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Iezzi G, Zavan B, Petrini M, Ferroni L, Pierfelice TV, D'Amora U, Ronca A, D'Amico E, Mangano C. 3D printed dental implants with a porous structure: The in vitro response of osteoblasts, fibroblasts, mesenchymal stem cells, and monocytes. J Dent 2024; 140:104778. [PMID: 37951493 DOI: 10.1016/j.jdent.2023.104778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/14/2023] Open
Abstract
AIMS The first aim of this study was to characterize the surface topography of a novel 3D-printed dental implant at the micro- and macro-level. Its second aim was to evaluate the osteogenic, angiogenic, and immunogenic responses of human oral osteoblasts (hOBs), gingival fibroblasts (hGFs), mesenchymal stem cells (hAD-MSCs), and monocytes to this novel implant surface. METHODS A 3D-printed Ti-6Al-4 V implant was produced by selective laser melting and subjected to organic acid etching (TEST). It was then compared to a machined surface (CTRL). Its biological properties were evaluated via cell proliferation assays, morphological observations, gene expression analyses, mineralization assessments, and collagen quantifications. RESULTS Scanning electron microscopy analysis showed that the TEST group was characterized by a highly interconnected porous architecture and a roughed surface. The morphological observations showed good adhesion of cells cultured on the TEST surface, with a significant increase in hOB growth. Similarly, the gene expression analysis showed significantly higher levels of osseointegration biomarkers. Picrosirius staining showed a slight increase in collagen production in the TEST group compared to the CTRL group. hAD-MSCs showed an increase in endothelial and osteogenic commitment-related markers. Monocytes showed increased mRNA synthesis related to the M2 (anti-inflammatory) macrophagic phenotype. CONCLUSIONS Considering the higher interaction with hOBs, hGFs, hAD-MSCs, and monocytes, the prepared 3D-printed implant could be used for future clinical applications. CLINICAL RELEVANCE This study demonstrated the excellent biological response of various cells to the porous surface of the novel 3D-printed implant.
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Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Barbara Zavan
- Translational Medicine Department, University of Ferrara, Ferrara 44121, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Letizia Ferroni
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna 48033, Italy
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy
| | - Ugo D'Amora
- Institute of Polymers, Composites and Biomaterials National Research Council (IPCB-CNR), Naples 80125, Italy
| | - Alfredo Ronca
- Institute of Polymers, Composites and Biomaterials National Research Council (IPCB-CNR), Naples 80125, Italy
| | - Emira D'Amico
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Via dei Vestini, 31, Chieti 66100, Italy.
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Matsko A, Shaker N, Fernandes ACBCJ, Haimeur A, França R. Nanoscale Chemical Surface Analyses of Recycled Powder for Direct Metal Powder Bed Fusion Ti-6Al-4V Root Analog Dental Implant: An X-ray Photoelectron Spectroscopy Study. Bioengineering (Basel) 2023; 10:bioengineering10030379. [PMID: 36978770 PMCID: PMC10045388 DOI: 10.3390/bioengineering10030379] [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: 01/29/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Over the past couple of decades, additive manufacturing and the use of root-analogue-printed titanium dental implants have been developed. Not all powder particles are sintered into the final product during the additive manufacturing process. Reuse of the remaining powder could reduce the overall implant manufacturing cost. However, Ti-6Al-4V powder particles are affected by heat, mechanical factors, and oxidization during the powder bed fusion manufacturing process. Degradation of the powder may harm the final surface composition and decrease the biocompatibility and survival of the implant. The uncertainty of the recycled powder properties prevents implant fabrication facilities from reusing the powder. This study investigates the chemical composition of controlled, clean, and recycled titanium alloy powder and root-analogue implants (RAI) manufactured from these powders at three different depths. The change in titanium's quantity, oxidization state, and chemical composition in powder and RAI implants have been demonstrated and analyzed. While not identical, the surface chemical composition of the recycled powder implant and the implant manufactured from unused powder are similar. The results also indicate the presence of TiO2 on all surfaces. Many studies confirmed that titanium dioxide on the implant's surface correlates with better osteointegration, reduced bacterial infection, and increased corrosion resistance. Considering economic and environmental aspects, surface chemical composition comparison of clean and reused powder is crucial for the future manufacturing of cost-effective and biocompatible implants.
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Affiliation(s)
- Anastasia Matsko
- Biomedical Engineering Program, Faculty of Engineering University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Nader Shaker
- Department of Restorative Dentistry, College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Ana Carla B C J Fernandes
- Department of Oral Biology, College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Asmaa Haimeur
- Department of Restorative Dentistry, College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Rodrigo França
- Department of Restorative Dentistry, College of Dentistry, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
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Hoque ME, Showva NN, Ahmed M, Rashid AB, Sadique SE, El-Bialy T, Xu H. Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects. Heliyon 2022; 8:e11300. [DOI: 10.1016/j.heliyon.2022.e11300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
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Dinu C, Berce C, Todea M, Vulpoi A, Leordean D, Bran S, Mitre I, Lazar MA, Crisan B, Crisan L, Rotaru H, Onisor F, Vacaras S, Barbur I, Baciut G, Baciut M, Armencea G. Bone quality around implants: a comparative study of coating with hydroxyapatite and SIO 2-TIO 2 of TI 6AL 7NB implants. PARTICULATE SCIENCE AND TECHNOLOGY 2020. [DOI: 10.1080/02726351.2019.1636916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C. Dinu
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C. Berce
- Laboratory Animal Facility – Centre for Experimental Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M. Todea
- Faculty of Physics, Institute of Interdisciplinary Research in Bio-Nano-Sciences, Babes Bolyai University, Cluj-Napoca, Romania
| | - A. Vulpoi
- Faculty of Physics, Institute of Interdisciplinary Research in Bio-Nano-Sciences, Babes Bolyai University, Cluj-Napoca, Romania
| | - D. Leordean
- Department of Manufacturing Engineering, Technical University, Cluj-Napoca, Romania
| | - S. Bran
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I. Mitre
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M. A. Lazar
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - B. Crisan
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - L. Crisan
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - H. Rotaru
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - F. Onisor
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - S. Vacaras
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I. Barbur
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G. Baciut
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M. Baciut
- Department of Implantology and Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G. Armencea
- Department of Oral and Maxillo-Facial Surgery, “Iuliu – Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Cucchi A, Bianchi A, Calamai P, Rinaldi L, Mangano F, Vignudelli E, Corinaldesi G. Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study. BMC Oral Health 2020; 20:219. [PMID: 32758217 PMCID: PMC7409710 DOI: 10.1186/s12903-020-01205-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. Methods Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. Results All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. Conclusions The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.
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Affiliation(s)
- Alessandro Cucchi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
| | - Alessandro Bianchi
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Lisa Rinaldi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Francesco Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Moscow, Russia
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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Elshaer A, Nair S, Hassanin H. Near Net Shape Manufacturing of Dental Implants Using Additive Processes. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-3-030-10579-2_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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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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3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up. Int J Dent 2016; 2016:8590971. [PMID: 27313616 PMCID: PMC4903129 DOI: 10.1155/2016/8590971] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 04/14/2016] [Accepted: 05/05/2016] [Indexed: 11/18/2022] Open
Abstract
This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.
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Bowers M, Yoo D, Marin C, Gil L, Shabaka N, Goldstein M, Janal M, Tovar N, Hirata R, Bonfante E, Coelho P. Surface characterization and in vivo evaluation of laser sintered and machined implants followed by resorbable-blasting media process: A study in sheep. Med Oral Patol Oral Cir Bucal 2016; 21:e206-13. [PMID: 26827064 PMCID: PMC4788801 DOI: 10.4317/medoral.20946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/17/2015] [Indexed: 12/03/2022] Open
Abstract
Background This study aimed to compare the histomorphometric and histological bone response to laser-sintered implants followed by resorbable-blasting media (RBM) process relative to standard machined/RBM surface treated implants. Material and Methods Six male sheep (n=6) received 2 Ti-6Al-4V implants (1 per surface) in each side of the mandible for 6 weeks in vivo. The histomorphometric parameters bone-implant contact (BIC) and bone area fraction occupancy (BAFO) were evaluated. Results Optical interferometry revealed higher Sa and Sq values for the laser-sintered/RBM surface in relation to standard/RBM implants. No significant differences in BIC were observed between the two groups (p>0.2), but significantly higher BAFO was observed for standard/RBM implants (p<0.01). Conclusions The present study demonstrated that both surfaces were biocompatible and osseoconductive, and the combination of laser sintering and RBM has no advantage over the standard machined implants with subsequent RBM. Key words:Dental implants, osseointegration, resorbable- blasting media, sheep, in vivo.
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Affiliation(s)
- Michelle Bowers
- 345 E 24th Street, 10010, Biomaterials and Biomimetics, New York University, New York, NY, USA, rh1694@@nyu.edu
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Surface deterioration and elemental composition of retrieved orthodontic miniscrews. Am J Orthod Dentofacial Orthop 2015; 147:S88-100. [DOI: 10.1016/j.ajodo.2014.10.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/01/2014] [Accepted: 10/01/2014] [Indexed: 11/19/2022]
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Mangano FG, Caprioglio A, Levrini L, Farronato D, Zecca PA, Mangano C. Immediate Loading of Mandibular Overdentures Supported by One-Piece, Direct Metal Laser Sintering Mini-Implants: A Short-Term Prospective Clinical Study. J Periodontol 2015; 86:192-200. [DOI: 10.1902/jop.2014.140343] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Maxillary overdentures supported by four splinted direct metal laser sintering implants: a 3-year prospective clinical study. Int J Dent 2014; 2014:252343. [PMID: 25580124 PMCID: PMC4279819 DOI: 10.1155/2014/252343] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/26/2014] [Indexed: 11/28/2022] Open
Abstract
Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.
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Direct metal laser sintering titanium dental implants: a review of the current literature. Int J Biomater 2014; 2014:461534. [PMID: 25525434 PMCID: PMC4267165 DOI: 10.1155/2014/461534] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 10/16/2014] [Accepted: 11/06/2014] [Indexed: 12/14/2022] Open
Abstract
Statement of Problem. Direct metal laser sintering (DMLS) is a technology that allows fabrication of complex-shaped objects from powder-based materials, according to a three-dimensional (3D) computer model. With DMLS, it is possible to fabricate titanium dental implants with an inherently porous surface, a key property required of implantation devices. Objective. The aim of this review was to evaluate the evidence for the reliability of DMLS titanium dental implants and their clinical and histologic/histomorphometric outcomes, as well as their mechanical properties. Materials and Methods. Electronic database searches were performed. Inclusion criteria were clinical and radiographic studies, histologic/histomorphometric studies in humans and animals, mechanical evaluations, and in vitro cell culture studies on DMLS titanium implants. Meta-analysis could be performed only for randomized controlled trials (RCTs); to evaluate the methodological quality of observational human studies, the Newcastle-Ottawa scale (NOS) was used. Results. Twenty-seven studies were included in this review. No RCTs were found, and meta-analysis could not be performed. The outcomes of observational human studies were assessed using the NOS: these studies showed medium methodological quality. Conclusions. Several studies have demonstrated the potential for the use of DMLS titanium implants. However, further studies that demonstrate the benefits of DMLS implants over conventional implants are needed.
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Calderoni DR, Gilioli R, Munhoz ALJ, Maciel Filho R, Zavaglia CADC, Lambert CS, Lopes ÉSN, Toro IFC, Kharmandayan P. Paired evaluation of calvarial reconstruction with prototyped titanium implants with and without ceramic coating. Acta Cir Bras 2014; 29:579-87. [DOI: 10.1590/s0102-8650201400150005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/23/2014] [Indexed: 11/21/2022] Open
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Histological and Synchrotron Radiation-Based Computed Microtomography Study of 2 Human-Retrieved Direct Laser Metal Formed Titanium Implants. IMPLANT DENT 2013; 22:175-81. [DOI: 10.1097/id.0b013e318282817d] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mangano FG, De Franco M, Caprioglio A, Macchi A, Piattelli A, Mangano C. Immediate, non-submerged, root-analogue direct laser metal sintering (DLMS) implants: a 1-year prospective study on 15 patients. Lasers Med Sci 2013; 29:1321-8. [PMID: 23494103 DOI: 10.1007/s10103-013-1299-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 03/01/2013] [Indexed: 11/29/2022]
Abstract
This study evaluated the 1-year survival and success rate of root-analogue direct laser metal sintering (DLMS) implants, placed into the extraction sockets of 15 patients. DLMS is a technology which allows solids with complex geometry to be fabricated by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model; the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer-by-layer, the desired object. Cone-beam computed tomography (CBCT) acquisition and 3D image conversion, combined with the DLMS process, allow the fabrication of custom-made, root-analogue implants (RAIs). CBCT images of 15 non-restorable premolars (eight maxilla; seven mandible) were acquired and transformed into 3D models: from these, custom-made, root-analogue DLMS implants with integral abutment were fabricated. Immediately after tooth extraction, the RAIs were placed in the sockets and restored with a single crown. One year after implant placement, clinical and radiographic parameters were assessed: success criteria included absence of pain, suppuration, and exudation; absence of implant mobility and absence of continuous peri-implant radiolucency; distance between the implant shoulder and the first visible bone-to-implant contact <1.5 mm from initial surgery; and absence of prosthetic complications. At the 1-year follow-up, no implants were lost, for a survival rate of 100 %. All implants were stable, with no signs of infection. The good conditions of the peri-implant tissues were confirmed by the radiographic examination, with a mean DIB of 0.7 mm (±0.2). The possibility of fabricating custom-made, RAI DLMS implants opens new interesting horizons for immediate placement of dental implants.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Surgical and Morphological Science, Dental School, University of Varese, Varese, Italy,
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Mangano F, Bazzoli M, Tettamanti L, Farronato D, Maineri M, Macchi A, Mangano C. Custom-made, selective laser sintering (SLS) blade implants as a non-conventional solution for the prosthetic rehabilitation of extremely atrophied posterior mandible. Lasers Med Sci 2012; 28:1241-7. [PMID: 22976817 DOI: 10.1007/s10103-012-1205-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 09/03/2012] [Indexed: 11/28/2022]
Abstract
The treatment of severely atrophied posterior mandibles with standard-diameter root-form implants may present a challenge. Bone reconstructive surgery represents the treatment of choice; however, it may not be accepted by some patients for economic reasons or due to higher morbidity. Computer-aided design/computer-aided manufacturing (CAD/CAM) technologies have recently opened new frontiers in biomedical applications. Selective laser sintering (SLS) is a CAD/CAM technique that allows the fabrication of complex three-dimensional (3D) structures created by computer-generated image-based design techniques. The aim of this study is to present a protocol for the manufacture and clinical use of custom-made SLS titanium blade implants as a non-conventional therapeutic treatment for the prosthetic rehabilitation of extremely atrophied posterior mandibles. Computed tomography datasets of five patients were transferred to a specific reconstruction software, where a 3D projection of the atrophied mandible was obtained, and custom-made endosseous blade implants were designed. The custom-made implants were fabricated with SLS technique, placed in the extremely atrophied posterior (<4 mm width) mandible, and immediately restored with fixed partial restorations. After 2 years of loading, all implants were in function, showing a good esthetic integration. Blade implants can be fabricated on an individual basis as a custom-designed device. This non-conventional approach may represent an option for restoring the atrophied posterior mandible of elderly patients.
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Affiliation(s)
- F Mangano
- Dental School, Oral Surgery Unit, University of Varese, Piazza Trento 4, 22015, Gravedona, Como, Italy.
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Reliability evaluation of alumina-blasted/acid-etched versus laser-sintered dental implants. Lasers Med Sci 2012; 28:851-8. [PMID: 22843309 DOI: 10.1007/s10103-012-1170-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
Abstract
Step-stress accelerated life testing (SSALT) and fractographic analysis were performed to evaluate the reliability and failure modes of dental implant fabricated by machining (surface treated with alumina blasting/acid etching) or laser sintering for anterior single-unit replacements. Forty-two dental implants (3.75 × 10 mm) were divided in two groups (n=21 each): laser sintered (LS) and alumina blasting/acid etching (AB/AE). The abutments were screwed to the implants and standardized maxillary central incisor metallic crowns were cemented and subjected to SSALT in water. Use-level probability Weibull curves and reliability for a mission of 50,000 cycles at 200 N were calculated. Polarized light and scanning electron microscopes were used for failure analyses. The Beta (β) value derived from use-level probability Weibull calculation of 1.48 for group AB/AE indicated that damage accumulation likely was an accelerating factor, whereas the β of 0.78 for group LS indicated that load alone likely dictated the failure mechanism for this group, and that fatigue damage did not appear to accumulate. The reliability was not significantly different (p>0.9) between AB/AE (61 %) and LS (62 %). Fracture of the abutment and fixation screw was the chief failure mode. No implant fractures were observed. No differences in reliability and fracture mode were observed between LS and AB/AE implants used for anterior single-unit crowns.
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Custom-made, root-analogue direct laser metal forming implant: a case report. Lasers Med Sci 2012; 27:1241-5. [PMID: 22699801 DOI: 10.1007/s10103-012-1134-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 05/31/2012] [Indexed: 10/28/2022]
Abstract
In the last few years, the application of digital technology in dentistry has become widespread with the introduction of cone beam computed tomography (CBCT) scan technology, and considerable progress has been made in the development of computer-aided design/ computer-aided manufacturing (CAD/CAM) techniques, including direct laser metal forming (DLMF). DLMF is a technology which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. At present, the combined use of CBCT 3D data and CAD/CAM technology makes it possible to manufacture custom-made, root-analogue implants (RAI) with sufficient precision. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CBCT images of a non-restorable right maxillary first premolar were acquired and transformed into a 3D model. From this model, a custom-made, root-analogue DLMF implant was fabricated. Immediately after tooth extraction, the RAI with a pre-operatively designed abutment was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the RAI showed a good functional and aesthetic integration. The introduction of DLMF technology signals the start of a new revolutionary era for implant dentistry as its immense potential for producing highly complex macro- and microstructures is receiving vast interest in different medical fields.
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Witek L, Marin C, Granato R, Bonfante EA, Campos F, Bisinotto J, Suzuki M, Coelho PG. Characterization and in vivo evaluation of laser sintered dental endosseous implants in dogs. J Biomed Mater Res B Appl Biomater 2012; 100:1566-73. [PMID: 22692877 DOI: 10.1002/jbm.b.32725] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 03/25/2012] [Accepted: 03/31/2012] [Indexed: 11/08/2022]
Abstract
Laser metal sintering has shown promising results, but no comparison with other commercially available surface has been performed. This study sought to evaluate the biomechanical and histological early bone response to laser sintered implants relative to alumina-blasted/acid-etched (AB/AE). Surface topography was characterized by scanning electron microscopy and optical interferometry. Surface chemistry was assessed by x-ray photoelectron spectroscopy. Beagle dogs (n = 18) received 4 Ti-6Al-4V implants (one per surface) in each radius, remaining for 1, 3, and 6 weeks (n = 6 dogs per evaluation time) in vivo. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were evaluated. Biomechanical evaluation comprised torque-to-interface failure. The laser sintered surface presented higher S(a) and S(q) than AB/AE. Chemistry assessment showed the alloy metallic components along with adsorbed carbon species. Significantly higher torque was observed at 1 (p < 0.02) and 6 week (p < 0.02) for the laser sintered, whereas at 3 week no significant differences were observed. Significantly higher BIC and BAFO was observed for the Laser Sintered (p < 0.04, and p < 0.03, respectively) only at 1 week, whereas no significant differences were observed at 3 and 6 weeks. The laser sintered implants presented biocompatible and osseoconductive properties and improved biomechanical response compared with the AB/AE surface only at 1 and 6 weeks in vivo.
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Affiliation(s)
- Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University, New York, New York, USA
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