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Muresan GC, Boca S, Lucaciu O, Hedesiu M. The Applicability of Nanostructured Materials in Regenerating Soft and Bone Tissue in the Oral Cavity-A Review. Biomimetics (Basel) 2024; 9:348. [PMID: 38921228 PMCID: PMC11201588 DOI: 10.3390/biomimetics9060348] [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: 04/28/2024] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Two of the most exciting new technologies are biotechnology and nanotechnology. The science of nanostructures, or nanotechnology, is concerned with the development, testing, and use of structures and molecules with nanoscale dimensions ranging from 1 to 100 nm. The development of materials and tools with high specificity that interact directly at the subcellular level is what makes nanotechnology valuable in the medical sciences. At the cellular or tissue level, this might be converted into focused clinical applications with the greatest possible therapeutic benefits and the fewest possible side effects. The purpose of the present study was to review the literature and explore the applicability of the nanostructured materials in the process of the regeneration of the soft and hard tissues of the oral cavity. MATERIALS AND METHODS An electronic search of articles was conducted in several databases, such as PubMed, Embase, and Web of Science, to conduct this study, and the 183 articles that were discovered were chosen and examined, and only 22 articles met the inclusion criteria in this review. RESULTS The findings of this study demonstrate that using nanoparticles can improve the mechanical properties, biocompatibility, and osteoinductivity of biomaterials. CONCLUSIONS Most recently, breakthroughs in tissue engineering and nanotechnology have led to significant advancements in the design and production of bone graft substitutes and hold tremendous promise for the treatment of bone abnormalities. The creation of intelligent nanostructured materials is essential for various applications and therapies, as it allows for the precise and long-term delivery of medication, which yields better results.
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Affiliation(s)
- Giorgiana Corina Muresan
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Sanda Boca
- Interdisciplinary Research Institute in Bio-Nano-Sciences, Babes-Bolyai University, 400271 Cluj-Napoca, Romania;
| | - Ondine Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Mihaela Hedesiu
- Department of Oral Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
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Bergamo ETP, de Oliveira PGFP, Campos TMB, Bonfante EA, Tovar N, Boczar D, Nayak VV, Coelho PG, Witek L. Osseointegration of implant surfaces in metabolic syndrome and type-2 diabetes mellitus. J Biomed Mater Res B Appl Biomater 2024; 112:e35382. [PMID: 38355936 PMCID: PMC10883641 DOI: 10.1002/jbm.b.35382] [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: 06/06/2022] [Revised: 11/20/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
This in vivo study evaluated the bone healing response around endosteal implants with varying surface topography/chemistry in a preclinical, large transitional model induced with metabolic syndrome (MS) and type-2 diabetes mellitus (T2DM). Fifteen Göttingen minipigs were randomly distributed into two groups: (i) control (normal diet, n = 5) and (ii) O/MS (cafeteria diet for obesity induction, n = 10). Following obesity induction, five minipigs from the obese/metabolic syndrome (O/MS) group were further allocated, randomly, into the third experimental group: (iii) T2DM (cafeteria diet + streptozotocin). Implants with different surface topography/chemistry: (i) dual acid-etched (DAE) and (ii) nano-hydroxyapatite coating over the DAE surface (NANO), were placed into the right ilium of the subjects and allowed to heal for 4 weeks. Histomorphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO) within implant threads were performed using histomicrographs. Implants with NANO surface presented significantly higher %BIC (~26%) and %BAFO (~35%) relative to implants with DAE surface (%BIC = ~14% and %BAFO = ~28%, p < .025). Data as a function of systemic condition presented significantly higher %BIC (~28%) and %BAFO (~42%) in the control group compared with the metabolically compromised groups (O/MS: %BIC = 14.35% and %BAFO = 26.24%, p < .021; T2DM: %BIC = 17.91% and %BAFO = 26.12%, p < .021) with no significant difference between O/MS and T2DM (p > .05). Statistical evaluation considering both factors demonstrated significantly higher %BIC and %BAFO for the NANO surface relative to DAE implant, independent of systemic condition (p < .05). The gain increase of %BIC and %BAFO for the NANO compared with DAE was more pronounced in O/MS and T2DM subjects. Osseointegration parameters were significantly reduced in metabolically compromised subjects compared with healthy subjects. Nanostructured hydroxyapatite-coated surfaces improved osseointegration relative to DAE, regardless of systemic condition.
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Affiliation(s)
- Edmara T P Bergamo
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paula G F P de Oliveira
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- CESUPA, Department of Periodontology, University Center of State of Para, Belem, Para, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Physics, Technological Institute of Aeronautics, São José dos Campos, São Paulo, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nick Tovar
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue, Hospital Center, New York, New York, USA
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York, USA
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Skiba THI, Kalil EC, Piattelli A, Shibli JA. Human Histological Analysis of Early Bone Response to Immediately Loaded Narrow Dental Implants with Biphasic Calcium Phosphate ® Grid-Blasted Surface Treatment: A Case Report. Dent J (Basel) 2023; 11:177. [PMID: 37504243 PMCID: PMC10377936 DOI: 10.3390/dj11070177] [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: 04/23/2023] [Revised: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
Implant surface topography using bioactive material provides faster bone-to-implant healing. This histological report described the analysis of human bone tissue around an immediately loaded implant, with BPC® (Biphasic Calcium Phosphate) grit-blasted surface treatment, after two months of healing. Two temporary mini-implants (2.8 × 10 mm) with BPC® grit-blasting surfaces were placed and immediately loaded to retain a complete interim denture. After a 60-day healing period, one mini-implant was removed for histologic analysis. The ground section showed the whole implant surrounded by healthy peri-implant tissues. Implant surface presented a close contact with newly formed bone, showing some areas of osteoblasts secreting mineral matrix. The ground section depicted a bone contact of 60.3 + 8.5%. The BPC® grit-blasted surface was biocompatible and enabled the osseointegration process after a short-term period.
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Affiliation(s)
| | - Eduardo C Kalil
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
| | - Adriano Piattelli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Via di Sant'Alessandro 8, 00131 Rome, Italy
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
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Gershov S, Xie J, Shah FA, Shemtov-Yona K, Rittel D. Modelling the resonant frequency associated with the spatio-temporal evolution of the bone-dental implant interface. Acta Biomater 2022; 154:302-311. [PMID: 36306984 DOI: 10.1016/j.actbio.2022.10.042] [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: 08/18/2022] [Revised: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023]
Abstract
Dental implant stability is greatly affected by the mechanical properties of the bone-implant interface (BII), and it is key to long-term successful osseointegration. Implant stability is often evaluated using the Resonant Frequency Analysis (RFA) method, and also by the quality of this interface, namely the bone-implant contact (BIC). True to this day, there is a scarcity of models tying BIC, RFA and a spatially and mechanically evolving BII. In this paper, based on the contact/distance osteogenesis concept, a novel numerical spatio-temporal model of the implant, surrounding bone and evolving interface, was developed to assess the evolution of the interfacial stresses on the one hand and the corresponding resonant frequencies on the other. We postulate that, since the BIC percentage reaches saturation over a very short time, long before densification of the interface, it becomes irrelevant as to load transmission between the implant and the bone due to the existence of an open gap. Gap closure is the factor that provides continuity between the implant and the surrounding bone. The results of the calculated RFA evolution match and provide an explanation for the multiple clinical observations of a sharp initial decline in RFA, followed by a gradual increase and plateau formation. STATEMENT OF SIGNIFICANCE: A novel three-dimensional numerical model of an evolving bone-dental implant interface (BII) is presented. The spatio-temporal evolution of the bone-implant contact (BIC) and the BII, based on contact/distance (CO/DO) osteogenesis, is modeled. A central outcome is that, until BII maturation into a solid continuous bone (no open gap between CO-DO fronts), the bone-implant load transfer is hampered, irrespective of the BIC. The resonant frequencies' evolution of the jawbone-BII-implant is calculated to reproduce the well-established implant stability analysis based on the Resonant Frequency Analysis. The results resemble those reported clinically, and here too, the determinant transition occurs only after interfacial gap closure. Those results should motivate clinicians to re-consider structural continuity of the BII rather than the BIC only.
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Affiliation(s)
- Sapir Gershov
- Technion Autonomous Systems Program, Technion - Israel Institute of Technology, Haifa 32000, Israel.
| | - Jing Xie
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Furqan A Shah
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Keren Shemtov-Yona
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel; The Maurice and Gabriela Goldschleger School of Dental Medicine, Department of Oral Biology, Tel Aviv University, Tel Aviv 39040, Israel
| | - Daniel Rittel
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel
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Zhang D, Guo X, Zong X, Du H, Zhao J, Du L, Cao C, Jin X, Song G. Study on the difference of osteogenesis and Notch signaling pathway expression in biphasic calcium-phosphorus ceramic granule materials with different microstructure. J Biomed Mater Res B Appl Biomater 2022; 110:2028-2038. [PMID: 35377532 DOI: 10.1002/jbm.b.35057] [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: 10/28/2021] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 11/12/2022]
Abstract
Different microstructures including micropore diameter, micropore volume, and micropore area of biphasic calcium phosphate (BCP, hydroxyapatite: β-tricalcium phosphate = 8:2) ceramics granules were obtained by varying their sintering temperatures. Sprague-Dawley rat bone marrow-derived stem cells (BMSCs) were co-cultured with BCPs in vitro study and the BMSCs showed different degrees of proliferative activity under the influence of three materials. Cell proliferation and vitality were assessed. Three kinds of BCPs were implanted in the dorsal muscle of beagle dogs. At 1, 2, and 3 months, histological analyses were conducted to estimate the rate of osteogenesis. Expression of Notch pathway genes and osteogenic-related genes were detected by quantitative real-time polymerase chain reaction (q-rtPCR). The proportion of osteogenesis area increased to:48.75 ± 4.20%, 29.48 ± 1.55%, and 26.58 ± 3.86% at 3 months after the implantation (1050, 1150, 1250). Significant differences were observed in the upregulation of Notch pathway genes among different BCPs. BCPs with different micropore diameters have different ectopic osteogenesis effects and led to up-regulation of the Notch signaling pathway genes to different extents.
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Affiliation(s)
- Dong Zhang
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoshuang Guo
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xianlei Zong
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Du
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingyi Zhao
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Le Du
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chunyan Cao
- Animal Lab Center, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaolei Jin
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Guodong Song
- 16th Department, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Osteosphere Model to Evaluate Cell-Surface Interactions of Implantable Biomaterials. MATERIALS 2021; 14:ma14195858. [PMID: 34640255 PMCID: PMC8510223 DOI: 10.3390/ma14195858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 01/01/2023]
Abstract
Successful biomaterials for bone tissue therapy must present different biocompatible properties, such as the ability to stimulate the migration and proliferation of osteogenic cells on the implantable surface, to increase attachment and avoid the risks of implant movement after surgery. The present work investigates the applicability of a three-dimensional (3D) model of bone cells (osteospheres) in the evaluation of osteoconductive properties of different implant surfaces. Three different titanium surface treatments were tested: machined (MA), sandblasting and acid etching (BE), and Hydroxyapatite coating by plasma spray (PSHA). The surfaces were characterized by Scanning Electron Microscopy (SEM) and atomic force microscopy (AFM), confirming that they present very distinct roughness. After seeding the osteospheres, cell–surface interactions were studied in relation to cell proliferation, migration, and spreading. The results show that BE surfaces present higher densities of cells, leaving the aggregates towards than titanium surfaces, providing more evidence of migration. The PSHA surface presented the lowest performance in all analyses. The results indicate that the 3D model allows the focal analysis of an in vitro cell/surfaces interaction of cells and surfaces. Moreover, by demonstrating the agreement with the clinical data observed in the literature, they suggest a potential use as a predictive preclinical tool for investigating osteoconductive properties of novel biomaterials for bone therapy.
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Zhang D, Zong X, Guo X, Du H, Song G, Jin X. [Influence of different sintering temperatures on mesoporous structure and ectopic osteogenesis of biphasic calcium phosphate ceramic granule materials]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:95-103. [PMID: 33448206 DOI: 10.7507/1002-1892.202007074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To detect the difference in the osteogenesis ability of biphasic calcium phosphate (BCP) ceramic granular materials with different mesoporous diameters prepared at different sintering temperatures through in vivo and in vitro experiments, so as to provide evidence for screening BCP materials with better clinical application parameters. Methods Three kinds of BCP (materials 1, 2, 3) were prepared by mixing hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) at a ratio of 8∶2 and sintered at 1 050, 1 150, and 1 250℃ for 3 hours, respectively. The internal porosity and the diameter, volume, and area of the mesopore were measured by Brunauer-Emmett-Teller test (BET); the composition of the material was evaluated by X-ray diffraction (XRD); the microscopic surface morphology of the material was observed by scanning electron microscopy (SEM). The 3rd generation bone marrow mesenchymal stem cells (BMSCs) from Sprague-Dawley rats were co-cultured with the materials 1, 2, and 3 for 7 days in vitro respectively (groups A, B, and C), and the cells adhesion on the materials was observed by SEM and phalloidine staining, respectively. Cell proliferation activity was measured by cell counting kit 8 method. In vivo, 9 muscle bags were made in dorsal muscles of 9 beagles, respectively. The muscle bags were randomly divided into 3 groups (3 per beagle in each group) and materials 1, 2, and 3 were placed into the muscle bags of groups A, B, and C, respectively. After 1, 2, and 3 months of operation, 3 beagles were anesthetized and the samples were stained with HE, Masson, and Safranin, and the bone formation area ratio in the BCP gap was calculated. Real-time fluorescence quantitative PCR (qRT-PCR) was performed to detect the expressions of bone-related genes [including alkaline phosphatase (ALP), osteopontin (OPN), and osteocalcin (OC)]. Results The BET test showed that with the increase of sintering temperature, the internal porosity of the particles did not change significantly, but the diameter, volume, and area of the mesopores gradually decreased. The XRD detection showed that the XRD waves of HA and β-TCP could be seen in all 3 kinds of materials; SEM showed that there were widely distributed macropores on the surface of 3 kinds of BCPs, and the interpores connected with the others. In vitro, BMSCs adhered and proliferated on the surfaces of 3 kinds of BCPs, and the cell biocompatibility of the materials in groups B and C was better than that in group A. In vivo, obvious osteoid tissue deposition could be observed in the intergranular space of 3 kinds of BCPs from 2 months after implantation. The bone formation area ratio of each group increased with time. The bone formation area ratio in group A was significantly higher than that in groups B and C at 2 and 3 months after implantation, and in group A than in group B at 1 month ( P<0.05). qRT-PCR showed that the expressions of osteogenic related genes peaked at 2 months in group A, and gradually increased with time in groups B and C. The relative expressions of ALP and OPN mRNAs in group A were significantly higher than those in groups B and C at 1 month after implantation, the relative expression of OC mRNA in group A was significantly higher than that in groups B and C at 2 months after operation, the relative expression of ALP mRNA in groups B and C and the relative expression of OPN mRNA in group B were significantly higher than those in group A, all showing significant differences ( P<0.05); there was no significant difference in the relative expression of each gene among the other groups at each time point ( P>0.05). Conclusion The mesoporous diameter of BCP decreases with the increase of sintering temperature. Different mesoporous diameters lead to different ectopic osteogenesis of BCP materials. BCP material with mesoporous diameter of 12.57 nm has better osteogenic ability which can activate the osteogenic gene earlier. The mesoporous diameter is expected to be an adjustable index for optimizing the osteogenic capacity of BCP materials.
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Affiliation(s)
- Dong Zhang
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Xianlei Zong
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Xiaoshuang Guo
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Hong Du
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Guodong Song
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Xiaolei Jin
- The 16th Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
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Zamparini F, Prati C, Generali L, Spinelli A, Taddei P, Gandolfi MG. Micro-Nano Surface Characterization and Bioactivity of a Calcium Phosphate-Incorporated Titanium Implant Surface. J Funct Biomater 2021; 12:jfb12010003. [PMID: 33430238 PMCID: PMC7838783 DOI: 10.3390/jfb12010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022] Open
Abstract
The surface topography of dental implants and micro-nano surface characterization have gained particular interest for the improvement of the osseointegration phases. The aim of this study was to evaluate the surface micro-nanomorphology and bioactivity (apatite forming ability) of Ossean® surface, a resorbable blast medium (RBM) blasted surface further processed through the incorporation of a low amount of calcium phosphate. The implants were analyzed using environmental scanning electronic microscopy (ESEM), connected to Energy dispersive X-ray spectroscopy (EDX), field emission gun SEM-EDX (SEM-FEG) micro-Raman spectroscopy and X-ray photoelectron spectroscopy (XPS) before and after immersion in weekly refreshed Hank’s balanced salt solution (HBSS) for 28 days. The analysis of the samples before immersion showed a moderately rough surface, with micropits and microgrooves distributed on all of the surface; EDX microanalysis revealed the constitutional elements of the implant surface, namely titanium (Ti), aluminum (Al) and vanadium (V). Limited traces of calcium (Ca) and phosphorous (P) were detected, attributable to the incorporated calcium phosphate. No traces of calcium phosphate phases were detected by micro-Raman spectroscopy. ESEM analysis of the implant aged in HBSS for 28 days revealed a significantly different surface, compared to the implant before immersion. At original magnifications <2000×, a homogeneous mineral layer was present on all the surface, covering all the pits and microgrooves. At original magnifications ≥10,000×, the mineral layer revealed the presence of small microspherulites. The structure of these spherulites (approx. 2 µm diameter) was observed in nanoimmersion mode revealing a regular shape with a hairy-like contour. Micro-Raman analysis showed the presence of B-type carbonated apatite on the implant surface, which was further confirmed by XPS analysis. This implant showed a micro-nano-textured surface supporting the formation of a biocompatible apatite when immersed in HBSS. These properties may likely favor bone anchorage and healing by stimulation of mineralizing cells.
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Affiliation(s)
- Fausto Zamparini
- Laboratory of Biomaterials and Oral Pathology, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (F.Z.); (A.S.)
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Carlo Prati
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Andrea Spinelli
- Laboratory of Biomaterials and Oral Pathology, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (F.Z.); (A.S.)
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Paola Taddei
- Biochemistry Unit, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Maria Giovanna Gandolfi
- Laboratory of Biomaterials and Oral Pathology, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (F.Z.); (A.S.)
- Correspondence:
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Tumedei M, Piattelli A, Degidi M, Mangano C, Iezzi G. A Narrative Review of the Histological and Histomorphometrical Evaluation of the Peri-Implant Bone in Loaded and Unloaded Dental Implants. A 30-Year Experience (1988-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062088. [PMID: 32245226 PMCID: PMC7143607 DOI: 10.3390/ijerph17062088] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
Background: The aim of the present review was to assess the histological and histomorphometrical data from the paper published by our Laboratory on peri-implant bone in dental implants in different loading conditions. Methods: The papers published in different implant loading conditions, in dental implants retrieved from humans, and in the Hard Tissues Research Center of the University of Chieti-Pescara, Italy, were screened on MEDLINE/PubMed, Embase, Scopus, and other electronic databases until 31 December 2018. Only articles that reported the histological and histomorphometrical values of the Bone-Implant Contact (BIC) were selected. Results: The system selection provided a total of 155 papers. The manuscripts included for the narrative review were 57. These papers provided histological and histomorphometrical data. Conclusions: The bone remodeling around dental implants was found to be a dynamic process; loading changed the microstructure of the peri-implant bone; and implants were found to provide a successful function, over several decades, with different range of degrees of BIC in vivo (varying from a little more than 30% to a little more than 90%). Loaded implants presented a 10%-12% higher BIC values when compared to submerged, unloaded implants, and rougher surfaces had, on average, about a 10% higher BIC than machined surfaces.
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Affiliation(s)
- Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
- Correspondence: ; Tel.: +39-0871-3554083
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
- Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Av. de los Jerónimos, Guadalupe, 135 30107 Murcia, Spain
- Fondazione Villaserena per la Ricerca, 65121 Città Sant’Angelo (Pescara), Italy
| | | | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
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Bagryantseva N, Gazhva S, Baranov A, Shubin L, Bagryantsev V, Bagryantseva O. The feasibility of using computer-based models for reducing the risks of complications associated with temporary dentures. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2019. [DOI: 10.24075/brsmu.2019.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Contemporary prosthetic dentistry has a vast arsenal of solutions for completely edentulous patients. However, it is crucial to consider a variety of factors that can cause complications in patients wearing temporary dentures in the osseointegration period. The aim of this study was to retrospectively analyze the medical records of completely edentulous patients wearing temporary removable or fixed dentures in the osseointegration period, to identify the risk factors for complications and to calculate the odds of adverse events. We performed a multivariate analysis and developed a computerized algorithm that could be used to facilitate selection of the proper denture type and material. The algorithm demonstrates high sensitivity and specificity: 94.37 (76.2 : 98.7) and 92.56 (79.8 : 97.6), respectively; the AUC value is 0.921 (0.843 : 0.963). We are planning to develop a software based on the proposed algorithm that would help the dentist to make a more objective decision when selecting the type of temporary denture and its material.
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Affiliation(s)
- N.V. Bagryantseva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia; Yaroslavl State Medical University, Yaroslavl, Russia
| | - S.I. Gazhva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - A.A. Baranov
- Yaroslavl State Medical University, Yaroslavl, Russia
| | - L.B. Shubin
- Yaroslavl State Medical University, Yaroslavl, Russia
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Ratio between Height and Thickness of the Buccal Tissues: A Pilot Study on 32 Single Implants. Dent J (Basel) 2019; 7:dj7020040. [PMID: 30987026 PMCID: PMC6631890 DOI: 10.3390/dj7020040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous studies have suggested that mucosal height is related to the bone level and soft tissue thickness. The purpose of this pilot study was to investigate the ratio between the height and width of the tissues around single implants with a conical connection and platform switching. METHODS All patients receiving single implants (Anyridge®, MegaGen, Gyeongbuk, South Korea) and restored with single crowns, in a three-month period, were included in this study. After a provisionalization of 12 months, precision impressions were taken and stone casts were poured for measurements. For each implant, two values were collected at the buccal site: the mucosal height (MH), calculated from the vestibular shoulder of the implant to the upper gingival margin of the supra-implant tissue; and the mucosal thickness (MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. Mean, standard deviation (SD), and confidence intervals (CI 95%) for MH and MT, as well as their ratios, were calculated. Correlation between MH and MT was assessed by Pearson's correlation coefficient, with significance level set at 0.05. RESULTS 32 single Anyridge® implants were eligible for this evaluation. The mean MH was 3.44 mm (±1.28), the mean MT was 3.29 (±1.46). The average of the ratio between MH and MT of the supra-implant mucosa was therefore 1:1.19 (±0.55). The relation between MH and MT was statistically significant at p ≤ 0.01 (Pearson two-tailed 95% CI). CONCLUSIONS Our study found a constant relationship between width and height of the peri-implant mucosa. However, our results are different from those of Nozawa et al., who found a ratio of 1:1.5 between height and thickness of the peri-implant tissues. This may be determined by the different sample and follow-up period, as well as by the implants used in our study.
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The Root Membrane Technique: A Retrospective Clinical Study With Up to 10 Years of Follow-Up. IMPLANT DENT 2019; 27:564-574. [PMID: 30161062 DOI: 10.1097/id.0000000000000818] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Immediate implant placement in conjunction with intentional root retention is a recently introduced technique, but the majority of existing documentation is limited to short-term reports with low level of evidence. Hence, the aim of this study was to document the long-term clinical and radiographic results of the root membrane technique. METHODS This retrospective study reports on clinical results of the root membrane technique for periodontal ligament-mediated immediate implant placement with up to 10 years of follow-up from 3 private dental practices. Anterior implants placed with immediate loading from January 2006 to December 2016 were assessed. Kaplan-Meier estimators were computed for reporting of implant success and survival. RESULTS A sample of 182 patients (82 men and 100 women, age range: 18-83 years) received 250 immediate implants (230 maxilla, 20 mandible) after the root membrane concept and followed-up for a mean of 49.94 months (±32.5). Overall, 5 implant failures were recorded for a 10-year cumulative patient-level implant survival rate of 96.5%. Considering mechanical and biological complications, the 10-year cumulative implant success rate was 87.9%. CONCLUSIONS Within the limits of the retrospective design, the root membrane technique showed long-term success rates comparable to those of conventional immediate implants.
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Biomimetic Surfaces Coated with Covalently Immobilized Collagen Type I: An X-Ray Photoelectron Spectroscopy, Atomic Force Microscopy, Micro-CT and Histomorphometrical Study in Rabbits. Int J Mol Sci 2019; 20:ijms20030724. [PMID: 30744023 PMCID: PMC6387268 DOI: 10.3390/ijms20030724] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 12/28/2022] Open
Abstract
Background: The process of osseointegration of dental implants is characterized by healing phenomena at the level of the interface between the surface and the bone. Implant surface modification has been introduced in order to increase the level of osseointegration. The purpose of this study is to evaluate the influence of biofunctional coatings for dental implants and the bone healing response in a rabbit model. The implant surface coated with collagen type I was analyzed through X-ray Photoelectron Spectroscopy (XPS), Atomic Force Microscopy (AFM), micro-CT and histologically. Methods: The sandblasted and double acid etched surface coated with collagen type I, and uncoated sandblasted and double acid etched surface were evaluated by X-ray Photoelectron Spectroscopy (XPS) and Atomic Force Microscopy (AFM) analysis in order evaluate the different morphology. In vivo, a total of 36 implants were positioned in rabbit articular femoral knee-joint, 18 fixtures for each surface. Micro-CT scans, histological and histomorphometrical analysis were conducted at 15, 30 and 60 days. Results: A histological statistical differences were evident at 15, 30 and 60 days (p < 0.001). Both implant surfaces showed a close interaction with newly formed bone. Mature bone appeared in close contact with the surface of the fixture. The AFM outcome showed a similar roughness for both surfaces. Conclusion: However, the final results showed that a coating of collagen type I on the implant surface represents a promising procedure able to improve osseointegration, especially in regions with a low bone quality.
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Abstract
OBJECTIVE In the anterior regions, the resorption of the buccal bone after tooth extraction leads to a contraction of the overlying soft tissues, resulting in an esthetic problem, particularly with immediate implant placement. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this prospective study was to investigate the survival, stability, and complication rates of implants placed using a "modified" socket shield technique. METHODS Over a 2-year period, all patients referred to a dental clinic for treatment with oral implants were considered for inclusion in this study. Inclusion criteria were healthy adult patients who presented nonrestorable single teeth with intact buccal periodontal tissues in the anterior regions of both jaws. Exclusion criteria were teeth with present/past periodontal disease, vertical root fractures on the buccal aspect, horizontal fractures below bone level, and external/internal resorptions. The buccal portion of the root was retained to prevent the resorption of the buccal bone; the shield was 1.5 mm thick with the most coronal portion at the bone crest level. All patients then underwent immediate implants. In the patient with a gap between the implant and shield, no graft material was placed. All implants were immediately restored with single crowns and followed for 1 year. The main outcomes were implant survival, stability, and complications. RESULTS Thirty patients (15 males, 15 females; mean age was 48.2 ± 15.0 years) were enrolled in the study and installed with 40 immediate implants. After 1 year, all implants were functioning, for a survival rate of 100%; excellent implant stability was reported (mean implant stability quotient at placement: 72.9 ± 5.9; after 1 year: 74.6 ± 2.7). No biologic complications were reported, and the incidence of prosthetic complications was low (2.5%). CONCLUSIONS The "modified" socket shield technique seems to be a successful procedure when combined with immediate implant placement, because the root fragment does not interfere with osseointegration and may be beneficial for the esthetics, protecting the buccal bone from resorption.
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Slepička P, Siegel J, Lyutakov O, Slepičková Kasálková N, Kolská Z, Bačáková L, Švorčík V. Polymer nanostructures for bioapplications induced by laser treatment. Biotechnol Adv 2018; 36:839-855. [DOI: 10.1016/j.biotechadv.2017.12.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 01/26/2023]
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Raes F, Eccellente T, Lenzi C, Ortolani M, Luongo G, Mangano C, Mangano F. Immediate functional loading of single implants: a multicenter study with 4 years of follow-up. J Dent Res Dent Clin Dent Prospects 2018; 12:26-37. [PMID: 29732018 PMCID: PMC5928471 DOI: 10.15171/joddd.2018.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background. In the current scientific literature there are only few studies on the immediate functional loading of single implants. The aim of the present present study was to evaluate the 4-year survival rate, complication rate and peri-implant marginal bone loss (PIMBL) of immediately loaded single implants inserted in healed ridges and fresh post-extraction sites.
Methods. Six centers were involved in this prospective study. The surgical and prosthetic protocol was defined in detail, before the start of recruiting patients. Recruitment of patients and performance of surgeries took place between February 2012 and February 2013. Criteria for inclusion were single-tooth gaps in healed ridges and fresh post-extraction sockets. All the fixtures (Anyridge®, Megagen Corporation, Gyeongbuk, South Korea) were functionally loaded immediately after insertion and followed for a period of 4 years. Outcome measures were implant survival, complications and PIMBL.
Results. Forty-six patients (18‒73 years of age) were selected. In total, 57 fixtures were placed (10 in fresh post-extraction sockets). After 4 years of functional loading, only one fixture was lost; therefore, high survival rates (97.6% patient-based; 98.1% implant-based) were reported. In addition, a limited incidence of biologic (4.8% patient-based; 3.8% implant-based) and prosthetic (9.7% patient-based; 7.6% implant-based) complications was reported. The overall 4-year PIMBL amounted to 0.38±0.21 mm (healed ridges: 0.4±0.21 mm; fresh post-extraction sockets: 0.33±0.20 mm).
Conclusion. Loading single implants immediately seems to be a highly successful treatment modality. However, long-term data are needed to confirm these positive outcomes.
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Affiliation(s)
- Filiep Raes
- Professor, Department of Periodontology and Oral Implantology, University of Ghent, Belgium
| | | | | | | | - Giuseppe Luongo
- Professor, Department of Oral and Maxillofacial Surgery, Dental School, University of Naples, Italy
| | - Carlo Mangano
- Professor, Department of Dental Sciences, University Vita Salute San Raffaele, Milan, Italy
| | - Francesco Mangano
- Lecturer, Department of Surgical and Morphological Science, Dental School, University of Varese, Italy
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Mangano F, Raspanti M, Maghaireh H, Mangano C. Scanning Electron Microscope (SEM) Evaluation of the Interface between a Nanostructured Calcium-Incorporated Dental Implant Surface and the Human Bone. MATERIALS 2017; 10:ma10121438. [PMID: 29258208 PMCID: PMC5744373 DOI: 10.3390/ma10121438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 12/26/2022]
Abstract
Purpose. The aim of this scanning electron microscope (SEM) study was to investigate the interface between the bone and a novel nanostructured calcium-incorporated dental implant surface in humans. Methods. A dental implant (Anyridge®, Megagen Implant Co., Gyeongbuk, South Korea) with a nanostructured calcium-incorporated surface (Xpeed®, Megagen Implant Co., Gyeongbuk, South Korea), which had been placed a month earlier in a fully healed site of the posterior maxilla (#14) of a 48-year-old female patient, and which had been subjected to immediate functional loading, was removed after a traumatic injury. Despite the violent trauma that caused mobilization of the fixture, its surface appeared to be covered by a firmly attached, intact tissue; therefore, it was subjected to SEM examination. The implant surface of an unused nanostructured calcium-incorporated implant was also observed under SEM, as control. Results. The surface of the unused implant showed a highly-structured texture, carved by irregular, multi-scale hollows reminiscent of a fractal structure. It appeared perfectly clean and devoid of any contamination. The human specimen showed trabecular bone firmly anchored to the implant surface, bridging the screw threads and filling the spaces among them. Conclusions. Within the limits of this human histological report, the sample analyzed showed that the nanostructured calcium-incorporated surface was covered by new bone, one month after placement in the posterior maxilla, under an immediate functional loading protocol.
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Affiliation(s)
- Francesco Mangano
- Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy.
| | - Mario Raspanti
- Department of Medicine and Surgery, University of Insubria, Varese 21100, Italy.
| | | | - Carlo Mangano
- Department of Dental Sciences, University Vita Salute S. Raffaele, Milan 20132, Italy.
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The Root Membrane Technique: Human Histologic Evidence after Five Years of Function. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7269467. [PMID: 29333449 PMCID: PMC5735593 DOI: 10.1155/2017/7269467] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 11/16/2017] [Indexed: 01/27/2023]
Abstract
Background The "root membrane" (RM) is a technique that has become popular among implantologists for placement of immediate implants in the anterior maxilla. Purpose To present histologic evidence of an immediate implant placed in the human anterior maxilla, according to the RM technique, and retrieved after five years. Methods A fixture, along with the surrounding tissues, was retrieved from the anterior maxilla of a 68-year-old patient, who had been treated five years earlier with immediate implant placement and RM technique. The specimen was processed for histologic/histomorphometric evaluation. Results The buccal bone plate was maintained without any resorption; a healthy periodontal ligament was evidenced. The implant showed osseointegration, with a high percentage of bone-to-implant contact (BIC = 76.2%). With regard to the space between the RM and the implant, the apical and medial thirds were filled with compact, mature bone; the coronal third was colonized by noninfiltrated connective tissue. Conclusions The RM technique appears to be effective in preventing bone resorption of the buccal bone plate of the human anterior maxilla, five years after the placement of an immediate implant.
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Histological Evidence of the Osseointegration of Fractured Direct Metal Laser Sintering Implants Retrieved after 5 Years of Function. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9732136. [PMID: 28929117 PMCID: PMC5592009 DOI: 10.1155/2017/9732136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/30/2017] [Indexed: 11/17/2022]
Abstract
Background Direct metal laser sintering (DMLS) is an additive manufacturing technique that allows the fabrication of dental implants layer by layer through the laser fusion of titanium microparticles. The surface of DMLS implants is characterized by a high open porosity with interconnected pores of different sizes; therefore, it has the potential to enhance and accelerate bone healing. To date, however, there are no histologic/histomorphometric studies in the literature evaluating the interface between bone and DMLS implants in the long-term. Purpose To evaluate the interface between bone and DMLS implants retrieved after 5 years of functional loading. Methods Two fractured DMLS implants were retrieved from the human jaws, using a 5 mm trephine bur. Both the implants were clinically stable and functioned regularly before fracture. The specimens were processed for histologic/histomorphometric evaluation; the bone-to-implant contact (BIC%) was calculated. Results Compact, mature lamellar bone was found over most of the DMLS implants in close contact with the implant surface; the histomorphometric evaluation showed a mean BIC% of 66.1% (±4.5%). Conclusions The present histologic/histomorphometric study showed that DMLS implants were well integrated in bone, after 5 years of loading, with the peri-implant bone undergoing continuous remodeling at the interface.
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Abstract
Aim To evaluate the primary and secondary stability of implants in the posterior maxilla. Methods Patients were allocated into three groups: (A) native bone, (B) partially regenerated bone, and (C) nearly totally regenerated bone. Insertion torque (IT) and implant stability quotient (ISQ) were measured at placement, to evaluate whether satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60) was achieved; ISQ was measured 15, 30, 45, and 60 days after placement, to investigate the evolution to secondary stability. Results 133 implants (Anyridge®, Megagen) were installed in 59 patients: 55 fixtures were placed in Group A, 57 in Group B, and 21 in Group C. Fifty-two implants had satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60). A positive correlation was found between all variables (IT, ISQ at t = 0, t = 60), and statistically higher IT and ISQ values were found for implants with satisfactory high primary stability. Significant differences were found for IT and ISQ between the groups (A, B, and C); however, no drops were reported in the median ISQ values during the healing period. Conclusions The evaluation of the primary and secondary implant stability may contribute to higher implant survival/success rates in critical areas, such as the regenerated posterior maxilla. The present study is registered in the ISRCTN registry with ID ISRCTN33469250.
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Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients. Int J Dent 2017; 2017:8346496. [PMID: 28611844 PMCID: PMC5458381 DOI: 10.1155/2017/8346496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/13/2017] [Indexed: 01/10/2023] Open
Abstract
Purpose To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Methods Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. Results 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea) were installed. Two implants were not sufficiently stable at placement (ISQ < 60) and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. Conclusions In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100%) and success (95.2%) rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478).
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