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Scarano A, Khater AGA, Gehrke SA, Inchingolo F, Tari SR. Animal Models for Investigating Osseointegration: An Overview of Implant Research over the Last Three Decades. J Funct Biomater 2024; 15:83. [PMID: 38667540 PMCID: PMC11051165 DOI: 10.3390/jfb15040083] [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: 02/24/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Dental implants and bone augmentation are among dentistry's most prevalent surgical treatments; hence, many dental implant surfaces and bone grafts have been researched to improve bone response. Such new materials were radiologically, histologically, and histomorphometrically evaluated on animals before being used on humans. As a result, several studies used animals to evaluate novel implant technologies, biocompatibility, surgical techniques, and osseointegration strategies, as preclinical research on animal models is essential to evaluate bioactive principles (on cells, compounds, and implants) that can act through multiple mechanisms and to predict animal behavior, which is difficult to predict from in vitro studies alone. In this study, we critically reviewed all research on different animal models investigating the osseointegration degree of new implant surfaces, reporting different species used in the osseointegration research over the last 30 years. Moreover, this is the first study to summarize reviews on the main animal models used in the translational research of osseointegration, including the advantages and limitations of each model and determining the ideal location for investigating osseointegration in small and large animal models. Overall, each model has advantages and disadvantages; hence, animal selection should be based on the cost of acquisition, animal care, acceptability to society, availability, tolerance to captivity, and housing convenience. Among small animal models, rabbits are an ideal model for biological observations around implants, and it is worth noting that osseointegration was discovered in the rabbit model and successfully applied to humans.
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Affiliation(s)
- Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
| | - Ahmad G. A. Khater
- Faculty of Oral and Dental Medicine, Egyptian Russian University (ERU), Badr City 11829, Egypt;
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif 62511, Egypt
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Sergio Rexhep Tari
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
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Musskopf ML, Finger Stadler A, Wikesjö UME, Susin C. The minipig intraoral dental implant model: A systematic review and meta-analysis. PLoS One 2022; 17:e0264475. [PMID: 35226690 PMCID: PMC8884544 DOI: 10.1371/journal.pone.0264475] [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: 11/22/2021] [Accepted: 02/10/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal bone remodeling. METHODS A systematic review including PubMed and EMBASE databases through June 2021 was conducted. Two independent examiners screened titles/abstracts and selected full-text articles. Studies evaluating titanium dental implant osseointegration in native alveolar bone were included. A quality assessment of reporting was performed. Random-effects meta-analyses and meta-regressions were produced for bone-implant contact (BIC), first BIC, and crestal bone level. RESULTS 125 out of 249 full-text articles were reviewed, 55 original studies were included. Quality of reporting was generally low, omissions included animal characteristics, examiner masking/calibration, and sample size calculation. The typical minipig model protocol included surgical extraction of the mandibular premolars and first molar, 12±4 wks post-extraction healing, placement of three narrow regular length dental implants per jaw quadrant, submerged implant healing and 8 wks of osseointegration. Approximately 90% of studies reported undecalcified incandescent light microscopy histometrics. Overall, mean BIC was 59.88% (95%CI: 57.43-62.33). BIC increased significantly over time (p<0.001): 40.93 (95%CI: 34.95-46.90) at 2 wks, 58.37% (95%CI: 54.38-62.36) at 4 wks, and 66.33% (95%CI: 63.45-69.21) beyond 4 wks. Variability among studies was mainly explained by differences in observation interval post-extraction and post-implant placement, and implant surface. Heterogeneity was high for all studies (I2 > 90%, p<0.001). CONCLUSIONS The minipig intraoral dental implant model appears to effectively demonstrate osseointegration and alveolar bone remodeling similar to that observed in humans and canine models.
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Affiliation(s)
- Marta Liliana Musskopf
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Amanda Finger Stadler
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Ulf ME Wikesjö
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Cristiano Susin
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Yue G, Edani H, Sullivan A, Jiang S, Kazerani H, Saghiri MA. Is maxillary diastema an appropriate site for implantation in rats? Int J Implant Dent 2020; 6:8. [PMID: 32100121 PMCID: PMC7042428 DOI: 10.1186/s40729-019-0203-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/24/2019] [Indexed: 01/04/2023] Open
Abstract
Background Implantology or implant dentistry is growing fast during last four decades. Facing the growing demand of implant treatment, there are extreme challenges to clinicians and researchers. First is peri-implantitis with remarkable prevalence. Though investigators have revealed that the etiology of the peri-implant infection is similar to periodontitis, clinically there is no effective treatment. Second, implantation in patients with severe systemic conditions, i.e., severe diabetes, lupus, osteoporosis, organ transplant, and cancer with intensive radiotherapy and/or chemotherapy, is another challenge to implant treatment for lack of scientific research data. Animal models are crucial to help investigators reveal the mechanisms underlying these disorders. Murine models are used most commonly. Rats are the better subject in dental implant research, due to mice could not provide clinical compatible and macro-level measurable data for implant osseointegration and peri-implantitis in oral cavity for lacking enough cancellous bone to support an implant more than 1 mm in length. Objective Our aim of this research is to find a clinical comparable rat dental implant model. Methods Six male Sprague-Dawley rats with body weight more than 500 g were used in the experiment. Each rat received two implants. One implant was placed at maxillary diastema in each side. Seven weeks after the implantation, only one implant successfully osseointegrated without movement and inflammation. Implant success and failure rate is analyzed by using Clopper-Pearson’s exact method at 95% confidence interval. Results The present data indicate that the true success rate of implantation in maxillary natural diastema in rat is less than 38.4% at a confident level of 95%. Meanwhile, Micro-CT indicates maxillary first molar position will be a promising site for implantation. Conclusion Maxillary nature diastema may not be an appropriate site for implantation research for its low successful rate, but maxillary first molar position could be a candidate for implantation research. Further researches are required to illustrate the details.
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Affiliation(s)
- Gang Yue
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Husham Edani
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Andrew Sullivan
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Shuying Jiang
- The Office of Institutional Assessment, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Hamed Kazerani
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, 07103, USA
| | - Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, 07103, USA. .,Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Silva RDO, Passador F, Caria PHF. Twist removal of healed vs. nonhealed implants-a mechanical and histological study in mini pigs. Int J Implant Dent 2016; 2:23. [PMID: 27888491 PMCID: PMC5124023 DOI: 10.1186/s40729-016-0059-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/18/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The objective of this study was to evaluate the effect of removal torque (reverse torque) of titanium implants in peri-implant bone. METHODS The P1-M1 teeth were extracted bilaterally of 6 mini pigs (BR-1). Each animal received 6 titanium implants, three for each side of mandible. On the right side of mandible, 3 implants reminded 9 months (9M) under masticatory activity and on the left side, other 3 implants were placed and immediately removed (IR). All 36 implants were removed by removal torque, and the recorded values were statistically analyzed. Animals were euthanized right after the removal torque and recording. Each third (cervical, medium, and apical) of peri-implant bone was extracted and analyzed histological and immunohistochemically. Student's t test was used to determine statistical differences in the values between the 9M and IR samples. Data were presented as means with standard deviations. The level of significance was set at 5% (P < 0.05). RESULTS Removal torque was higher in 9M experimental situation than in IR. Histological characteristics of mature bone were presented in the 9M experimental condition, and immature bone characteristics were presented in the IR experimental condition. Removal torque caused small fractures and rounding in the bone grooving. Immunohistochemical analysis reinforced the histological results; Student's t test provided statistically significant differences to osteocalcin expression in 9M samples and no statistically significant differences expression to collagen I in both experimental conditions (P < 0.05). CONCLUSIONS Removal torque caused microscopical fractures and smoothing in the peri-implant bone grooves, but it does not compromise the bone healing.
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Stokholm R, Isidor F, Nyengaard JR. Histologic and histomorphometric evaluation of peri-implant bone of immediate or delayed occlusal-loaded non-splinted implants in the posterior mandible--an experimental study in monkeys. Clin Oral Implants Res 2013; 25:1311-1318. [PMID: 24118392 DOI: 10.1111/clr.12274] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The primary aim of this study was to compare the bone reaction around immediate-loaded non-splinted single implants vs. delayed loaded non-splinted single implants placed in healed ridges in the posterior mandible. MATERIALS AND METHODS Six adult Macaca Fascicularis monkeys were used in this study. The first and second premolars and the first molar were extracted in both sides of the mandible. After 3 months of healing, four implants (Replace Select Tapered; Nobel Biocare, Gothenburg, Sweden) with a moderately rough surface (TiUnite, Nobel Biocare) were placed in the edentulous areas of each monkey, two in each side. The implants had a length of 10 mm and a diameter of 3.5 mm. Four groups of varying time and occlusal loading aspects were created: (i) control group: implant placed non-loaded for 3 months; (ii) immediate loaded: implant placed and loaded immediately for 3 months; (iii) immediate loaded: implant placed and loaded immediately for 6 months; and (iv) delayed loaded: implant placed submerged for 3 months and then loaded for 3 months. At the loaded implants, after a second stage surgery, a composite crown was made directly on an abutment mounted on the implant reinsuring simultaneous occlusal contact on the implant crown and the neighboring teeth. After euthanization of the animals, histologic specimens were quantified in the light microscope. RESULTS All implants were clinically, radiographically, and histologically osseointegrated at the time of euthanization and with only mild signs of inflammation in the peri-implant mucosa. The histologic marginal bone level was located on average 1.14-1.74 mm apical to the margin of the implants in the various groups. The average bone-to-implant contact (BIC) varied between 55% and 65% and the average bone density (i.e., the proportion of mineralized bone tissue from the implant surface and to a distance of 1 mm lateral to the implant) varied between 30.6% and 34.2%. No statistical significant differences between groups were observed in the above-stated histomorphometric parameters. CONCLUSIONS Similar histologic and histomorphometric findings were observed in immediately and delayed loaded non-splinted implants placed in the posterior mandible of macaque monkeys.
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Affiliation(s)
- Rie Stokholm
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Centre for Stochastic Geometry and Advanced Bioimaging, Aarhus University, Aarhus, Denmark
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Mehl C, Becker ST, Acil Y, Harder S, Wiltfang J, Dabbagh-Afrouz AA, de Buhr W, Kern M. Impact of vertical loading on the implant-bone interface. Clin Oral Implants Res 2012; 24:949-56. [PMID: 22524429 DOI: 10.1111/j.1600-0501.2012.02487.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The main aim of this study was to evaluate the impact of vertical loading occurring during removal of cemented restorations on the implant-bone interface. METHODS Thirty-six titanium implants (Camlog 4.3 × 9 mm) were placed 1 mm supraosseous in the frontal skull of four minipigs. After a 13 week healing period the implants were exposed and the implant stability was measured. Three implants per minipig were vertically loaded using 20 or 100 impulses, respectively with an 18 Ns impulse imitating a crown removal. Three implants were left unloaded as control. The animals were sacrificed after 13 or 18 weeks. The harvested specimens were analyzed using scanning electron microscopy (SEM), light and fluorescence microscopy. RESULTS No post operative complications or deaths of the minipigs occurred. All implants osseointegrated. The average bone-implant contact area (BIC) was 78 ± 5.1%. No statistically significant difference could be found when comparing the BIC areas of the control and the experimental groups between the sacrificed animals at 13 weeks and 18 weeks (P > 0.05). Therefore, the results of each subgroup were pooled. No significant differences regarding the BIC area could be detected between the control and the experimental groups (P > 0.05). Except one failing implant no cracks due to vertical loading could be evaluated in the SEM. Fluorescence microscopy revealed a significantly higher bone remodeling activity in the vertically loaded groups. CONCLUSIONS Removal of cemented implant restorations seems not to have an impact on the mechanical implant stability, but seems to increase bone remodeling activity.
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Affiliation(s)
- Christian Mehl
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Kiel, Germany.
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Zambon R, Mardas N, Horvath A, Petrie A, Dard M, Donos N. The effect of loading in regenerated bone in dehiscence defects following a combined approach of bone grafting and GBR. Clin Oral Implants Res 2011; 23:591-601. [PMID: 22092957 DOI: 10.1111/j.1600-0501.2011.02279.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate by histology the effect of loading on the regenerated bone at dehiscence type defects around implants when treated with a combined approach of bone grafting and guided bone regeneration (GBR). MATERIALS AND METHODS In twelve Göttingen mini-pigs, the lower premolars and first molars were extracted and the alveolar process was reduced in width. After 3 months, two Straumann SLActive (Straumann AG, Basel, Switzerland) implants were placed in each hemi-mandible. Twelve implants were placed into the reduced alveolar ridge (group P) with no further defect or treatment on the site, while on 36 implants, buccal dehiscence defects were created and treated as follows: Group T1: synthetic bone substitute (Straumann Bone Ceramic, SBC, Straumann AG). Group T2: SBC with a polyethylene glycol membrane (Straumann MembraGel, Straumann AG); Group N: the dehiscence remained untreated. Three months following implantation, long, custom-made, healing abutments were placed in one hemi-mandible only to ensure functional loading. After 2 months, histological analysis was performed. RESULTS A trend for lower residual defect height and higher bone-to-implant contact was observed in the loaded sites compared with non-loaded sites in groups P, T1 and N. In group T2, the opposite effect was observed. In terms of bone formation, sites treated with SBC grafting and GBR (group T2) exhibited the largest surface area of regenerated bone followed by T1 and N. Significant resorption of the graft particles was noted in group T2 and the graft surface area occupied by SBC was significantly higher in group T1 compared with group T2 (P < 0.05). CONCLUSIONS Loading may have a positive effect on bone-to-implant contact in implants inserted in pristine bone or inserted in dehiscence sites and treated by grafting/no grafting.
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Affiliation(s)
- Riccardo Zambon
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
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