmentation. Following microCT scanning and histological processing, a modified version of the U-Net architecture was trained to categorize tissues on the sections. Detector-free local feature matching with transformers was used to create the histological reconstruction. The micromorphometric parameters were calculated using Bruker's CTAn software (version 1.18.8.0, Bruker, Kontich, Belgium) for both histological and microCT datasets. Results: Correlation coefficients calculated between the micromorphometric parameters measured on the microCT and histological reconstruction suggest a strong linear relationship between the two with p-values of 0.777, 0.717, 0.705, 0.666, and 0.687 for BV/TV, BS/TV, Tb.Pf Tb.Th, and Tb.Sp, respectively. Bland-Altman and mountain plots suggest good agreement between BV/TV measurements on the two reconstruction methods. Conclusions: This novel method for three-dimensional histological reconstruction provides researchers with a tool that enables the assessment of accurate trabecular microarchitecture and histological information simultaneously.
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Affiliation(s)
- János Báskay
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Dorottya Pénzes
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Endre Kontsek
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - Adrián Pesti
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - András Kiss
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | | | - Miklós Szócska
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Dániel Csete
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Attila Mócsai
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Péter Pollner
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;
- Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
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Starch-Jensen T, Schou S, Terheyden H, Bruun NH, Aludden H. Bone regeneration after maxillary sinus floor augmentation with different ratios of autogenous bone and deproteinized bovine bone mineral an in vivo experimental study. Clin Oral Implants Res 2023; 34:1406-1416. [PMID: 37766500 DOI: 10.1111/clr.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/01/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Test the hypothesis of no difference in bone regeneration after maxillary sinus floor augmentation (MSFA) with different ratios of iliac or mandibular autogenous bone (AB) graft and deproteinized bovine bone mineral (DBBM). MATERIALS AND METHODS Forty minipigs were randomly allocated to bilateral MSFA using: (A) 100% AB, (B) 75% AB and 25% DBBM, (C) 50% AB and 50% DBBM, (D) 25% AB and 75% DBBM, or (E) 100% DBBM. The animals were euthanized 12 weeks after surgery. Percentage of bone, non-mineralized tissue, and residual DBBM were estimated by histomorphometric analysis in a randomly selected region of interest and summarized as mean percentage with 95% confidence interval (CI). RESULTS Mean percentage of bone following MSFA with iliac or mandibular AB graft was: (A) 55.5% and 64.2%, (B) 60.3% and 61.6%, (C) 54.4% and 52.1%, (D) 51.8% and 53.1%, and (E) 47.6%, respectively. There was a significant trend toward a higher percentage of bone, with a higher ratio of AB within the graft (p < .01), regardless of the origin of AB graft (iliac or mandible). CONCLUSIONS The hypothesis was rejected since percentage of bone was significantly increased with larger proportions of AB within the graft. Consequently, AB or a mixture of AB and diminutive quantities of DBBM seem to be the preferred graft for MSFA based solely on histomorphometric assessment. However, it should be emphasized that newly formed bone and residual AB graft particles could not be distinguished by the applied histologic procedure.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Søren Schou
- Private Practice in Oral Surgery, Specialtandlaegerne Seedorffs Straede, Aarhus, Denmark
| | - Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery, Red Cross Hospital, Kassel, Germany
| | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Hanna Aludden
- Department of Oral and Maxillofacial Surgery, NU-Hospital Organization, Trollhättan, Sweden
- Department of Biomaterials, Institute for Surgical Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cascos R, Celemín-Viñuela A, Mory-Rubiños N, Gómez-Polo C, Ortega R, Agustín-Panadero R, Gómez-Polo M. Influence of the Use of Transepithelial Abutments vs. Titanium Base Abutments on Microgap Formation at the Dental Implant-Abutment Interface: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6532. [PMID: 37834669 PMCID: PMC10573618 DOI: 10.3390/ma16196532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
This in vitro study aimed to assess the presence of microgaps at the implant-abutment interface in monolithic zirconia partial implant-supported fixed prostheses on transepithelial abutments versus Ti-base abutments. METHODS Sixty conical connection dental implants were divided into two groups (n = 30). The control group consisted of three-unit bridge monolithic zirconia connected to two implants by a transepithelial abutment. The test group consisted of monolithic zirconia three-unit restoration connected to two implants directly by a titanium base (Ti-base) abutment. The sample was subjected to thermocycling (10,000 cycles at 5 °C to 55 °C, dwelling time 50 s) and chewing simulation (300,000 cycles, under 200 N at frequencies of 2 Hz, at a 30° angle). The microgap was evaluated at six points (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) of each implant-abutment interface by using a scanning electron microscope (SEM). The data were analyzed using the Mann-Whitney U tests (p > 0.05). RESULTS The SEM analysis showed a smaller microgap at the implant-abutment interface in the control group (0.270 μm) than in the test group (3.902 μm). Statistically significant differences were observed between both groups (p < 0.05). CONCLUSIONS The use or not of transepithelial abutments affects the microgap size. The transepithelial abutments group presented lower microgap values at the interface with the implant than the Ti-base group in monolithic zirconia partial implant-supported fixed prostheses. However, both groups had microgap values within the clinically acceptable range.
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Affiliation(s)
- Rocío Cascos
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Alicia Celemín-Viñuela
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Nataly Mory-Rubiños
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain;
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
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Zhan YJ, Zhang SW, Zhu S, Jiang N. Tissue Clearing and Its Application in the Musculoskeletal System. ACS OMEGA 2023; 8:1739-1758. [PMID: 36687066 PMCID: PMC9850472 DOI: 10.1021/acsomega.2c05180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
The musculoskeletal system is an integral part of the human body. Currently, most skeletal muscle research is conducted through conventional histological sections due to technological limitations and the structure of skeletal muscles. For studying and observing bones and muscles, there is an urgent need for three-dimensional, objective imaging technologies. Optical tissue-clearing technologies seem to offer a novel and accessible approach to research of the musculoskeletal system. Using this approach, the components which cause refraction or prevent light from penetrating into the tissue are physically and chemically eliminated; then the liquid in the tissue is replaced with high-refractive-index chemicals. This innovative method, which allows three-dimensional reconstruction at the cellular and subcellular scale, significantly improves imaging depth and resolution. Nonetheless, this technology was not originally developed to image bones or muscles. When compared with brain and nerve organs which have attracted considerable attention in this field, the musculoskeletal system contains fewer lipids and has high levels of hemoglobin, collagen fibers, and inorganic hydroxyapatite crystals. Currently, three-dimensional imaging methods are widely used in the diagnosis and treatment of skeletal and muscular illnesses. In this regard, it is vitally important to review and evaluate the optical tissue-clearing technologies currently employed in the musculoskeletal system, so that researchers may make an informed decision. In the meantime, this study offers guidelines and recommendations for expanding the use of this technology in the musculoskeletal system.
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Affiliation(s)
- Yan-Jing Zhan
- State
Key Laboratory of Oral Diseases & National Clinical Research Center
for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shi-Wen Zhang
- State
Key Laboratory of Oral Diseases & National Clinical Research Center
for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- West
China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - SongSong Zhu
- State
Key Laboratory of Oral Diseases & National Clinical Research Center
for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- West
China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Nan Jiang
- State
Key Laboratory of Oral Diseases & National Clinical Research Center
for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- West
China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Hong JM, Kim UG, Yeo ISL. Comparison of three-dimensional digital analyses and two-dimensional histomorphometric analyses of the bone-implant interface. PLoS One 2022; 17:e0276269. [PMID: 36240217 PMCID: PMC9565376 DOI: 10.1371/journal.pone.0276269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 10/03/2022] [Indexed: 11/21/2022] Open
Abstract
Histological analysis is considered to be the gold standard method of evaluating osseointegration around a bone-implant. However, this method requires invasive specimen preparation and is capable of representing only one plane. By comparison, micro-computed tomography (μCT) is a fast and convenient method that offers three-dimensional information but is hampered by problems related to resolution and artifacts, making it a supplementary method for osseointegration analysis. To verify the reliability of μCT for osseointegration evaluation, this animal model study compared bone-to-implant contact (BIC) ratios obtained by the gold standard histomorphometric method with those obtained by the μCT method, using a rabbit tibia implant model. A sandblasted, large-grit, acid-etched (SLA) implant and a machined surface implant were inserted into each tibia of two rabbits (giving eight implants in total). Bone-implant specimens were analyzed using μCT with a spiral scan technique (SkyScan 1275) and histological sections were prepared thereafter. Three-dimensional (3D) reconstructed μCT data and four two-dimensional (2D) μCT sections, including one section corresponding to the histologic section and three additional sections rotated 45°, 90°, and 135°, were used to calculate the BIC ratio. The Pearson's test was used for correlation analysis at a significance level of 0.05. The histomorphometric BIC and the 2D-μCT BIC showed strong correlation (r = 0.762, P = 0.046), whereas the histomorphometric BIC and 3D-μCT BIC did not (r = -0.375, P = 0.385). However, the mean BIC value of three or four 2D-μCT sections showed a strong correlation with the 3D-μCT BIC (three sections: r = 0.781, P = 0.038; four sections: r = 0.804, P = 0.029). The results of this animal model study indicate that μCT can be used to complement the histomorphometric method in bone-implant interface analyses. With the limitations of this study, 3D-μCT analysis may even have a superior aspect in that it eliminates random variables that arise as a consequence of the selected cutting direction.
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Affiliation(s)
- Jeong-Min Hong
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ung-Gyu Kim
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
- * E-mail:
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Werny JG, Sagheb K, Diaz L, Kämmerer PW, Al-Nawas B, Schiegnitz E. Does vitamin D have an effect on osseointegration of dental implants? A systematic review. Int J Implant Dent 2022; 8:16. [PMID: 35403929 PMCID: PMC9001786 DOI: 10.1186/s40729-022-00414-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/23/2022] [Indexed: 12/14/2022] Open
Abstract
Abstract
Purpose
The aim of this study was to systematically review the available evidence to evaluate the efficacy of vitamin D supplementation or vitamin D depletion on the osseointegration of implants in animals and humans.
Methods
The focus questions addressed were “Do vitamin D deficient subjects treated with (dental) implants have an inferior osseointegration than subjects with adequate serum vitamin D level?” and “Do vitamin D supplemented subjects treated with (dental) implants have a superior osseointegration than subjects with adequate serum vitamin D level?” Humans and animals were considered as subjects in this study. Databases were searched from 1969 up to and including March 2021 using different combination of the following terms: “implant”, “bone to implant contact”, “vitamin D” and “osseointegration”. Letters to the editor, historic reviews, commentaries and articles published in languages other than English and German were excluded. The pattern of the present systematic review was customize to primarily summarize the pertinent data.
Results
Thirteen experimental studies with animals as subject, two clinical studies and three case reports, with humans as subjects, were included. The amount of inserted titanium implants ranged between 24 and 1740. Results from three animal studies showed that vitamin D deficiency has a negative effect on new bone formation and/or bone to implant contact (BIC). Eight animal studies showed that vitamin D supplementation has a enhancing effect on BIC and/or new bone formation around implants. Furthermore, enhancing the impact of vitamin D supplementation on the osseointegration of implants in subjects with diabetes mellitus, osteoporosis and chronic kidney disease (CKD) were assessed. Studies and case reports involving human subjects showed that patients with a low serum vitamin D level have a higher tendency to exhibit an early dental implant failure. When supplemented with vitamin D the osseointegration was successful in the case reports and a beneficial impact on the changes in the bone level during the osseointegration were determined.
Conclusions
Vitamin D deficiency seems to have a negative effect on the osseointegration of implants in animals. The supplementation of vitamin D appears to improve the osseointegration in animals with systemic diseases, such as vitamin D deficiency, diabetes mellitus, osteoporosis, and CKD. Slight evidence supports the hypothesis that humans similarly benefit from vitamin D supplementation in terms of osseointegration. Further investigation is required to maintain these assumptions.
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López-Valverde N, López-Valverde A, Cortés MP, Rodríguez C, Macedo De Sousa B, Aragoneses JM. Bone Quantification Around Chitosan-Coated Titanium Dental Implants: A Preliminary Study by Micro-CT Analysis in Jaw of a Canine Model. Front Bioeng Biotechnol 2022; 10:858786. [PMID: 35464727 PMCID: PMC9023049 DOI: 10.3389/fbioe.2022.858786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/17/2022] [Indexed: 12/11/2022] Open
Abstract
Surface treatments of Ti in the dental implant industry are performed with the aim of in-creasing its bioactivity and osseointegration capacity. Chitosan (Cht) is a polysaccharide that has been proposed as a promising biomaterial in tissue engineering and bone regeneration, due to its ability to stimulate the recruitment and adhesion of osteogenic progenitor cells. The aim of our preliminary study was to evaluate, by micro-computed tomography (micro-CT), the osseointegration and bone formation around Cht-coated implants and to compare them with conventional surface-etched implants (SLA type). Four im-plants (8.5 mm length × 3.5 mm Ø) per hemiarch, were inserted into the jaws of five dogs, divided into two groups: chitosan-coated implant group (ChtG) and control group (CG). Twelve weeks after surgery, euthanasia was performed, and sectioned bone blocks were obtained and scanned by micro-CT and two bone parameters were measured: bone in contact with the implant surface (BCIS) and peri-implant bone area (PIBA). For BCIS and PIBA statistically significant values were obtained for the ChtG group with respect to CG (p = 0.005; p = 0.014 and p < 0.001 and p = 0.002, respectively). The results, despite the limitations, demonstrated the usefulness of chitosan coatings. However, studies with larger sample sizes and adequate experimental models would be necessary to confirm the results.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Alcalá de Henares, Spain
| | - Antonio López-Valverde
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Sala-manca (IBSAL), Salamanca, Spain
- *Correspondence: Antonio López-Valverde,
| | - Marta Paz Cortés
- Faculty of Dentistry, Universidad Alfonso X El Sabio, Villanueva de la Cañada, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
| | - Bruno Macedo De Sousa
- Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Polo I‐Edifício Central Rua Larga, Coimbra, Portugal
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Timing of orthodontic tooth movement in bone defects repaired with synthetic scaffolds: A scoping review of animal studies. Arch Oral Biol 2021; 132:105278. [PMID: 34634537 DOI: 10.1016/j.archoralbio.2021.105278] [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] [Received: 07/31/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The optimal timing of orthodontic tooth movement (OTM) could allow earlier tooth movements across alveolar bone defects while minimizing the adverse effects. The objective of this scoping systematic review was therefore designed to review pre-clinical animal studies on the ideal protocol for the timing of orthodontic traction across alveolar defects augmented with synthetic scaffolds. DESIGN Following the PRISMA-ScR guidelines, three electronic databases were searched (Pubmed, Scopus and Web of Science). RESULTS A total of twelve studies were included in the final review that reported on small-animal (rats, guinea pigs, rabbits) and large-animal (dogs and goats) models. Based on the grafting biomaterials, eight papers used cell-free scaffolds, four articles utilised cell-based scaffolds. The timing protocol for the initiation of OTM employed in the studies ranged from immediate to 6 months after surgical grafting. Only four studies included autologous bone graft (gold standard) as positive control. Most papers reported positive results with regards to the rate of OTM and bone augmentation effects while only a few reported side effects such as root resorptions. Overall, the included articles showed a massive heterogeneity in terms of the animal bone defect model characteristics, scaffold materials, study designs, parameters of OTM and methods of analysis. CONCLUSION Since there was inadequate evidence to identify the optimal protocol of OTM, optimization of animal bone defect models and outcome measurements is needed to improve the translational ability of future studies.
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Subchondral Bone Relative Area and Density in Human Osteoarthritic Femoral Heads Assessed with Micro-CT before and after Mechanical Embedding of the Innovative Multi-Spiked Connecting Scaffold for Resurfacing THA Endoprostheses: A Pilot Study. J Clin Med 2021; 10:jcm10132937. [PMID: 34208953 PMCID: PMC8268800 DOI: 10.3390/jcm10132937] [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] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of resurfacing total hip arthroplasty (THRA) endoprostheses in the subchondral trabecular bone. We conducted the computed micro-tomography (micro-CT) assessment of the subchondral trabecular bone microarchitecture before and after the MSC-Scaffold embedding in femoral heads removed during long-stem endoprosthesis total hip arthroplasty (THA) of different bone densities from 4 patients with hip osteoarthritis (OA). The embedding of the MSC-Scaffold in subchondral trabecular bone causes the change in its relative area (BA/TA, bone area/total area ratio) ranged from 18.2% to 24.7% (translating to the calculated density ρB relative change 11.1–14.4%, and the compressive strength S relative change 75.3–122.7%) regardless of its initial density (before the MSC-Scaffold embedding). The densification of the trabecular microarchitecture of subchondral trabecular bone due to the MSC-Scaffold initial embedding gradually decreases with the increasing distance from the apexes of the MSC-Scaffold’s spikes while the spatial extent of this subchondral trabecular bone densification ranged from 1.5 to 2.5 mm (which is about half the height of the MSC-Scaffold’s spikes). It may be suggested, despite the limited number of examined femoral heads, that: (1) the magnitude of the effect of the MSC-Scaffold embedding on subchondral trabecular bone densification may be a factor contributing to the maintenance of the MSC-Scaffold also for decreased initial bone density values, (2) the deeper this effect of the subchondral trabecular bone densification, the better strength of subchondral trabecular bone, and as consequence, the better post-operative embedding of the MSC-Scaffold in the bone should be expected.
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Villaça-Carvalho MFL, de Araújo JCR, Beraldo JM, do Prado RF, de Moraes MEL, Manhães Junior LRC, Codaro EN, Acciari HA, Machado JPB, Regone NN, Lobo AO, Marciano FR, de Vasconcellos LMR. Bioactivity of an Experimental Dental Implant with Anodized Surface. J Funct Biomater 2021; 12:jfb12020039. [PMID: 34200191 PMCID: PMC8293239 DOI: 10.3390/jfb12020039] [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: 03/18/2021] [Revised: 05/20/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Several studies proved that anodic oxidation improves osseointegration. This study aimed to optimize osseointegration through anodization in dental implants, obtaining anatase phase and controlled nanotopography. Methods: The division of the groups with 60 titanium implants was: control (CG); sandblasted (SG); anodized (AG): anodized pulsed current (duty cycle 30%, 30 V, 0.2 A and 1000 Hz). Before surgery, surface characterization was performed using Atomic Force Microscopy (AFM), Scanning Electron Microscopy (SEM), X-ray Dispersive Energy Spectroscopy (EDS) and Raman Spectroscopy. For in vivo tests, 10 New Zealand white rabbits received an implant from each group. The sacrifice period was 2 and 6 weeks (n = 5) and the specimens were subjected to computed microtomography (μCT) and reverse torque test. Results: AFM and SEM demonstrated a particular nanotopography on the surface in AG; the anatase phase was proved by Raman spectroscopy. In the μCT and in the reverse torque test, the AG group presented better results than the other groups. Conclusion: The chemical composition and structure of the TiO2 film were positively affected by the anodizing technique, intensifying the biological characteristics in osseointegration.
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Affiliation(s)
- Maria Fernanda Lima Villaça-Carvalho
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
| | - Juliani Caroline Ribeiro de Araújo
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
| | - Juliana Mariano Beraldo
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
| | - Renata Falchete do Prado
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
- Correspondence: (R.F.d.P.); (L.M.R.d.V.); Tel.: +55-129-8818-1514 (R.F.d.P.); +55-129-9773-3291 (L.M.R.d.V.)
| | - Mari Eli Leonelli de Moraes
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
| | - Luiz Roberto Coutinho Manhães Junior
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
| | - Eduardo Norberto Codaro
- Department of Chemistry and Energy, School of Engineering, Guaratinguetá Campus, UNESP—São Paulo State University, Guaratinguetá, São Paulo 12516-410, Brazil; (E.N.C.); (H.A.A.)
| | - Heloisa Andrea Acciari
- Department of Chemistry and Energy, School of Engineering, Guaratinguetá Campus, UNESP—São Paulo State University, Guaratinguetá, São Paulo 12516-410, Brazil; (E.N.C.); (H.A.A.)
| | - João Paulo Barros Machado
- Associated Laboratory of Sensors and Materials, National Institute for Space Research, INPE, São José dos Campos, São Paulo 12227-010, Brazil;
| | - Natal Nerímio Regone
- Department of Aeronautic and Communication Engineering São João da Boa Vista Campus, UNESP—São Paulo State University, São João da Boa Vista, São Paulo 13876-750, Brazil;
| | - Anderson Oliveira Lobo
- LIMAV—Interdisciplinary Laboratory for Advanced Materials, BioMatLab, UFPI—Federal University of Piaui, Teresina 64049-550, Brazil;
| | | | - Luana Marotta Reis de Vasconcellos
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP—São Paulo State University São José dos Campos, São Paulo 12245-000, Brazil; (M.F.L.V.-C.); (J.C.R.d.A.); (J.M.B.); (M.E.L.d.M.); (L.R.C.M.J.)
- Correspondence: (R.F.d.P.); (L.M.R.d.V.); Tel.: +55-129-8818-1514 (R.F.d.P.); +55-129-9773-3291 (L.M.R.d.V.)
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Mitra I, Bose S, Dernell WS, Dasgupta N, Eckstrand C, Herrick J, Yaszemski MJ, Goodman SB, Bandyopadhyay A. 3D Printing in alloy design to improve biocompatibility in metallic implants. MATERIALS TODAY (KIDLINGTON, ENGLAND) 2021; 45:20-34. [PMID: 34220288 PMCID: PMC8248902 DOI: 10.1016/j.mattod.2020.11.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
3D Printing (3DP) or additive manufacturing (AM) enables parts with complex shapes, design flexibility, and customization opportunities for defect specific patient-matched implants. 3DP or AM also offers a design platform that can be used to innovate novel alloys for application-specific compositional modifications. In medical applications, the biological response from a host tissue depends on a biomaterial's structural and compositional properties in the physiological environment. Application of 3DP can pave the way towards manufacturing innovative metallic implants, combining structural variations at different length scales and tailored compositions designed for specific biological responses. This study shows how 3DP can be used to design metallic alloys for orthopedic and dental applications with improved biocompatibility using in vitro and in vivo studies. Titanium (Ti) and its alloys are used extensively in biomedical devices due to excellent fatigue and corrosion resistance and good strength to weight ratio. However, Ti alloys' in vivo biological response is poor due to its bioinert surface. Different coatings and surface modification techniques are currently being used to improve the biocompatibility of Ti implants. We focused our efforts on improving Ti's biocompatibility via a combination of tantalum (Ta) chemistry in Ti, the addition of designed micro-porosity, and nanoscale surface modification to enhance both in vitro cytocompatibility and early stage in vivo osseointegration, which was studied in rat and rabbit distal femur models.
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Affiliation(s)
- Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
| | - William S. Dernell
- College of Veterinary Medicine, Washington State
University, Pullman, WA 99164, USA
| | - Nairanjana Dasgupta
- Department of Mathematics and Statistics, Washington State
University, Pullman, WA 99164, USA
| | - Chrissy Eckstrand
- College of Veterinary Medicine, Washington State
University, Pullman, WA 99164, USA
| | - Jim Herrick
- Department of Orthopedic Surgery, Mayo Clinic, Rochester,
MN, USA
| | | | - Stuart B. Goodman
- Department of Orthopedic Surgery, Stanford University
Medical Center, Redwood City, CA 94063, USA
| | - Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School
of Mechanical and Materials Engineering, Washington State University, Pullman, WA
99164 2920, USA
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Molinero-Mourelle P, Cascos-Sanchez R, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt-Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study. MATERIALS 2021; 14:ma14092348. [PMID: 33946477 PMCID: PMC8125438 DOI: 10.3390/ma14092348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
The aim of this in vitro study was to investigate the microgaps at the implant-abutment interface when zirconia (Zr) and CAD/CAM or cast Co-Cr abutments were used. METHODS Sixty-four conical connection implants and their abutments were divided into four groups (Co-Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant-abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal-Wallis and pair-wise comparison were used to analyze the data (α = 0.05). RESULTS The SEM analysis revealed smaller microgaps with Co-Cr milled abutments (0.69-8.39 μm) followed by Zr abutments (0.12-6.57 μm), Co-Cr sintered (7.31-25.7 μm) and cast Co-Cr (1.68-85.97 μm). Statistically significant differences were found between milled and cast Co-Cr, milled and laser-sintered Co-Cr, and between Zr and cast and laser-sintered Co-Cr (p < 0.05). CONCLUSIONS The material and the abutment fabrication technique affected the implant-abutment microgap magnitude. The Zr and the milled Co-Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Correspondence: ; Tel.: +34-913941922
| | - Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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Lyu HZ, Lee JH. Correlation between two-dimensional micro-CT and histomorphometry for assessment of the implant osseointegration in rabbit tibia model. Biomater Res 2021; 25:11. [PMID: 33849652 PMCID: PMC8042957 DOI: 10.1186/s40824-021-00213-x] [Citation(s) in RCA: 4] [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: 02/02/2021] [Accepted: 03/24/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Histology is considered as a gold standard for analyzing bone architecture. However, histomorphometry is a destructive method and only offers the bone information of a limited location. Micro-computed tomography (μCT) is a non-destructive technology and provides a slice at any site. The aim of this study was to compare the correlation of the Bone-to-Implant Contact ratio (BIC) between 2D micro-CT (μCT) and histomorphometry and to investigate a method for assessing the osseointegration of the implant by 2D μCT. METHODS A total of 18 implants were divided into three groups (6 implants per group), and inserted into the rabbit tibia defects as follow: implant only (Implant group), implant with β-TCP/hydrogel (TCP group), implant with rhBMP-2 loaded β-TCP/hydrogel composite (BMP-2 group). After 4 weeks of implantation, the specimens were collected to take the micro-CT scan with an aluminum filter and performed H&E staining on the undecalcified sections. The 2D μCT slices were chosen at an angle of 0°, 45°, 90° and 135° with the representative histological section to measure BIC. And the correlations between BICs of 2D μCT and BICs of histology were evaluated. RESULTS In each group, BICs at the same sites measured by histomorphometry and corresponding 2D μCT presented the same trend and shown no significant difference between the two methods (P > 0.05). BICs of histological sections and BICs of corresponding 2D μCT slices presented a strong correlation in the implant group (γ = 0.74, P = 0.09), a moderate correlation in the TCP group (γ = 0.46, P = 0.35), a weak correlation in the BMP-2 group (γ = 0.30, P = 0.56). In the implant group, the relationship between BIC-Mean-μCTs and BICs-Histology has presented a significant linear correlation (γ = 0.84, P = 0.04). CONCLUSIONS Integrating bone information of several 2D μCT slices in different sites to measure BIC is a feasible method for assessing the implant osseointegration.
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Affiliation(s)
- Hao-Zhen Lyu
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Boramae-ro 5-gil 20, Dongjak-gu, Seoul, 07061, South Korea
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Boramae-ro 5-gil 20, Dongjak-gu, Seoul, 07061, South Korea.
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, South Korea.
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, South Korea.
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Avila JD, Stenberg K, Bose S, Bandyopadhyay A. Hydroxyapatite reinforced Ti6Al4V composites for load-bearing implants. Acta Biomater 2021; 123:379-392. [PMID: 33450413 DOI: 10.1016/j.actbio.2020.12.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 01/24/2023]
Abstract
Titanium has been used in various biomedical applications; however, titanium exhibits poor wear resistance, and its bioinert surface slows osseointegration in vivo. In this study, directed energy deposition (DED)-based additive manufacturing (AM) was used to process hydroxyapatite (HA) reinforced Ti6Al4V (Ti64) composites to improve biocompatibility and wear resistance simultaneously. Electron micrographs of the composites revealed dense microstructures where HA was observed at the β-phase grain boundaries. Hardness increased by 57% and 71% for 2 and 3 wt.% HA in Ti64 composites, respectively. XRD analysis revealed no change in the phases with the addition of HA, when compared to the control. Tribological studies displayed an increase in contact resistance (CR) due to an in situ formed HA-based tribofilm, reduction in wear rate when testing in Dulbecco's Modified Eagle Medium (DMEM) with a ZrO2 counter wear ball, <1% wear ball volume loss, and suppression of cohesive shear failure of the Ti matrix. Histomorphometric analysis from a rat distal femur study revealed an increase in the osteoid surface over the bone surface (OS/BS) for 3 wt.% HA composite over the control Ti64 from 9 ± 1% to 14 ± 1%. Additionally, from push-out testing, the shear modulus was observed to increase from 17 ± 3 MPa for control Ti64 to 32 ± 5 MPa for the 3 wt.% HA composite after 5-weeks in vivo. The present study demonstrates that the addition of HA in Ti64 can simultaneously improve bone tissue-implant response and wear resistance.
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Histological and Nanomechanical Properties of a New Nanometric Hydroxiapatite Implant Surface. An In Vivo Study in Diabetic Rats. MATERIALS 2020; 13:ma13245693. [PMID: 33322243 PMCID: PMC7764315 DOI: 10.3390/ma13245693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 01/01/2023]
Abstract
Implant therapy is a predictable treatment to replace missing teeth. However, the osseointegration process may be negatively influenced by systemic conditions, such as diabetes mellitus (DM). Microtopography and implant surface developments are strategies associated to better bone repair. This study aimed to evaluate, in healthy and diabetic rats, histomorphometric (bone to implant contact = %BIC; and bone area fraction occupancy = %BAFO) and nanomechanical (elastic modulus = EM; and hardness = H) bone parameters, in response to a nanometric hydroxyapatite implant surface. Mini implants (machined = MAC; double acid etched = DAE, and with addition of nano-hydroxyapatite = NANO) were installed in tibias of healthy and diabetic rats. The animals were euthanized at 7 and 30 days. NANO surface presented higher %BIC and %BAFO when compared to MAC and DAE (data evaluated as a function of implant surface). NANO surface presented higher %BIC and %BAFO, with statistically significant differences (data as a function of time and implant surface). NANO surface depicted higher EM and H values, when compared to machined and DAE surfaces (data as a function of time and implant surface). Nano-hydroxyapatite coated implants presented promising biomechanical results and could be an important tool to compensate impaired bone healing reported in diabetics.
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Ozcan M, Salimov F, Temmerman A, Ucak Turer O, Alkaya B, Haytac CM. Evaluation of Different Osteotomy Drilling Speed Protocols on Cortical Bone Temperature, Implant Stability and Bone Healing: An Experimental Animal Study. J ORAL IMPLANTOL 2020; 48:3-8. [PMID: 33270867 DOI: 10.1563/aaid-joi-d-20-00228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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 measure the effect of drilling speed on heat generation in the cortical bone, on primary and secondary implant stability of implants and on early and late bone healing with micro-computed tomography (micro-CT). Sixty implants were placed in the iliac crest of six sheep in order to form 5 different drilling protocols: 50rpm without saline cooling, and 400rpm, 800rpm, 1200rpm and 2000rpm with saline cooling. Simultaneous cortical bone temperature and primary stability at the time of placement; secondary stability and the ratio between relative bone and tissue volume (BV/TV) in 2D and 3D in micro-CT analysis were evaluated after 4 and 8 weeks. The 50rpm group had the highest cortical bone temperature and the longest operation duration with the highest primary stability. Slightly higher values of secondary stability (T2) and subsequent 2D and 3D BV/TV values were found in 1200 rpm with irrigation at 8 weeks. All groups had sufficient ISQ values at 8 weeks for loading although the micro-CT analysis showed varying percentages of bone tissue around implants. The influence of drill speed for implant osteotomy and its irrigation is minimal when it comes to changes in temperature of the cortical bone, primary and secondary implant stability and BV/TV.
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Affiliation(s)
- Mustafa Ozcan
- Cukurova Universitesi Dis Hekimligi Fakultesi Assistant Professor Periodontology Balcali TURKEY Adana Adana 01330 Cukurova Universitesi Dis Hekimligi Fakultesi
| | - Fariz Salimov
- Cukurova University, Faculty of Dentistry, Department of Maxillofacial Surgery, Turkey
| | - Andy Temmerman
- KU Leuven University, Faculty of Dentistry, Department of Oral Health Sciences, Belgium
| | - Onur Ucak Turer
- Cukurova University, Faculty of Dentistry, Department of Periodontology, Turkey
| | - Bahar Alkaya
- Cukurova University, Faculty of Dentistry, Department of Periodontology, Turkey
| | - Cenk Mehmet Haytac
- Cukurova University, Faculty of Dentistry, Department of Periodontology, Turkey
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Karakaya M, Demirbaş AE. Effect of low-level laser therapy on osseointegration of titanium dental implants in ovariectomized rabbits: biomechanics and micro-CT analysis. Int J Implant Dent 2020; 6:61. [PMID: 33043397 PMCID: PMC7548265 DOI: 10.1186/s40729-020-00257-z] [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: 01/27/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The primary aim of this study is to assess, in an animal model, whether biostimulation of osteoporotic bone with low-level laser therapy improves the osseointegration of dental implants. MATERIAL AND METHODS Twenty-two female rabbits were randomly divided into two groups: sham-ovariectomy and bilateral-ovariectomy. Laser therapy was applied to the implants placed in the right tibial bones and was not applied to implants placed in the left tibial bones. The periotest device was used for the stability test. Periotest values were recorded after the implantation (T0) and when the animals were euthanized (T1). The removal torque test and micro-computed tomography examination were evaluated. RESULTS As a result of removal torque, the mean of ovariectomy-laser group (56.1 ± 5.1 Ncm) was higher than sham-ovariectomy group (55.4 ± 18.5 Ncm) (p = 0.9). In periotest analysis, a significant difference was found between the values of T1 and T0 in all groups, except sham-ovariectomy group (p < 0.05); and the highest difference was found in the ovariectomy-laser group. Micro-CT examination demonstrated that ovariectomy-laser group showed an increase of implant-bone contact when compared with ovariectomy (p < 0.05). CONCLUSIONS The values obtained from biomechanical tests and micro-CT in the ovariectomy-laser group were significantly higher than the ovariectomy group and achieved the values in the healthy bone.
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Affiliation(s)
- Mustafa Karakaya
- Sancaktepe Oral and Dental Health Hospital, Department of Oral and Maxillofacial Surgery, Ministry of Health, İstanbul, Turkey.
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Erciyes University Faculty of Dentistry, Melikgazi, Kayseri, Turkey
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Soares PBF, Soares CJ, Limirio PHJO, Lara VC, Moura CCG, Zanetta-Barbosa D. Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant. J Appl Oral Sci 2020; 28:e20200191. [PMID: 32997090 PMCID: PMC7521423 DOI: 10.1590/1678-7757-2020-0191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/03/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: This study analyzed the effect of ionizing radiation on bone microarchitecture and biomechanical properties in the bone tissue surrounding a dental implant. Methodology: Twenty rabbits received three dental morse taper junction implants: one in the left tibia and two in the right tibia. The animals were randomized into two groups: the nonirradiated group (control group) and the irradiated group, which received 30 Gy in a single dose 2 weeks after the implant procedure. Four weeks after the implant procedure, the animals were sacrificed, and the implant/bone specimens were used for each experiment. The specimens (n=10) of the right tibia were examined by microcomputed tomography to measure the cortical volume (CtV, mm3), cortical thickness (CtTh, mm) and porosity (CtPo, %). The other specimens (n=10) were examined by dynamic indentation to measure the elastic modulus (E, GPa) and Vickers hardness (VHN, N/mm2) in the bone. The specimens of the left tibia (n=10) were subjected to pull-out tests to calculate the failure load (N), displacement (mm) up to the failure point and interface stiffness (N/mm). In the irradiated group, two measurements were performed: close, at 1 mm surrounding the implant surface, and distant, at 2.5 mm from the external limit of the first measurement. Data were analyzed using one-way ANOVA, Tukey’s test and Student’s t-test (α=0.05). Results: The irradiated bone closer to the implant surface had lower elastic modulus (E), Vickers hardness (VHN), Ct.Th, and Ct.V values and a higher Ct.Po value than the bone distant to the implant (P<0.04). The irradiated bone that was distant from the implant surface had lower E, VHN, and Ct.Th values and a higher Ct.Po value than the nonirradiated bone (P<0.04). The nonirradiated bone had higher failure loads, displacements and stiffness values than the irradiated bone (P<0.02). Conclusion: Ionizing radiation in dental implants resulted in negative effects on the microarchitecture and biomechanical properties of bone tissue, mainly near the surface of the implant.
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Affiliation(s)
| | - Carlos José Soares
- Federal University of Uberlândia, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brasil
| | | | - Vitor Carvalho Lara
- Federal University of Triângulo Mineiro, School of Medicine, Department of Radiology, Uberaba, MG, Brasil
| | | | - Darceny Zanetta-Barbosa
- Federal University of Uberlândia, School of Dentistry, Department of Oral and Maxillofacial Surgery, Uberlândia, MG, Brasil
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21
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Assessment of irradiated socket healing in the rabbit's mandible: Experimental study. Res Vet Sci 2020; 133:226-231. [PMID: 33032109 DOI: 10.1016/j.rvsc.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/24/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022]
Abstract
As bone healing is altered after external radiation therapy, its evaluation is mandatory and lacks in clinical practice. The aim of the pilot study was to validate micro computed tomography (microCT) as a simple and reliable technique for assessing irradiated bone healing in the rabbit's mandible and compare with histologic findings. Nineteen rabbits (female New Zealand white) were used. The radiation protocol consisted of 5 sessions delivering 8.5 Gy each. MicroCT was performed at D0, D7, D14, D28 and D42 for the control group and D0, D28 and D42 for the irradiated group. A modified Perry's score was determined on histologic samples, and comparison between microCT and histological findings was performed. The main differences between irradiated and non-irradiated rabbits were observed at Day 28 and 42. There was a strong correlation between imaging and histologic findings. Radiation decreases bone quality and bone mineral density. As the correlation was strong between microCT and histologic findings, micro imaging could be considered as a simple and reliable technique to assess bone healing after radiation therapy and allows an easy comparison between samples, without invasive procedures. Great attention should be kept on the parameters and on the region of interest. The development of in-vivo microCT enlarges the perspectives of microCT use in experimental studies, avoiding invasive procedures, and preserving animal lives and well-being, and furthermore lead to clinical applications.
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22
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Karimipour-Fard P, Naeem I, Mohany A, Pop-Iliev R, Rizvi G. Enhancing the accuracy and efficiency of characterizing polymeric cellular structures using 3D-based computed tomography. J CELL PLAST 2020. [DOI: 10.1177/0021955x20948556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Characterizing the morphology of polymeric foams is crucial for determining their practical applicability. The internal cellular structure of polymeric foams is typically analyzed by 2 D imaging techniques, such as Scanning Electron Microscopy (SEM) and optical microscopy. The problem with these techniques is that their tests are tedious, destructive, and the accuracy of the obtained results is questionable. The objective of this paper is to establish and experimentally verify an efficient 3- dimensional (3 D) Microcomputed-tomography based methodology for reliably estimating and characterizing each of the phases commonly present in multiple types of polymeric foam samples, such as the open, the closed, and the solid phase. A comparative study was carried out between morphology data obtained from 2-dimensional (2 D) analysis and those obtained from 3 D analysis to investigate the reliability of the 2 D analysis results. In this context, the experimental results revealed that by using a 2 D method the open porosity was underestimated at the expense of closed porosity, which in turn was overestimated, while the total porosity was not impacted. Also, visualization of the internal structure of polymer foams by using Micro-CT provides details about the 3 D space which cannot be obtained from SEM images. The analysis of foamed specimen demonstrated that the polymeric foam phases extracted from Micro-CT images were in agreement with the experimentally measured values of total porosity of the samples. In an effort to reduce computational requirements, the effects of reducing data size on the accuracy of results has also been studied by averaging image pixels in 3 D space and the results were compared for multiple types of foam structures. This method reduced the processing time considerably, and yielded comparable porosity values. However, the number of detected pores were lowered due to the inability of this method to detect very small cells after 3 D averaging of image pixels.
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Affiliation(s)
- Pedram Karimipour-Fard
- Faculty of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Ibrahim Naeem
- Faculty of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Atef Mohany
- Faculty of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Remon Pop-Iliev
- Faculty of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Ghaus Rizvi
- Faculty of Engineering and Applied Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
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23
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Le Cann S, Tudisco E, Tägil M, Hall SA, Isaksson H. Bone Damage Evolution Around Integrated Metal Screws Using X-Ray Tomography - in situ Pullout and Digital Volume Correlation. Front Bioeng Biotechnol 2020; 8:934. [PMID: 32850760 PMCID: PMC7419699 DOI: 10.3389/fbioe.2020.00934] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/20/2020] [Indexed: 12/22/2022] Open
Abstract
Better understanding of the local deformation of the bone network around metallic implants subjected to loading is of importance to assess the mechanical resistance of the bone-implant interface and limit implant failure. In this study, four titanium screws were osseointegrated into rat tibiae for 4 weeks and screw pullout was conducted in situ under x-ray microtomography, recording macroscopic mechanical behavior and full tomographies at multiple load steps before failure. Images were analyzed using Digital Volume Correlation (DVC) to access internal displacement and deformation fields during loading. A repeatable failure pattern was observed, where a ∼300–500 μm-thick envelope of bone detached from the trabecular structure. Fracture initiated close to the screw tip and propagated along the implant surface, at a distance of around 500 μm. Thus, the fracture pattern appeared to be influenced by the microstructure of the bone formed closely around the threads, which confirmed that the model is relevant for evaluating the effect of pharmacological treatments affecting local bone formation. Moreover, cracks at the tibial plateau were identified by DVC analysis of the tomographic images acquired during loading. Moderate strains were first distributed in the trabecular bone, which localized into higher strains regions with subsequent loading, revealing crack-formation not evident in the tomographic images. The in situ loading methodology followed by DVC is shown to be a powerful tool to study internal deformation and fracture behavior of the newly formed bone close to an implant when subjected to loading. A better understanding of the interface failure may help improve the outcome of surgical implants.
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Affiliation(s)
- Sophie Le Cann
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Erika Tudisco
- Division of Geotechnical Engineering, Lund University, Lund, Sweden
| | - Magnus Tägil
- Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
| | - Stephen A Hall
- Division of Solid Mechanics, Lund University, Lund, Sweden.,Lund Institute for Advanced Neutron and X-ray Science, Lund, Sweden
| | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, Lund, Sweden.,Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden
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24
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de Oliveira PGFP, de Melo Soares MS, Silveira E Souza AMM, Taba M, Palioto DB, Messora MR, Ghiraldini B, Nunes FADS, de Souza SLS. Influence of nano-hydroxyapatite coating implants on gene expression of osteogenic markers and micro-CT parameters. An in vivo study in diabetic rats. J Biomed Mater Res A 2020; 109:682-694. [PMID: 32608088 DOI: 10.1002/jbm.a.37052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 06/08/2020] [Accepted: 06/12/2020] [Indexed: 12/13/2022]
Abstract
This study evaluated the response of a nano-hydroxyapatite coating implant through gene expression analysis (runt-related transcription factor 2 (Runx2), alkaline phosphatase (Alp), osteopontin (Opn), osteocalcin (Oc), receptor activator of nuclear factor-kappa B (Rank), receptor activator of nuclear factor-kappa B ligand (Rank-L), and osteoprotegerin (Opg)). Three-dimensional evaluation (percent bone volume (BV/TV); percent intersection surface (BIC); bone surface/volume ratio (BS/BV); and total porosity (To.Po)) were also analyzed. Mini implants were surgically placed in tibias of both healthy and diabetic rats. The animals were euthanized at 7 and 30 days. Evaluating all factors the relative expression of Rank showed that NANO surface presented the best results at 7 days (diabetic rats). Furthermore the levels of Runx2, Alp, Oc, and Opn suggest an increase in osteoblasts proliferation, especially in early stages of osseointegration. %BIC in healthy and diabetic (7 days) depicted statistically significant differences for NANO group. BV/TV, BS/BV and To.Po demonstrated higher values for NANO group in all evaluated time point and irrespective of systemic condition, but BS/BV 30 days (healthy rat) and 7 and 30 days (diabetic rat). Microtomographic and gene expression analyses have shown the benefits of nano-hydroxyapatite coated implants in promoting new bone formation in diabetic rats.
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Affiliation(s)
| | - Mariana Sales de Melo Soares
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Mário Taba
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniela Bazan Palioto
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Michel Reis Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bruna Ghiraldini
- Paulista University, School of Dentistry, São Paulo, São Paulo, Brazil
| | - Felipe Anderson de Sousa Nunes
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio Luís Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, FORP/USP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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25
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An In Vivo Study in Rat Femurs of Bioactive Silicate Coatings on Titanium Dental Implants. J Clin Med 2020; 9:jcm9051290. [PMID: 32365687 PMCID: PMC7288333 DOI: 10.3390/jcm9051290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/10/2020] [Accepted: 04/26/2020] [Indexed: 12/16/2022] Open
Abstract
Silica-based ceramics have been proposed for coating purposes to enhance dental and orthopedic titanium (Ti) implant bioactivity. The aim of this study was to investigate the influence of sphene-based bioceramic (CaO.TiO2.SiO2) coatings on implant osseointegration in vivo. Sphene coatings were obtained from preceramic polymers and nano-sized active precursors and deposited by an automatic airbrush. Twenty customized Ti implants, ten sphene-coated and ten uncoated rough implants were implanted into the proximal femurs of ten Sprague-Dawley rats. Overall, cortical and cancellous bone-to-implant contact (BIC) were determined using micro-computed tomography (micro-CT) at 14 and 28 days. Moreover, peri-implant bone healing was histologically and histomorphometrically evaluated. The white blood cell count in the synovial fluid of the knee joints, if present, was also assessed. No difference in the BIC values was observed between the sphene-coated and uncoated implants, overall and in the two bone compartments (p > 0.05). Delamination of the coating occurred in three cases. Consistently with micro-CT data, the histological evaluation revealed no differences between the two groups. In addition, no synovial fluid could be collected on the test side, thus confirming sphene biocompatibility. In conclusion, sphene coating was found to be a suitable material for biomedical applications. Further studies are needed to improve coating adhesion to the implants.
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Nakahara K, Haga-Tsujimura M, Igarashi K, Kobayashi E, Schaller B, Lang NP, Saulacic N. Single-staged implant placement using the bone ring technique with and without membrane placement: Micro-CT analysis in a preclinical in vivo study. Clin Oral Implants Res 2019; 31:29-36. [PMID: 31541500 DOI: 10.1111/clr.13543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the impact of collagen membrane application on bone formation surrounding implants placed simultaneously with the bone ring technique. MATERIAL AND METHODS Dental implants were inserted simultaneously with the bone ring technique in standardized, vertical alveolar bony defects in the mandible of dogs. On one side of the mandible, the augmented sites were covered with a collagen membrane (M-Group). On the contralateral side, no membranes were used (NM-Group). Implants were left to heal with osseointegration for three and six months. The harvested samples were analyzed by means of micro-CT. RESULTS A nonparametric analysis of data revealed that the membranes were not a significant negative factor for bone volume (BV), but for bone-to-implant contact (BIC, p = .04). Absence of healing caps impaired BV (p = .04) and BIC (p = .02) as well. Furthermore, loss of healing caps and exposure to the oral environment significantly and negatively affected BV (p < .001) and bone mineral density (p < .05) within 2 mm below the implant shoulder. Implant exposure and healing time had a negative interaction effect on both BV (p = .01) and BIC (p = .01). CONCLUSIONS Within its limitations, the present study revealed no benefit of membrane application to implant placement simultaneous with the bone ring technique. Disruption of soft tissue healing was identified as a risk factor for decrease in BV and BIC.
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Affiliation(s)
- Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry, Niigata, Japan
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry, Niigata, Japan
| | - Kensuke Igarashi
- Department of Life Science Dentistry, The Nippon Dental University, Niigata, Japan
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry, Niigata, Japan
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
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27
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Huang Y, Li Z, Van Dessel J, Salmon B, Huang B, Lambrichts I, Politis C, Jacobs R. Effect of platelet-rich plasma on peri-implant trabecular bone volume and architecture: A preclinical micro-CT study in beagle dogs. Clin Oral Implants Res 2019; 30:1190-1199. [PMID: 31506979 DOI: 10.1111/clr.13532] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 05/26/2019] [Accepted: 08/21/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To evaluate the peri-implant trabecular bone volume and architecture changes with 6-month follow-up after local application of platelet-rich plasma (PRP) and platelet-poor plasma (PPP) using high-resolution micro-CT. MATERIAL AND METHODS Seventy-two dental implants were placed into healed mandibular sites of 9 beagle dogs. Implants were randomly divided into 4 groups following a split-mouth design: control I; control II; PPP; and PRP. Primary and secondary stabilities were assessed using resonance frequency analyses. At 1, 3, and 6 months after implant loading, trabecular structural parameters were evaluated at 0.5, 1, and 1.5 mm away from implants using micro-CT (voxel = 20 μm). RESULTS Primary and secondary stabilities were equivalent in all conditions. PPP and PRP groups showed higher bone volume fraction (BV/TV) and trabecular thickness (Tb.Th) but lower trabecular separation (Tb.Sp) and total porosity percentage (Po (tot)) at all 3 time points. A significant decrease in BV/TV and Tb.Th was found for the control groups after 3 months of healing, while this was not observed in both the PPP and PRP groups. However, no distinct difference was found between the PRP and PPP groups over time. Moreover, as the investigated distance from the implant surface increased, BV/TV and Po (tot) within the same group and time point stayed the same, yet Tb.Th and Tb.Sp continued to increase. CONCLUSIONS Platelet-rich plasma and PPP with conventional implant placement lead to similar primary and secondary implant stability, but improved peri-implant bone volume and structural integration. The present research does not seem to suggest a different bone remodeling pattern when using PRP or PPP.
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Affiliation(s)
- Yan Huang
- West China College of Stomatology, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.,Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Zhaokai Li
- Department of Geriatric Medicine & National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jeroen Van Dessel
- Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Benjamin Salmon
- Paris Descartes University - Sorbonne Paris Cité, EA 2496 - Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris, France
| | - Bo Huang
- Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Ivo Lambrichts
- Group of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Constantinus Politis
- Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging & Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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28
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Bandyopadhyay A, Shivaram A, Mitra I, Bose S. Electrically polarized TiO 2 nanotubes on Ti implants to enhance early-stage osseointegration. Acta Biomater 2019; 96:686-693. [PMID: 31326668 PMCID: PMC6717678 DOI: 10.1016/j.actbio.2019.07.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/18/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
Ti is characteristically bioinert and is supplemented with modifications in surface topography and chemistry to find use in biomedical applications. The aim of this study is to understand the effects of surface charge on TiO2 nanotubes (TNT) on Ti implants towards early stage osseointegration. We hypothesize that charge storage on TNT will improve bioactivity and enhance early-stage osseointegration in vivo. Commercially pure Ti surface was altered by growing TNT via anodic oxidation followed by the introduction of surface charge through electrothermal polarization to form bioelectret. Our results indicate a stored charge of 37.15 ± 14 mC/cm2 for TNT surfaces. The polarized TNT (TNT-Ps) samples did not show any charge leakage up to 18 months, and improved wettability with a measured contact angle less than 1°. No cellular toxicity through osteoblast proliferation and differentiation in vitro were shown by the TNT-Ps. Enhanced new bone formation at 5 weeks post-implantation for the TNT-Ps in contrast to TNTs was observed in vivo. Histomorphometric analyses show ∼40% increase in mineralized bone formation around the TNT-P implants than the TNTs at 5 weeks, which is indicative of accelerated bone remodeling cycle. These results show that stored surface charge on TiO2 nanotubes helped to accelerate bone healing due to early-stage osseointegration in vivo. STATEMENT OF SIGNIFICANCE: To improve surface bioactivity of metallic biomaterials, various approaches have been proposed and implemented. Among them, stored surface charge has been explored to enhance biological responses for hydroxyapatite ceramics where charged surfaces show favorable bone tissue ingrowth. However, surface charge effects have not yet been explored as a way to mitigate bio-inertness of titanium. This study intends to understand novel integration of bioactive titania-nanotubes and charge storage as surface modification for titanium implants. Our results show excellent biological response due to surface charge on titania-nanotubes offering possibilities of faster healing particularly for patients with compromised bone health.
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Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA.
| | - Anish Shivaram
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
| | - Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA 99164-2920, USA
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29
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Bandyopadhyay A, Mitra I, Shivaram A, Dasgupta N, Bose S. Direct comparison of additively manufactured porous titanium and tantalum implants towards in vivo osseointegration. ADDITIVE MANUFACTURING 2019; 28:259-266. [PMID: 31406683 PMCID: PMC6690615 DOI: 10.1016/j.addma.2019.04.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Material properties of implants such as volume porosity and nanoscale surface modification have been shown to enhance cell-material interactions in vitro and osseointegration in vivo. Porous tantalum (Ta) and titanium (Ti) coatings are widely used for non-cemented implants, which are fabricated using different processing routes. In recent years, some of those implants are being manufactured using additive manufacturing. However, limited knowledge is available on direct comparison of additively manufactured porous Ta and Ti structures towards early stage osseointegration. In this study, we have fabricated porous Ta and Ti6Al4V (Ti64) implants using laser engineered net shaping (LENS™) with similar volume fraction porosity to compare the influence of surface characteristics and material chemistry on in vivo response using a rat distal femur model for 5 and 12 weeks. We have also assessed whether surface modification on Ti64 can elicit similar in vivo response as porous Ta in a rat distal femur model for 5 and 12 weeks. The harvested implants were histologically analyzed for osteoid surface per bone surface. Field emission scanning electron microscopy (FESEM) was done to assess the bone-implant interface. The results presented here indicate comparable performance of porous Ta and surface modified porous Ti64 implants towards early stage osseointegration at 5 weeks post implantation through seamless bone-material interlocking. However, a continued and extended efficacy of porous Ta is found in terms of higher osteoid formation at 12 weeks post-surgery.
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Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Indranath Mitra
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Anish Shivaram
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
| | - Nairanjana Dasgupta
- Department of Mathematics and Statistics, Washington State University, Pullman, WA, 99164, USA
| | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, Pullman, WA, 99164, USA
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30
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Bandyopadhyay A, Shivaram A, Isik M, Avila JD, Dernell WS, Bose S. Additively manufactured calcium phosphate reinforced CoCrMo alloy: Bio-tribological and biocompatibility evaluation for load-bearing implants. ADDITIVE MANUFACTURING 2019; 28:312-324. [PMID: 31341790 PMCID: PMC6656377 DOI: 10.1016/j.addma.2019.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Cobalt-chromium-molybdenum (CoCrMo) alloys are widely used in load-bearing implants; specifically, in hip, knee, and spinal applications due to their excellent wear resistance. However, due to in vivo corrosion and mechanically assisted corrosion, metal ion release occurs and accounts for poor biocompatibility. Therefore, a significant interest to find an alternative to CoCrMo alloy exists. In the present work we hypothesize that calcium phosphate (CaP) will behave as a solid lubricant in CoCrMo alloy under tribological testing, thereby minimizing wear and metal ion release concerns associated with CoCrMo alloy. CoCrMo-CaP composite coatings were processed using laser engineered net shaping (LENS™) system. After LENS™ processing, CoCrMo alloy was subjected to laser surface melting (LSM) using the same LENS™ set-up. Samples were investigated for microstructural features, phase identification, and biocompatibility. It was found that LSM treated CoCrMo improved wear resistance by 5 times. CoCrMo-CaP composites displayed the formation of a phosphorus-based tribofilm. In vitro cell-material interactions study showed no cytotoxic effect. Sprague-Dawley rat and rabbit in vivo study displayed increased osteoid formation for CoCrMo-CaP composites, up to 2 wt.% CaP. Our results show that careful surface modification treatments can simultaneously improve wear resistance and in vivo biocompatibility of CoCrMo alloy, which can correlate to a reduction of metal ion release in vivo.
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Affiliation(s)
- Amit Bandyopadhyay
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering
| | - Anish Shivaram
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering
| | - Murat Isik
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering
| | - Jose D. Avila
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering
| | | | - Susmita Bose
- W. M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering
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Yi Y, Men Y, Jing D, Luo W, Zhang S, Feng JQ, Liu J, Ge W, Wang J, Zhao H. 3-dimensional visualization of implant-tissue interface with the polyethylene glycol associated solvent system tissue clearing method. Cell Prolif 2019; 52:e12578. [PMID: 30714253 PMCID: PMC6536405 DOI: 10.1111/cpr.12578] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/14/2018] [Accepted: 12/28/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Dental implants are major treatment options for restoring teeth loss. Biological processes at the implant-tissue interface are critical for implant osseointegration. Superior mechanical properties of the implant constitute a major challenge for traditional histological techniques. It is imperative to develop new technique to investigate the implant-tissue interface. MATERIALS AND METHODS Our laboratory developed the polyethylene glycol (PEG)-associated solvent system (PEGASOS) tissue clearing method. By immersing samples into various chemical substances, bones and teeth could be turned to transparent with intact internal structures and endogenous fluorescence being preserved. We combined the PEGASOS tissue clearing method with transgenic mouse line and other labelling technique to investigate the angiogenesis and osteogenesis processes occurring at the implant-bone interface. RESULTS Clearing treatment turned tissue highly transparent and implant could be directly visualized without sectioning. Implant, soft/hard tissues and fluorescent labels were simultaneously imaged in decalcified or non-decalcified mouse mandible samples without disturbing their interfaces. Multi-channel 3-dimensional image stacks at high resolution were acquired and quantified. The processes of angiogenesis and osteogenesis surrounding titanium or stainless steel implants were investigated. CONCLUSIONS Both titanium and stainless steel implants support angiogenesis at comparable levels. Successful osseointegration and calcium precipitation occurred only surrounding titanium, but not stainless steel implants. PEGASOS tissue clearing method provides a novel approach for investigating the interface between implants and hard tissue.
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Affiliation(s)
- Yating Yi
- State Key Laboratory of Oral Diseases, West China School of StomatologySichuan UniversityChengduChina
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Yi Men
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Dian Jing
- State Key Laboratory of Oral Diseases, West China School of StomatologySichuan UniversityChengduChina
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Wenjing Luo
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Shiwen Zhang
- State Key Laboratory of Oral Diseases, West China School of StomatologySichuan UniversityChengduChina
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Jian Q. Feng
- Department of Biomedical Sciences, College of DentistryTexas A&M UniversityDallasTexas
| | - Jin Liu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China HospitalSichuan UniversityChengduChina
| | - Woo‐Ping Ge
- Children’s Research InstituteUniversity of Texas Southwestern Medical CentreDallasTexas
| | - Jun Wang
- State Key Laboratory of Oral Diseases, West China School of StomatologySichuan UniversityChengduChina
| | - Hu Zhao
- Department of Restorative Sciences, College of DentistryTexas A&M UniversityDallasTexas
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Bohner L, Habor D, Gremse F, Tortamano P, Wolfart S, Marotti J. Accuracy of High-Frequency Ultrasound Scanner in Detecting Peri-implant Bone Defects. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:650-659. [PMID: 30593434 DOI: 10.1016/j.ultrasmedbio.2018.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to assess the accuracy of high-frequency ultrasound (US) in the measurement of peri-implant bone defects in comparison with cone-beam computed tomography (CBCT) and micro-computed tomography (µCT). Bone defects were mechanically created around dental implants inserted into porcine ribs (n = 10). The bone samples were scanned by CBCT, µCT and US. Linear dimensions of the peri-implant defects were determined for supra-alveolar component, intra-bony component and width. The accuracy of measurements was evaluated with repeated-measures analysis of variance and the intra-class correlation coefficient at p ≤ 0.05. US underestimated the measurements for the supra-alveolar and intra-bony components in comparison to CBCT and µCT, and there were no statistically significant differences in the measurements of width. The intra-class correlation coefficient of US ranged from 0.96 to 0.98, whereas that for CBCT ranged from 0.77 to 0.97. US was accurate in measuring the width of peri-implant defects, although vertical measurements were underestimated by approximately 1 mm in comparison to those of CBCT and µCT.
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Affiliation(s)
- Lauren Bohner
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Aachen, Germany; Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Daniel Habor
- Chair of Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Felix Gremse
- Department of Experimental Molecular Imaging, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Pedro Tortamano
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Aachen, Germany
| | - Juliana Marotti
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Aachen, Germany.
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Section Plane Effects on Morphometric Values of Microcomputed Tomography. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7905404. [PMID: 30792997 PMCID: PMC6354147 DOI: 10.1155/2019/7905404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/07/2018] [Accepted: 12/31/2018] [Indexed: 11/18/2022]
Abstract
Objectives Histomorphometry is the established gold standard for inspection of trabecular microstructures in biomaterial research. However, microcomputed tomography can provide images from the perspective of various section planes. The aim of the present study was to evaluate the effects of different section planes, which may cause bias in two-dimensional morphometry, on the morphometric values of microcomputed tomography. Methods A socket preservation technique was performed on the extracted premolar area of 4 beagle dogs. After an 8-week healing period, a total of 16 specimens were obtained and analyzed with conventional histomorphometry and microtomographic morphometry. Using the original images of the histologic specimens for comparison, the most similar tomographic image was selected by trial and error. Then, the section plane was then moved with ±79 μm parallel offsets and rotated ±10° around the center from the occlusal view. The images were compared in terms of bone, graft, and noncalcified area, and the concordance correlation coefficient (CCC) was calculated. Results There was a high CCC in the comparison between histomorphometric images and the most similar microtomographic images. However, the CCC value was low in the comparisons with both parallel movement and rotation. Our results demonstrate that the sectioning plane has a significant effect on measurements. Conclusion Two-dimensional morphometric values for biomaterial research should be interpreted with caution, and the simultaneous use of complementary 3-dimensional tools is recommended.
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Choi JY, Park JI, Chae JS, Yeo ISL. Comparison of micro-computed tomography and histomorphometry in the measurement of bone-implant contact ratios. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:87-95. [PMID: 30692058 DOI: 10.1016/j.oooo.2018.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/07/2018] [Accepted: 12/21/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to measure the 3-dimensional (3D) bone-to-implant contact (BIC) ratios calculated with an associated software algorithm on 3D micro-computed tomography (μCT) scans and compare them with measurements made with 2-dimensional histomorphometry. STUDY DESIGN For uncomplicated calculation of the 3D BIC ratios, 16 implants (8 grade 2 titanium and 8 grade 4 titanium) with simple cylindrical geometry were inserted into 8 rabbit tibiae; 2 implants were inserted into each tibia. The experimental animals were sacrificed at 2 weeks after surgery. The implants were surgically removed en bloc with surrounding bone. 3D μCT images were acquired and reconstructed, and histomorphometric procedures were performed. The calculated 3D BIC ratios were compared with the histomorphometrically measured BIC ratios. RESULTS When the 3D BIC ratios calculated in this study were compared with the BIC ratios measured conventionally by using histologic slides for light microscopy, no significant statistical correlation was found between the 2 ratios (P ≥ .35). CONCLUSIONS This study indicated that 3D μCT should be used for more accurate BIC assessment to produce an overall 3D picture for the bone-implant interface.
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Affiliation(s)
- Jung-Yoo Choi
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jae-Il Park
- Senior Researcher, Animal Facility of Aging Science, Korea Basic Science Institute, Gwangju, Korea
| | - Ji Soo Chae
- Life Sciences, PerkinElmer Korea, Guro-gu, Seoul, Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
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Choi JYC, Choi CA, Yeo ISL. Spiral scanning imaging and quantitative calculation of the 3-dimensional screw-shaped bone-implant interface on micro-computed tomography. J Periodontal Implant Sci 2018; 48:202-212. [PMID: 30202604 PMCID: PMC6125666 DOI: 10.5051/jpis.2018.48.4.202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/01/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose Bone-to-implant contact (BIC) is difficult to measure on micro-computed tomography (CT) because of artifacts that hinder accurate differentiation of the bone and implant. This study presents an advanced algorithm for measuring BIC in micro-CT acquisitions using a spiral scanning technique, with improved differentiation of bone and implant materials. Methods Five sandblasted, large-grit, acid-etched implants were used. Three implants were subjected to surface analysis, and 2 were inserted into a New Zealand white rabbit, with each tibia receiving 1 implant. The rabbit was sacrificed after 28 days. The en bloc specimens were subjected to spiral (SkyScan 1275, Bruker) and round (SkyScan 1172, SkyScan 1275) micro-CT scanning to evaluate differences in the images resulting from the different scanning techniques. The partial volume effect (PVE) was optimized as much as possible. BIC was measured with both round and spiral scanning on the SkyScan 1275, and the results were compared. Results Compared with the round micro-CT scanning, the spiral scanning showed much clearer images. In addition, the PVE was optimized, which allowed accurate BIC measurements to be made. Round scanning on the SkyScan 1275 resulted in higher BIC measurements than spiral scanning on the same machine; however, the higher measurements on round scanning were confirmed to be false, and were found to be the result of artifacts in the void, rather than bone. Conclusions The results of this study indicate that spiral scanning can reduce metal artifacts, thereby allowing clear differentiation of bone and implant. Moreover, the PVE, which is a factor that inevitably hinders accurate BIC measurements, was optimized through an advanced algorithm.
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Affiliation(s)
| | | | - In-Sung Luke Yeo
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Korea
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Igarashi K, Nakahara K, Kobayashi E, Watanabe F, Haga-Tsujimura M. Hard and soft tissue responses to implant made of three different materials with microgrooved collar in a dog model. Dent Mater J 2018; 37:964-972. [PMID: 29998938 DOI: 10.4012/dmj.2017-197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of the present study was to assess hard and soft tissue around dental implants made of three different materials with microgrooves on the collar surface. Microgrooved implants were inserted in the mandibles of five male beagles. Implants were made of three kinds of material; titanium (Ti), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) and ceria partially stabilized zirconia/alumina nanocomposite (Ce-TZP/Al2O3). The animals were euthanatized at three months after implantation, and harvested tissue was analyzed by means of histology. All kinds of implant were osseointegrated, and there were no significant differences in any histomorphometric parameters among the three groups of microgrooved implants made of different materials. Within the limitations of this study, implants with microgrooves integrated into the surrounding bone tissue, without statistically significant differences among the three tested materials, Ti, Y-TZP, and Ce-TZP/Al2O3.
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Affiliation(s)
- Kensuke Igarashi
- Department of Life Science Dentistry, The Nippon Dental University
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Fumihiko Watanabe
- Department of Crown and Bridge Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata
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Meagher MJ, Parwani RN, Virdi AS, Sumner DR. Optimizing a micro-computed tomography-based surrogate measurement of bone-implant contact. J Orthop Res 2018; 36:979-986. [PMID: 28851105 PMCID: PMC5832531 DOI: 10.1002/jor.23716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/19/2017] [Indexed: 02/04/2023]
Abstract
Histology and backscatter scanning electron microscopy (bSEM) are the current gold standard methods for quantifying bone-implant contact (BIC), but are inherently destructive. Microcomputed tomography (μCT) is a non-destructive alternative, but attempts to validate μCT-based assessment of BIC in animal models have produced conflicting results. We previously showed in a rat model using a 1.5 mm diameter titanium implant that the extent of the metal-induced artefact precluded accurate measurement of bone sufficiently close to the interface to assess BIC. Recently introduced commercial laboratory μCT scanners have smaller voxels and improved imaging capabilities, possibly overcoming this limitation. The goals of the present study were to establish an approach for optimizing μCT imaging parameters and to validate μCT-based assessment of BIC. In an empirical parametric study using a 1.5 mm diameter titanium implant, we determined 90 kVp, 88 µA, 1.5 μm isotropic voxel size, 1600 projections/180°, and 750 ms integration time to be optimal. Using specimens from an in vivo rat experiment, we found significant correlations between bSEM and μCT for BIC with the manufacturer's automated analysis routine (r = 0.716, p = 0.003) or a line-intercept method (r = 0.797, p = 0.010). Thus, this newer generation scanner's improved imaging capability reduced the extent of the metal-induced artefact zone enough to permit assessment of BIC. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:979-986, 2018.
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Affiliation(s)
- Matthew J. Meagher
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Rachna N. Parwani
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612,Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607,College of Engineering, University of Portsmouth, Portsmouth, UK P01 3DJ
| | - Amarjit S. Virdi
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612
| | - D. Rick Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL 60612
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A comparison of micro-CT and histomorphometry for evaluation of osseointegration of PEO-coated titanium implants in a rat model. Sci Rep 2017; 7:16270. [PMID: 29176604 PMCID: PMC5701240 DOI: 10.1038/s41598-017-16465-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/13/2017] [Indexed: 11/16/2022] Open
Abstract
The aim of the present study was to determine the correlation between bone volume density (BV/TV) around a titanium implant determined by micro-computed tomography (micro-CT) and bone area density (BA/TA) measurements obtained using histomorphometry. An intramedullary rat femur implant model was evaluated to compare raw titanium implants with plasma electrolytic oxidation (PEO)-coated titanium implants. Titanium and PEO-treated titanium pins were inserted into rat femurs under general anesthesia. The animals were sacrificed and femurs harvested at 0, 2, 4 and 6 weeks, and subsequently, histomorphometry and micro-CT were performed. BV/TV and BA/TA values were strongly and positively correlated at all time points and locations (with all correlation coefficients being >0.8 and with P < 0.001). BV/TV and BA/TA were significantly higher proximal to the growth plate than distal to the growth plate, with estimated differences of 14.10% (P < 0.001) and 11.95% (P < 0.001), respectively. BV/TV and BA/TA were significantly higher on the PEO-coated surface than on the raw titanium surface, with estimated differences of 3.20% (P = 0.044) and 4.10% (P = 0.018), respectively. Therefore, quantitative micro-CT analysis of BV/TV is correlated with BA/TA determined by histomorphometry when artifacts around titanium implants are minimized by a region of interest modification.
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Martins R, Cestari TM, Arantes RVN, Santos PS, Taga R, Carbonari MJ, Oliveira RC. Osseointegration of zirconia and titanium implants in a rabbit tibiae model evaluated by microtomography, histomorphometry and fluorochrome labeling analyses. J Periodontal Res 2017; 53:210-221. [PMID: 29044523 DOI: 10.1111/jre.12508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study compares the osseointegration of machined-zirconia implants containing yttria (M-Y-TZP) with machined (M-Ti) and resorbable blast media (RBM-Ti) titanium implants. MATERIAL AND METHODS M-Y-TZP, M-Ti and RBM-Ti implants were randomly placed in rabbit tibiae. Fluorochrome bone labels (tetracycline, alizarin and calcein) were administered at different time periods. After 8 weeks, osseointegration was evaluated in terms of bone-to-implant contact (BIC), new bone area (nBA), remaining cortical bone area (rBA) and temporal quantification of fluorochromes, using micro-CT and histomorphometric analyses. RESULTS RBM-Ti implants showed higher resorption of the remaining cortical bone and bone formation (rBA = 36.9% and nBA = 38.8%) than M-Y-TZP implants (rBA = 48% and nBA = 26.5%). The BIC values showed no differences among the groups in the cortical region (mean = 52.2%) but in the medullary region, they were 0.45-fold higher in the RBM-Ti group (51.2%) than in the M-Y-TZP group (35.2%). In all groups, high incorporation of tetracycline was observed (2nd to 4th weeks), followed by alizarin (4th to 6th weeks) and calcein (6th to 8th weeks). In the cortical region, incorporation of tetracycline was similar between RBM-Ti (49.8%) and M-Y-TZP (35.9%) implants, but higher than M-Ti (28.2%) implants. Subsequently, alizarin and calcein were 1.1-fold higher in RBM-Ti implants than in the other implants. In the medullary region, no significant differences were observed for all fluorochromes. CONCLUSION All implants favored bone formation and consequently promoted primary stability. Bone formation around the threads was faster in RBM-Ti and M-Y-TZP implants than in M-Ti implants, but limited bone remodeling with M-Y-TZP implants over time can have significant effects on secondary stability, suggesting caution for its use as an alternative substitute for titanium implants.
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Affiliation(s)
- R Martins
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - T M Cestari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - R V N Arantes
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - P S Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - R Taga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - M J Carbonari
- Insper - Instituto de Ensino e Pesquisa, São Paulo, SP, Brazil
| | - R C Oliveira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Shanbhag S, Pandis N, Mustafa K, Nyengaard JR, Stavropoulos A. Alveolar bone tissue engineering in critical-size defects of experimental animal models: a systematic review and meta-analysis. J Tissue Eng Regen Med 2017; 11:2935-2949. [PMID: 27524517 DOI: 10.1002/term.2198] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/07/2016] [Accepted: 03/14/2016] [Indexed: 01/17/2023]
Abstract
Regeneration of large, 'critical-size' bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as a promising alternative to autogenous, allogeneic and biomaterial-based bone grafting. The objective of this systematic review was to answer the focused question: in animal models, do cell-based BTE strategies enhance regeneration in alveolar bone critical-size defects (CSDs), compared with grafting with only biomaterial scaffolds or autogenous bone? Following PRISMA guidelines, electronic databases were searched for controlled animal studies reporting maxillary or mandibular CSD and implantation of mesenchymal stem cells (MSCs) or osteoblasts (OBs) seeded on biomaterial scaffolds. A random effects meta-analysis was performed for the outcome histomorphometric new bone formation (%NBF). Thirty-six studies were included that reported on large- (monkeys, dogs, sheep, minipigs) and small-animal (rabbits, rats) models. On average, studies presented with an unclear-to-high risk of bias and short observation times. In most studies, MSCs or OBs were used in combination with alloplastic mineral-phase scaffolds. In five studies, cells were modified by ex vivo gene transfer of bone morphogenetic proteins (BMPs). The meta-analysis indicated statistically significant benefits in favour of: (1) cell-loaded vs. cell-free scaffolds [weighted mean difference (WMD) 15.59-49.15% and 8.60-13.85% NBF in large- and small-animal models, respectively]; and (2) BMP-gene-modified vs. unmodified cells (WMD 10.06-20.83% NBF in small-animal models). Results of cell-loaded scaffolds vs. autogenous bone were inconclusive. Overall, heterogeneity in the meta-analysis was high (I2 > 90%). In summary, alveolar bone regeneration is enhanced by addition of osteogenic cells to biomaterial scaffolds. The direction and estimates of treatment effect are useful to predict therapeutic efficacy and guide future clinical trials of BTE. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Bergen, Norway
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Bissinger O, Götz C, Jeschke A, Haller B, Wolff KD, Kaiser P, Kolk A. Comparison of contact radiographed and stained histological sections for osseointegration analysis of dental implants: an in vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:20-26. [PMID: 29079369 DOI: 10.1016/j.oooo.2017.06.118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/15/2017] [Accepted: 06/19/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Histology is still regarded as the gold-standard to determine bone implant contact (BIC) as a parameter representing implant stability. As the further processing of cut slices for contact radiography (CR) to stained and polished histological sections is time consuming and error prone, our aim was to assess agreement between CR and Giemsa-eosin (GE) stained sections with regard to dental implants. STUDY DESIGN Threaded dental titanium implants (n = 54) from the maxillae of Goettingen minipigs were evaluated. After 28 and 56 days, BIC and the ratio of bone volume to total volume (BV/TV; 1000 μm) were determined on the same sections by using CR and GE staining, and the results were compared. RESULTS Moderate differences for BIC (0.6%; P = .53) and BV/TV (1.3%; P = .01) between the methods were determined, in which CR overestimated BIC and BV/TV. A strong correlation was seen between the modalities concerning BIC (28 days: r = 0.84; 56 days: r = 0.85; total: r = 0.85) and BV/TV (r = 0.96; r = 0.94; r = 0.96; all: P < .0001). CONCLUSIONS CR enabled determination of the bone-to-implant interface in comparison with GE-stained sections. BIC and BV/TV were slightly overestimated but correlated strongly between the methods. Therefore, if BIC and BV/TV are sufficient endpoints, CR is adequate and no further preparation and staining are necessary.
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Affiliation(s)
- Oliver Bissinger
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
| | - Carolin Götz
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Anke Jeschke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernhard Haller
- Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Pascal Kaiser
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
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Shanbhag S, Pandis N, Mustafa K, Nyengaard JR, Stavropoulos A. Bone tissue engineering in oral peri-implant defects in preclinical in vivo research: A systematic review and meta-analysis. J Tissue Eng Regen Med 2017; 12:e336-e349. [PMID: 28095650 DOI: 10.1002/term.2412] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/23/2016] [Accepted: 01/13/2017] [Indexed: 12/12/2022]
Abstract
The regeneration and establishment of osseointegration within oral peri-implant bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as a promising alternative to autogenous and/or biomaterial-based bone grafting. The objective of this systematic review was to answer the focused question: in animal models, do cell-based BTE strategies enhance bone regeneration and/or implant osseointegration in experimental peri-implant defects, compared with grafting with autogenous bone or only biomaterial scaffolds? Electronic databases were searched for controlled animal studies reporting on peri-implant defects and implantation of mesenchymal stem cells (MSC) or other cells seeded on biomaterial scaffolds, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Random effects meta-analyses were performed for the outcomes histomorphometric bone area fraction (BA) and bone-to-implant contact (BIC). Nineteen studies reporting on large animal models (dogs and sheep) were included. Experimental defects were created surgically (16 studies) or via ligature-induced peri-implantitis (LIPI, three studies). In general, studies presented with an unclear to high risk of bias. In most studies, MSC were used in combination with alloplastic mineral phase or polymer scaffolds; no study directly compared cell-loaded scaffolds vs. autogenous bone. In three studies, cells were also modified by ex vivo gene transfer of osteoinductive factors. The meta-analyses indicated statistically significant benefits in favour of: (a) cell-loaded vs. cell-free scaffolds [weighted mean differences (WMD) of 10.73-12.30% BA and 11.77-15.15% BIC] in canine surgical defect and LIPI models; and (b) gene-modified vs. unmodified cells (WMD of 29.44% BA and 16.50% BIC) in canine LIPI models. Overall, heterogeneity in the meta-analyses was high (I2 70-88%); considerable variation was observed among studies regarding the nature of cells and scaffolds used. In summary, bone regeneration and osseointegration in peri-implant defects are enhanced by the addition of osteogenic cells to biomaterial scaffolds. Although the direction of treatment outcome is clearly in favour of BTE strategies, due to the limited magnitude of treatment effect observed, no conclusive statements regarding the clinical benefit of such procedures for oral indications can yet be made. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Siddharth Shanbhag
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Norway.,Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Kamal Mustafa
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andreas Stavropoulos
- Department of Clinical Dentistry, Centre for Clinical Dental Research, University of Bergen, Norway
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Kuo TF, Lu HC, Tseng CF, Yang JC, Wang SF, Yang TCK, Lee SY. Evaluation of Osseointegration in Titanium and Zirconia-Based Dental Implants with Surface Modification in a Miniature Pig Model. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0230-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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44
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Bissinger O, Probst FA, Wolff KD, Jeschke A, Weitz J, Deppe H, Kolk A. Comparative 3D micro-CT and 2D histomorphometry analysis of dental implant osseointegration in the maxilla of minipigs. J Clin Periodontol 2017; 44:418-427. [DOI: 10.1111/jcpe.12693] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Oliver Bissinger
- Department of Oral and Maxillofacial Surgery; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
| | - Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery; Ludwig-Maximilians-University of Munich; Munich Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
| | - Anke Jeschke
- Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Jochen Weitz
- Department of Oral and Maxillofacial Surgery; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
| | - Herbert Deppe
- Department of Oral and Maxillofacial Surgery; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
- Institute of Molecular Immunology - Experimental Oncology; Klinikum rechts der Isar der Technischen Universität München; Munich Germany
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45
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A technique for evaluating bone ingrowth into 3D printed, porous Ti6Al4V implants accurately using X-ray micro-computed tomography and histomorphometry. Micron 2016; 94:1-8. [PMID: 27960108 DOI: 10.1016/j.micron.2016.11.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 01/10/2023]
Abstract
This paper investigates the application of X-ray micro-computed tomography (micro-CT) to accurately evaluate bone formation within 3D printed, porous Ti6Al4V implants manufactured using Electron Beam Melting (EBM), retrieved after six months of healing in sheep femur and tibia. All samples were scanned twice (i.e., before and after resin embedding), using fast, low-resolution scans (Skyscan 1172; Bruker micro-CT, Kontich, Belgium), and were analysed by 2D and 3D morphometry. The main questions posed were: (i) Can low resolution, fast scans provide morphometric data of bone formed inside (and around) metal implants with a complex, open-pore architecture?, (ii) Can micro-CT be used to accurately quantify both the bone area (BA) and bone-implant contact (BIC)?, (iii) What degree of error is introduced in the quantitative data by varying the threshold values?, and (iv) Does resin embedding influence the accuracy of the analysis? To validate the accuracy of micro-CT measurements, each data set was correlated with a corresponding centrally cut histological section. The results show that quantitative histomorphometry corresponds strongly with 3D measurements made by micro-CT, where a high correlation exists between the two techniques for bone area/volume measurements around and inside the porous network. On the contrary, the direct bone-implant contact is challenging to estimate accurately or reproducibly. Large errors may be introduced in micro-CT measurements when segmentation is performed without calibrating the data set against a corresponding histological section. Generally, the bone area measurement is strongly influenced by the lower threshold limit, while the upper threshold limit has little or no effect. Resin embedding does not compromise the accuracy of micro-CT measurements, although there is a change in the contrast distributions and optimisation of the threshold ranges is required.
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46
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Sun SP, Lee DW, Yun JH, Park KH, Park KB, Moon IS. Effects of Thread Depth in the Neck Area on Peri-Implant Hard and Soft Tissues: An Animal Study. J Periodontol 2016; 87:1360-1368. [DOI: 10.1902/jop.2016.150738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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47
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Evaluating the osseointegration of nanostructured titanium implants in animal models: Current experimental methods and perspectives (Review). Biointerphases 2016; 11:030801. [PMID: 27421518 DOI: 10.1116/1.4958793] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to review the experimental methods currently being used to evaluate the osseointegration of nanostructured titanium implants using animal models. The material modifications are linked to the biocompatibility of various types of oral implants, such as laser-treated, acid-etched, plasma-coated, and sand-blasted surface modifications. The types of implants are reviewed according to their implantation site (endoosseous, subperiosteal, and transosseous implants). The animal species and target bones used in experimental implantology are carefully compared in terms of the ratio of compact to spongy bone. The surgical technique in animal experiments is briefly described, and all phases of the histological evaluation of osseointegration are described in detail, including harvesting tissue samples, processing undemineralized ground sections, and qualitative and quantitative histological assessment of the bone-implant interface. The results of histological staining methods used in implantology are illustrated and compared. A standardized and reproducible technique for stereological quantification of bone-implant contact is proposed and demonstrated. In conclusion, histological evaluation of the experimental osseointegration of dental implants requires careful selection of the experimental animals, bones, and implantation sites. It is also advisable to use larger animal models and older animals with a slower growth rate rather than small or growing experimental animals. Bones with a similar ratio of compact to spongy bone, such as the human maxilla and mandible, are preferred. A number of practical recommendations for the experimental procedures, harvesting of samples, tissue processing, and quantitative histological evaluations are provided.
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48
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Feng SW, Ho KN, Chan YH, Chang KJ, Lai WY, Huang HM. Damping Factor as a Diagnostic Parameter for Assessment of Osseointegration during the Dental Implant Healing Process: An Experimental Study in Rabbits. Ann Biomed Eng 2016; 44:3668-3678. [DOI: 10.1007/s10439-016-1675-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 06/07/2016] [Indexed: 11/30/2022]
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49
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Hyzy SL, Cheng A, Cohen DJ, Yatzkaier G, Whitehead AJ, Clohessy RM, Gittens RA, Boyan BD, Schwartz Z. Novel hydrophilic nanostructured microtexture on direct metal laser sintered Ti-6Al-4V surfaces enhances osteoblast response in vitro and osseointegration in a rabbit model. J Biomed Mater Res A 2016; 104:2086-98. [PMID: 27086616 DOI: 10.1002/jbm.a.35739] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/21/2016] [Accepted: 03/31/2016] [Indexed: 01/16/2023]
Abstract
The purpose of this study was to compare the biological effects in vivo of hierarchical surface roughness on laser sintered titanium-aluminum-vanadium (Ti-6Al-4V) implants to those of conventionally machined implants on osteoblast response in vitro and osseointegration. Laser sintered disks were fabricated to have micro-/nano-roughness and wettability. Control disks were computer numerical control (CNC) milled and then polished to be smooth (CNC-M). Laser sintered disks were polished smooth (LST-M), grit blasted (LST-B), or blasted and acid etched (LST-BE). LST-BE implants or implants manufactured by CNC milling and grit blasted (CNC-B) were implanted in the femurs of male New Zealand white rabbits. Most osteoblast differentiation markers and local factors were enhanced on rough LST-B and LST-BE surfaces in comparison to smooth CNC-M or LST-M surfaces for MG63 and normal human osteoblast cells. To determine if LST-BE implants were osteogenic in vivo, we compared them to implant surfaces used clinically. LST-BE implants had a unique surface with combined micro-/nano-roughness and higher wettability than conventional CNC-B implants. Histomorphometric analysis demonstrated a significant improvement in cortical bone-implant contact of LST-BE implants compared to CNC-B implants after 3 and 6 weeks. However, mechanical testing revealed no differences between implant pullout forces at those time points. LST surfaces enhanced osteoblast differentiation and production of local factors in vitro and improved the osseointegration process in vivo. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2086-2098, 2016.
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Affiliation(s)
- Sharon L Hyzy
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Alice Cheng
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia.,Department of Biomedical Engineering, Peking University, Beijing, China
| | - David J Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | | | - Alexander J Whitehead
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Ryan M Clohessy
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Rolando A Gittens
- Center for Biodiversity and Drug Discovery, Institute for Advanced Scientific Research and High Technology Services (INDICASAT AIP), Panama City, Panama
| | - Barbara D Boyan
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia.,Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia.,University of Texas Health Science Center at San Antonio, San Antonio, Texas
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50
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de Faria Vasconcelos K, dos Santos Corpas L, da Silveira BM, Laperre K, Padovan LE, Jacobs R, de Freitas PHL, Lambrichts I, Bóscolo FN. MicroCT assessment of bone microarchitecture in implant sites reconstructed with autogenous and xenogenous grafts: a pilot study. Clin Oral Implants Res 2016; 28:308-313. [DOI: 10.1111/clr.12799] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Karla de Faria Vasconcelos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Lívia dos Santos Corpas
- Department of Prosthetic Dentistry, Oral Health Sciences, Faculty of Medicine; Katholieke Universiteit Leuven; Leuven Belgium
| | | | | | - Luis Eduardo Padovan
- Department of Implant Dentistry; Latin American Institute for Dental Research and Training (ILAPEO); Curitiba Brazil
| | - Reinhilde Jacobs
- OMFS Impath Research Group, Department of Imaging & Pathology, Faculty of Medicine; University of Leuven; Leuven Belgium
- Department of Maxillofacial Surgery; Leuven University Hospital; Leuven Belgium
| | | | - Ivo Lambrichts
- Biomedical Research Institute, Laboratory of Morphology; Hasselt University; Diepenbeek Belgium
| | - Frab Norberto Bóscolo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
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