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da Rosa de Souza PT, Manfro R, de Salles Santos FAO, Garcia GFF, Macedo NF, de Macedo BESF, Ignácio SA, Rosa EAR, de Souza EM, Azevedo-Alanis LR. Analysis of osseointegration of implants with macrogeometries with healing chambers: a randomized clinical trial. BMC Oral Health 2024; 24:1114. [PMID: 39300380 DOI: 10.1186/s12903-024-04857-8] [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: 07/21/2024] [Accepted: 09/03/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. METHODS In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. RESULTS The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). CONCLUSION Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. TRIAL REGISTRATION This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.
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Affiliation(s)
| | - Rafael Manfro
- Graduate Program in Dentistry, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | | | | | - Nayara Flores Macedo
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | | | - Sérgio Aparecido Ignácio
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | | | - Evelise Machado de Souza
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Gill T, Kühl S, Rawlinson S, Pippenger B, Bellon B, Shahdad S. Primary stability and osseointegration comparing a novel tapered design tissue-level implant with a parallel design tissue-level implant. An experimental in vivo study. Clin Oral Implants Res 2024; 35:1114-1127. [PMID: 38819108 DOI: 10.1111/clr.14301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES The aim of the present study was to compare a novel tapered, double-threaded self-tapping tissue-Level design implant (TLC) to a well-established parallel walled tissue-level (TL) implant in terms of primary and secondary stability over time. MATERIALS AND METHODS Test TLC (n = 10/per timepoint) and control TL (n = 10/per timepoint) implants were placed in the mandible of minipigs and left for submerged healing for 3, 6, and 12 weeks. Maximum insertion torque and implant stability quotient (ISQ) were measured for each implant at placement. Osseointegration and cortical bone maintenance were histologically evaluated by measuring total bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC). RESULTS A significantly higher maximum insertion torque was measured for the test implant TLC compared to the control TL implant (57.83 ± 24.73 Ncm and 22.62 ± 23.16 Ncm, respectively; p < .001). The mean ISQ values were comparable between the two implant types (75.00 ± 6.70 for TL compared to 75.40 ± 3.20 for TLC, p = .988). BIC was comparable between both implant types at each of the evaluated time points. The fBIC was found to be significantly more coronal at 12 weeks for the TLC implant compared to the TL implant (0.31 ± 0.83 mm for TLC compared to -0.22 ± 0.85 for TL, p = .027). CONCLUSION The novel tapered tissue level design implant showed improved primary stability and an overall improved crestal bone height maintenance compared to the parallel walled design at 12 weeks.
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Affiliation(s)
- Thomas Gill
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Simon Rawlinson
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Benjamin Pippenger
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Preclinical Research, Institut Straumann AG, Basel, Switzerland
| | - Benjamin Bellon
- Department of Preclinical Research, Institut Straumann AG, Basel, Switzerland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Shakeel Shahdad
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Restorative Dentistry, the Royal London Dental Hospital, Barts Health NHS Trust, London, UK
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Kalra J, Dhawan P, Jain N. Implant stability and crestal bone level in osseodensification and conventional drilling protocols: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00524-9. [PMID: 39191537 DOI: 10.1016/j.prosdent.2024.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024]
Abstract
STATEMENT OF PROBLEM How osseodensification osteotomy affects the implant stability and crestal bone level in patients requiring implant placement in low-density bone compared with conventional osteotomy is unclear. PURPOSE This systematic review and meta-analysis analyzed how implant stability and crestal bone level vary in a low-density bone in osseodensification osteotomy and conventional osteotomy. MATERIAL AND METHODS The SCOPUS, PUBMED, and Google Scholar databases were searched, along with a manual search, for articles published between January 2013 and January 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to select the studies for review. A total of 5 studies were included in this systematic review. The Joanna Briggs Institute (JBI) tools were used to conduct the risk of assessment of the included articles, and forest plots were generated for the included articles (α=.05). RESULTS The data were assimilated from a small sample size of 109 patients and 198 implants. The meta-analysis found that osseodensification resulted in significantly higher implant stability quotient (P<.05) values at baseline and follow-up, while the crestal bone level changes were not found to be significant (P>.05) at baseline or on follow-up visits. CONCLUSIONS The osseodensification drilling protocol displayed an advantage over the conventional drilling protocol regarding higher primary stability and secondary stability, as well as bone expansion in low-density bone. No significant difference in crestal bone loss was found in either technique at baseline or at follow-up.
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Affiliation(s)
- Janvi Kalra
- Postgraduate student, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India.
| | - Pankaj Dhawan
- Professor and Department Head, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
| | - Neha Jain
- Professor, Department of Prosthodontics and Crown & Bridge, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
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Imber JC, Khandanpour A, Roccuzzo A, Irani DR, Bosshardt DD, Sculean A, Pippenger BE. Comparative osseointegration of hydrophobic tissue-level tapered implants-A preclinical in vivo study. Clin Oral Implants Res 2024. [PMID: 39032079 DOI: 10.1111/clr.14318] [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: 11/10/2023] [Revised: 05/16/2024] [Accepted: 06/04/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE To histometrically compare the osseointegration and crestal bone healing of a novel tapered, self-cutting tissue-level test implant with a standard tissue-level control implant in a submerged healing regimen. MATERIALS AND METHODS In a mandibular minipig model, implants were inserted and evaluated histometrically after a healing period of 3, 6, and 12 weeks. The primary outcome was the evaluation of bone-to-implant contact (BIC) and secondary outcomes were primary stability as per insertion torque and first BIC (fBIC). Outcomes for the test and control implants were compared using Wilcoxon signed-rank tests and mixed linear regression models. RESULTS Insertion torque values were significantly higher for the test (50.0 ± 26.4 Ncm) compared to the control implants (35.2 ± 19.7 Ncm, p = .0071). BIC values of test implants were non-inferior to those of control implants over the investigated study period. After 12 weeks, the corresponding values measured were 81.62 ± 11.12% and 90.41 ± 4.81% (p = .1763) for test and control implants, respectively. Similarly, no statistical difference was found for fBIC values, except for the 12 weeks outcome that showed statistically lower values for the test (-675.58 ± 590.88 μm) compared to control implants (-182.75 ± 197.40 μm, p = .0068). CONCLUSIONS Novel self-cutting tissue-level implants demonstrated noninferior osseointegration and crestal bone height maintenance to the tissue-level implants. Histometric outcomes between both implants demonstrated test implants were statistically noninferior to control implants, despite substantial differences in the bone engagement mechanism and resulting differences in insertion torque and qualitative bone healing patterns.
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Affiliation(s)
- Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Azita Khandanpour
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Delia R Irani
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Dieter D Bosshardt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Benjamin E Pippenger
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Preclinical Research, Institut Straumann AG, Basel, Switzerland
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Banerjee S, Dasgupta D, Parasrampuria N, Pal D, Gandhi UV. Comparative evaluation of osseodensification drilling versus conventional drilling technique on dental implant stability: A systematic review. J Indian Prosthodont Soc 2024; 24:225-232. [PMID: 38946504 PMCID: PMC11321476 DOI: 10.4103/jips.jips_480_23] [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: 10/07/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
AIM The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods. SETTINGS AND DESIGN The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis. MATERIALS AND METHODS Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria. STATISTICAL ANALYSIS USED The risk of bias and quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials. RESULTS A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components. CONCLUSION The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns.
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Affiliation(s)
- Saurav Banerjee
- Department of Prosthodontics and Crown and Bridge, Dr. R. Ahmed Dental College and Hospital, West Bengal, India
| | - Dolanchanpa Dasgupta
- Department of Prosthodontics and Crown and Bridge, Kusum Devi Sunderlal Dugar Jain Dental College and Hospital, West Bengal, India
| | - Nikita Parasrampuria
- Department of Prosthodontics and Crown and Bridge, Kusum Devi Sunderlal Dugar Jain Dental College and Hospital, West Bengal, India
| | - Dipankar Pal
- Department of Dentistry, RG Kar Medical College and Hospital, West Bengal, India
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Orhan ZD, Ciğerim L. Evaluation of Effect of Different Insertion Speeds and Torques on Implant Placement Condition and Removal Torque in Polyurethane Dense D1 Bone Model. Polymers (Basel) 2024; 16:1361. [PMID: 38794554 PMCID: PMC11125928 DOI: 10.3390/polym16101361] [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: 04/13/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of this study was to evaluate the effect of two different insertion speeds at eight different insertion torque values ranging from 25 to 60 during implantation in a dense polyurethane (PU) D1 bone model on the placement condition and removal torque of dental implants. In this study, 50 pcf single-layer PU plates were used. In the study, a total of 320 implant sockets were divided into two groups, Group 1 (30 rpm) and Group 2 (50 rpm), in terms of insertion speed. Group 1 and Group 2 were divided into eight subgroups with 25, 30, 35, 40, 45, 50, 55 and 60 torques. There were 20 implant sockets in each subgroup. During the implantations, the implant placement condition and removal torque values were assessed. There was a statistically significant difference between the 30 and 50 rpm groups in terms of overall implant placement condition (p < 0.01). It was found that the removal torque values at 50 rpm were statistically significantly higher than those at 30 rpm (p < 0.01). This study showed that in dense D1 bone, the minimum parameters at which all implants could be placed at the bone level were 50 torque at 30 rpm and 40 torque at 50 rpm.
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Affiliation(s)
| | - Levent Ciğerim
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Van Yuzuncu Yil University, Van 65090, Turkey;
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Kreve S, Ferreira I, da Costa Valente ML, Dos Reis AC. Relationship between dental implant macro-design and osseointegration: a systematic review. Oral Maxillofac Surg 2024; 28:1-14. [PMID: 36171302 DOI: 10.1007/s10006-022-01116-4] [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: 05/24/2022] [Accepted: 09/17/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE This systematic review aimed to determine whether differences in the macro-geometry of titanium implants promote changes in osseointegration. MATERIAL AND METHOD SCOPUS, PubMed/Medline, Web of Science, and EMBASE databases were searched in June 2021. In addition, it was performed a manual search of the reference lists of the included articles. Eligibility criteria were in vivo studies that addressed the effect of titanium implant macro-geometry on osseointegration, studies that evaluated periodontally healthy models, and papers indexed in Journal Citation Reports. RESULTS The database search resulted in 1037 articles. Of the 19 articles selected for full reading, 16 remained in this systematic review. These had a high heterogeneity making it hard to perform statistical analysis of the data, so a descriptive analysis was performed. CONCLUSIONS Based on the studies included in this systematic review, implant macro-geometry provides influences on osseointegration. In this sense, the various isolated characteristics (thread type, thread pitch, thread depth, face angle) should be studied so that the implant geometry can balance the compressive stress and tensile stress and produce a minimum shear force.
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Affiliation(s)
- Simone Kreve
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. do Café, s/n 14040-904, Ribeirão Preto, SP, Brazil
| | - Izabela Ferreira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. do Café, s/n 14040-904, Ribeirão Preto, SP, Brazil
| | - Mariana Lima da Costa Valente
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. do Café, s/n 14040-904, Ribeirão Preto, SP, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. do Café, s/n 14040-904, Ribeirão Preto, SP, Brazil.
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Oskouei AB, Golkar M, Badkoobeh A, Jahri M, Sadeghi HMM, Mohammadikhah M, Abbasi K, Tabrizi R, Alam M. Investigating the effect of insertion torque on marginal bone loss around dental implants. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101523. [PMID: 37263526 DOI: 10.1016/j.jormas.2023.101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND/PURPOSE The use of dental implants in restoring function, esthetics, speech, and health of oral tissues has been growing in recent years. Evaluating marginal bone resorption and the survival rate of implants placed with different torques values is crucial. The primary aim of the present study was to evaluate the effect of different insertion torque values on marginal bone loss around dental implants placed in the posterior region of the mandible. MATERIALS AND METHODS 37 patients were involved in this study. Patient data (age, gender), implant characteristics (length, diameter), insertion torque values, gingival biotype, and bone quality were recorded, and parallel periapical radiographs measured marginal bone loss. The relationship between variables was obtained using independent t-tests, Pearson correlations, and regressions. RESULTS The present study found a positive and significant correlation between implant insertion torque and marginal bone loss (MBL)around the dental implants during the first year after placement. Furthermore, patients with D2 bone density at the implant placement site and thin gingival biotype also had significantly higher MBLs from baseline until crown delivery and first-year follow-up than those with D3 bone density and thick gingival biotypes, respectively. CONCLUSION A lower torque is necessary for high-risk patients to increase implantation success due to identifying patients with an increased risk for MBL.
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Affiliation(s)
- Asal Bagherzadeh Oskouei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Jahri
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Mir Mohammad Sadeghi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Gulati K, Chopra D, Kocak-Oztug NA, Verron E. Fit and forget: The future of dental implant therapy via nanotechnology. Adv Drug Deliv Rev 2023; 199:114900. [PMID: 37263543 DOI: 10.1016/j.addr.2023.114900] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak-Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, 34116 Istanbul, Turkey
| | - Elise Verron
- Nantes Université, CNRS, CEISAM, UMR 6230, 44000 Nantes, France
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de Carvalho Formiga M, da Silva HDP, Ghiraldini B, Siroma RS, Ardelean LC, Piattelli A, Shibli JA. Effects of Osseodensification on Primary Stability of Cylindrical and Conical Implants-An Ex Vivo Study. J Clin Med 2023; 12:jcm12113736. [PMID: 37297938 DOI: 10.3390/jcm12113736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Primary stability is an important factor for dental implant success. In the past years, a new method for bone site preparation was introduced, named osseodensification (OD). OD produces a condensation of the trabecular portion of the bone, increasing bone-to-implant contact and primary stability. This study aims to compare the effect of OD in cylindrical and conical implants to conventional instrumentation. A total of forty implants, divided into four groups, were placed in porcine tibia: cylindrical conventional (1a), cylindrical OD (1b), conical conventional (2a) and conical OD (2b). Each implant was measured for implant stability quotient (ISQ), insertion torque (IT) and removal torque (RT). Group 2b showed the higher values for each of the evaluated parameters; groups 1b and 2b showed better results than 1a and 2a, respectively. Regarding the IT and RT, group 1b achieved higher values than group 2a, but not for ISQ. The inter-group comparison showed significant difference between groups 1a vs 2a, 1a vs 2b and 1b vs 2b for ISQ and 1a vs 1b and 1a vs 2b for RT analysis. OD resulted in improved ISQ, IT and RT of both cylindrical and conical implants.
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Affiliation(s)
- Márcio de Carvalho Formiga
- Department of Periodontology and Oral Implantology, Unisul, Palhoça, 515 Felipe Schmidt Str., Florianopolis 88101-001, SC, Brazil
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Helio Doyle Pereira da Silva
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, Paulista University, 303 Borges de Figueiredo Str., São Paulo 03110-010, SP, Brazil
| | - Rafael Shinoske Siroma
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, 332 Viale Abruzzo Str., 66100 Chieti, Italy
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
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Albaqawi AH. "All-on-4" and "All-on-6" treatment concept applied using computer-guided surgery in a patient: Case report with a 2-year follow-up. Clin Case Rep 2023; 11:e7101. [PMID: 36937624 PMCID: PMC10014524 DOI: 10.1002/ccr3.7101] [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: 07/21/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
This case aimed to assess the clinical and radiographic outcomes of the All-on-4 and the All-on-6 concept using three-dimensional computer-assisted treatment planning, and computer-guided surgery. Two years after the treatment, the "All-on-4" and "All-on-6" concepts provided effective treatment for immediate restoration and showed predictable outcomes in a completely edentulous patient.
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Affiliation(s)
- Ahmed Heji Albaqawi
- Department of Restorative Dental ScienceCollege of DentistryUniversity of HaˈilHaˈilKingdom of Saudi Arabia
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Mussi MC, Ribeiro FV, Corrêa MG, Salmon CR, Pimentel SP, Cirano FR, Casati MZ. Impact of a modified implant macrogeometry on biomechanical parameters and bone-related markers in rats. Braz Oral Res 2023; 37:e44. [PMID: 37132731 DOI: 10.1590/1807-3107bor-2023.vol37.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/17/2022] [Indexed: 05/04/2023] Open
Abstract
This study investigated the impact of a modified implant macrogeometry on peri-implant healing and its effect on bone-related molecules in rats. Eighteen rats received one implant in each tibia: the control group received implants with conventional macrogeometry and the test group received implants with modified macrogeometry. After 30 days, the implants were removed for biomechanical analysis and the bone tissue around them was collected for quantifying gene expression of OPN, Runx2, β-catenin, BMP-2, Dkk1, and RANKL/OPG. Calcein and tetracycline fluorescent markers were used for analyzing newly formed bone at undecalcified sections of the tibial implants. These fluorescent markers showed continuous bone formation at cortical bone width and sparse new bone formed along the medullary implant surface in both groups. However, higher counter-torque values and upregulation of OPN expression were achieved by test implants when compared to controls. The modified macrogeometry of implants optimized peri-implant healing, favoring the modulation of OPN expression in the osseous tissue around the implants.
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Affiliation(s)
- Mounir Colares Mussi
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Monica Grazieli Corrêa
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Suzana Peres Pimentel
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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13
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Benalcázar Jalkh EB, Tovar N, Arbex L, Kurgansky G, Torroni A, Gil LF, Wall B, Kohanbash K, Bonfante EA, Coelho PG, Witek L. Effect of leukocyte-platelet-rich fibrin in bone healing around dental implants placed in conventional and wide osteotomy sites: A pre-clinical study. J Biomed Mater Res B Appl Biomater 2022; 110:2705-2713. [PMID: 35771197 DOI: 10.1002/jbm.b.35122] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Leukocyte-platelet-rich fibrin (L-PRF) has been suggested for gap management for immediate implant placement when the distance is greater than 2 mm. However, there remains a paucity in hierarchically designed research to support this application. The present study aimed to evaluate the effect of L-PRF on the osseointegration parameters of dental implants placed after conventional osteotomy of surgically created bone defects that simulate post extraction sockets in a canine model after 3, 6, and 12 weeks in vivo. Eighty dental implants (Intra-Lock, Boca Raton, FL) were placed in the radius of 13 beagle dogs. The experiment consisted of 4 groups (n = 20 implants/group): 1) Regular osteotomy (Reg n/L-PRF); 2) Regular osteotomy and implant placement with L-PRF membrane (Reg L-PRF); 3) Wide osteotomy with no gap management performed, where an osteotomy/bony defect (6 mm of diameter and ~5 mm deep) was created to simulate immediate implant placement in post-extraction sockets, and the gap was left for spontaneous healing (Wide nL-PRF); and 4) Wide osteotomy with L-PRF gap management (Wide L-PRF). L-PRF membranes were obtained by blood drawn from each subject and centrifuged at 2700 rpm (408 RCF-clot) for 12 min. In the experimental groups where L-PRF was utilized, the membrane was inserted into the osteotomy site prior to implant placement. Six dogs had implants placed in the radius for 3 weeks; and 7 dogs had implants placed in the left radius for 6 weeks and in the right radius for 12 weeks. At the corresponding experimental time points, samples were harvested, and subjected to histological processing for qualitative and quantitative analyses, via bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO). Qualitative analysis demonstrated increased amounts of bone formation around the implant and within the healing chambers over time for all groups. While comparable histological features were observed for both Reg groups (L-PRF and nL-PRF), the gap management performed in Wide L-PRF group resulted in effective gap filling with improved bone growth in close proximity to the implant surface. Quantitative analyses of BIC and BAFO yielded higher values for both variables at 3 weeks for Wide L-PRF (~38% and ~56% respectively) compared to Wide nL-PRF (~20% for BIC and BAFO) (p < .03). No statistical differences were detected between Wide groups at 6 and 12 weeks, neither between Reg groups, independent of the association with or without the L-PRF membrane at all healing times. L-PRF placed within wide osteotomies, prior to implant placement, resulted in increased early bone formation compared to unfilled wide osteotomies at the early healing time (3 weeks in vivo).
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Affiliation(s)
- Ernesto B Benalcázar Jalkh
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil
| | - Nick Tovar
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, New York, USA
| | - Leticia Arbex
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Gregory Kurgansky
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, New York, USA
| | - Luiz F Gil
- Department of Morphological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Brittany Wall
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Kimia Kohanbash
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil
| | - Paulo G Coelho
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA.,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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14
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de Carvalho Formiga M, Grzech-Leśniak K, Moraschini V, Shibli JA, Neiva R. Effects of Osseodensification on Immediate Implant Placement: Retrospective Analysis of 211 Implants. MATERIALS 2022; 15:ma15103539. [PMID: 35629566 PMCID: PMC9147081 DOI: 10.3390/ma15103539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 01/14/2023]
Abstract
Osseodensification is a new method of bone instrumentation for dental implant placement that preserves bulk bone and increases primary implant stability, and may accelerate the implant rehabilitation treatment period and provide higher success and survival rates than conventional methods. The aim of this retrospective study was to evaluate and discuss results obtained on immediate implant placement with immediate and delayed loading protocols under Osseodensification bone instrumentation. This study included private practice patients that required dental implant rehabilitation, between February 2017 and October 2019. All implants were placed under Osseodensification and had to be in function for at least 12 months to be included on the study. A total of 211 implants were included in the study, with a 98.1% total survival rate (97.9% in the maxilla and 98.5% in the mandible). For immediate implants with immediate load, 99.2% survival rate was achieved, and 100% survival rate for immediate implant placement without immediate load cases. A total of four implants were lost during this period, and all of them were lost within two months after placement. Within the limitations of this study, it can be concluded that Osseodensification bone instrumentation provided similar or better results on survival rates than conventional bone instrumentation.
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Affiliation(s)
| | - Kinga Grzech-Leśniak
- Laser Laboratory Oral Surgery Department, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Vittorio Moraschini
- Department of Periodontology, Veiga de Almeida University, Rio de Janeiro 20271-020, Brazil;
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos 07023-040, Brazil
- Correspondence:
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
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15
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Sant’Anna HR, Casati MZ, Mussi MC, Cirano FR, Pimentel SP, Ribeiro FV, Corrêa MG. Peri-Implant Repair Using a Modified Implant Macrogeometry in Diabetic Rats: Biomechanical and Molecular Analyses of Bone-Related Markers. MATERIALS 2022; 15:ma15062317. [PMID: 35329768 PMCID: PMC8953263 DOI: 10.3390/ma15062317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023]
Abstract
DM has a high prevalence worldwide and exerts a negative influence on bone repair around dental implants. Modifications of the microgeometry of implants have been related to positive results in bone repair. This study assessed, for the first time, the influence of an implant with modified macrodesign based on the presence of a healing chamber in the pattern of peri-implant repair under diabetic conditions. Thirty Wistar rats were assigned to receive one titanium implant in each tibia (Control Implant (conventional macrogeometry) or Test Implant (modified macrogeometry)) according to the following groups: Non-DM + Control Implant; Non-DM + Test Implant; DM + Control Implant; DM + Test Implant. One month from the surgeries, the implants were removed for counter-torque, and the bone tissue surrounding the implants was stored for the mRNA quantification of bone-related markers. Implants located on DM animals presented lower counter-torque values in comparison with Non-DM ones, independently of macrodesign (p < 0.05). Besides, higher biomechanical retention levels were observed in implants with modified macrogeometry than in the controls in both Non-DM and DM groups (p < 0.05). Moreover, the modified macrogeometry upregulated OPN mRNA in comparison with the control group in Non-DM and DM rats (p < 0.05). Peri-implant bone repair may profit from the use of implants with modified macrogeometry in the presence of diabetes mellitus, as they offer higher biomechanical retention and positive modulation of important bone markers in peri-implant bone tissue.
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16
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Gehrke SA, Júnior JA, Eirles Treichel TL, Dedavid BA. Biomechanical and histological evaluation of four different implant macrogeometries in the early osseointegration process: An in vivo animal study. J Mech Behav Biomed Mater 2021; 125:104935. [PMID: 34736028 DOI: 10.1016/j.jmbbm.2021.104935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/16/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022]
Abstract
This study aims to evaluate the effects of implant macrogeometry on the early period of the osseointegration process, comparing four different implant models through biomechanical and histological analysis after implantation in rabbit tibiae. Twenty New Zealand rabbits were used, evaluated at two different times (21 and 28 days) after installation of the implant. Eighty implants with different macrogeometries were used, forming four groups (n = 20 per group): cylindrical implants Ø4.1 mm and 8 mm in length (STRc group); cylindrical-conical implants Ø4.1 mm and 8 mm in length (STRt group); tapered implants Ø4.3 mm and 8 mm in length (NOBt group); and tapered implants with healing chambers Ø4.0 mm and 8 mm in length (MAEt group). Ten samples from each group were analyzed at each proposed time. The initial implant stability quotient (ISQ) was measured by resonance frequency analysis, both at the time of installation and at the time of sacrifice. In the histological sections, the percentage of bone-implant contact (BIC%), newly formed bone, osteoid matrix, and medullary spaces were measured in the pre-determined cortical and medullary bone portion for each sample. The three tapered implant groups (STRt, NOBt, and MAEt) showed higher values for the analyzed parameters in the early osseointegration period, in comparison with the cylindrical implant group (STRc). In all parameters, the three tapered groups showed no difference (p > 0.05); however, all three tapered groups presented significant differences, when compared to the cylindrical group (p < 0.05). No correlation was detected between the parameters analyzed. Within the limitations of the present study, in all parameters analyzed, the tapered implants demonstrated greater results when compared to the cylindrical implants.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Biotechnology, Universidad Católica de Murcia, 30107, Murcia, Spain; Department of Research, Biotecnos - Technology and Science, 11100, Montevideo, Uruguay.
| | | | | | - Berenice Anina Dedavid
- Department of Materials Engineering, Pontificia Universidade Católica do Rio Grande do Sul, 90619-900, Porto Alegre, Brazil.
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17
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Can the design of the instruments used for undersized osteotomies influence the initial stability of implants installed in low-density bone? An in vitro pilot study. PLoS One 2021; 16:e0257985. [PMID: 34618848 PMCID: PMC8496820 DOI: 10.1371/journal.pone.0257985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives The aims of this study were to compare the initial implant stability obtained using four different osteotomy techniques in low-density synthetic bone, to evaluate the instrument design in comparison to the implant design, and to determinate a possible correlation between the insertion torque and initial stability quotient (ISQ). Materials and methods Four groups were identified in accordance with the osteotomy technique used (n = 10 implants per group): group G1, osteotomy using the recommended drilling sequence; group G2, osteotomy using an undersized compactor drill; group G3, osteotomy using an undersized drill; and group G4, osteotomy using universal osseodensification drills. Two polyurethane blocks were used: block 1, with a medullary portion of 10 pounds per cubic foot (PCF 10) and with a 1 mm cortical portion of PCF 40, and block 2, with a medullary of PCF 15 and with a 2 mm cortical portion of PCF 40. Tapered implants of 4 mm in diameter and 11 mm in length were used. The insertion torque (IT) and ISQ were measured. The dimensions of the final instrument used in each group and the dimensions of the implant were used to calculate the total area of each part, and these data were compared. Results Differences between the four groups were found for IT and ISQ values depending on the technique used for the osteotomy in the two synthetic bone models (p < 0.0001). All groups showed lower values of initial stability in block 1 than in block 2. Conclusions Undersized osteotomies with instruments designed according to the implant body significantly increased the initial stability values compared to beds prepared with universal drills and using the drilling sequence standardized by the manufacturer.
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18
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Abrahamsson I, Carcuac O, Berglundh T. Influence of implant geometry and osteotomy design on early bone healing: A pre-clinical in vivo study. Clin Oral Implants Res 2021; 32:1190-1199. [PMID: 34352142 DOI: 10.1111/clr.13816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/18/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyze the early stages of osseointegration around implants with different geometry following installation in sites using different osteotomy protocols. MATERIALS AND METHODS Two types of implants were installed using regular or modified (reduced diameter) osteotomy protocols in mandibular premolar/molar regions following tooth extraction in six dogs. Three implant site categories were created: Reference (A implant and regular osteotomy), Test-1 (B implant and regular osteotomy), and Test-2 (B implant and modified osteotomy). Implant installation procedures were repeated after 4 and 6 weeks. The insertion torque (ITQ) was measured during implant installation and resonance frequency analysis providing implant stability quotient (ISQ) values was performed following implant installation and once every week during the course of the study. Biopsies were obtained immediately after the 3rd installation procedure and prepared for histological analysis. RESULTS The modified osteotomy protocol created a higher insertion torque (ITQ). The analysis also revealed a correlation between insertion torque at implant installation and radiographic bone loss after 6 weeks of healing. The decline in ISQ values during healing was more pronounced at Test-2 than other sites. While the degree of bone-to-implant contact (BIC%) in the marginal area was similar in test and reference sites at 6 weeks of healing, Test-2 implants presented with a significantly higher BIC% in the mid and apical areas than Test-1 implants. CONCLUSIONS It is suggested that placement of implants in undersized osteotomy sites will result in an increased remodeling of the cortical bone during the early healing process.
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Affiliation(s)
- Ingemar Abrahamsson
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Olivier Carcuac
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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19
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El Chaar E, Puisys A, Sabbag I, Bellón B, Georgantza A, Kye W, Pippenger BE. A novel fully tapered, self-cutting tissue-level implant: non-inferiority study in minipigs. Clin Oral Investig 2021; 25:6127-6137. [PMID: 33861379 PMCID: PMC8531107 DOI: 10.1007/s00784-021-03912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
Objectives To assess the osseointegration and crestal bone level maintenance of a novel fully tapered self-cutting tissue-level implant for immediate placement (test) compared to a clinically established tissue-level implant (control) in moderate bone quality. Materials and methods Test and control implants were compared in 3 groups, i.e., small-, medium-, and large-diameter implants in an edentulous mandibular minipig model with moderate bone quality after 12 weeks of healing. Histometrically derived bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC) were subjected to statistical non-inferiority testing. Maximum insertion torque values in artificial bone were assessed for comparison. Results BIC values for the tests and control implants for all 3 diameters were comparable and non-inferior: small diameter (61.30 ± 10.63% vs. 54.46 ± 18.31%) (p=0.99), medium diameter (60.91 ± 14.42 vs. 54.68 ± 9.16) (p=0.55), and large diameter (45.60 ± 14.67 vs. 52.52 ± 14.76) (p=0.31). fBIC values for test implants were higher and non-inferior compared to control implants in all three groups. Test implants further showed distinctly higher maximum insertion torque values compared to control implants. Conclusion The investigated novel tissue-level implant is able to achieve high levels of primary and secondary implant stability under simultaneous preservation of crestal bone levels. This qualifies the studied implant as an attractive candidate for immediate placement in bone of limited quality. Clinical relevance This pilot pre-clinical study investigated a novel tissue-level implant for immediate placement. With the aim of translating the studied prototype into clinical application pre-clinical models, procedures and controls have been chosen with the aim of reflecting its future clinical indication and use. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-03912-w.
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Affiliation(s)
- Edgard El Chaar
- Department of Periodontology and Implant Dentistry, New York University, New York, USA
| | - Algirdas Puisys
- Vilnius Research Group, Vilnius, Lithuania.,Vilnius Implantology Center, Vilnius, Lithuania
| | - Itai Sabbag
- Lahav Research Institute, Kibbutz Lahav, Israel
| | - Benjamin Bellón
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Aikaterini Georgantza
- Department of Periodontology and Implant Dentistry, New York University, New York, USA
| | - Wayne Kye
- Department of Periodontology and Implant Dentistry, New York University, New York, USA
| | - Benjamin E Pippenger
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland. .,Department of Periodontology, Faculty of Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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20
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Atieh MA, Baqain ZH, Tawse-Smith A, Ma S, Almoselli M, Lin L, Alsabeeha NHM. The influence of insertion torque values on the failure and complication rates of dental implants: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:341-360. [PMID: 33764648 DOI: 10.1111/cid.12993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The influence of using different insertion torque values on clinical and radiographic outcomes of implant therapy is unclear in the current literature. The aim of this systematic review and meta-analysis was to evaluate the implant outcomes and complications rates using high insertion torque values compared with those using regular insertion torque value levels. METHODS Randomized controlled trials (RCTs), nonrandomized controlled clinical trials (NRCCTs), prospective and retrospective cohorts were searched for in electronic databases and complemented by hand searching relevant dental journals. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized and nonrandomized studies. Data were analyzed using a statistical software. RESULTS A total of 718 studies were identified, of which, nine studies were included with 1229 dental implants in 684 participants. The meta-analysis of RCTs showed that the overall implant failure rate was not notably in favor of any insertion torque value and the difference between the two groups was not statistically significant (risk ratio 0.85; 95% confidence interval 0.07-10.52; P = 0.90). None of the RCTs was registered. The secondary analyses of non-RCTs did not either show any statistically significant difference. Overall meta-analysis did not show any significant differences in peri-implant marginal bone loss or biological/technical complications between high (≥50 Ncm) and regular insertion torque (<50 Ncm). CONCLUSIONS There is insufficient evidence to support the use of high or regular insertion torque even with immediate implant restoration/loading. The short-term implant failure rates, changes in marginal bone level and complication rates were comparable when high or regular insertion torques were used for implant placement. The wide confidence interval indicated that results cannot be interpreted with clinically meaningful benefit for using either high or regular insertion torque.
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Affiliation(s)
- Momen A Atieh
- Chair of Oral Diagnostic and Surgical Sciences, Associate Professor of Periodontology, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates.,Honorary Associate Professor, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Zaid H Baqain
- Provost and Professor of Oral and Maxillofacial Surgery, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sunyoung Ma
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Mohamed Almoselli
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine Dubai Healthcare City, Dubai, United Arab Emirates
| | - Lifeng Lin
- Department of Statistics, Florida State University, Tallahassee, Florida, USA
| | - Nabeel H M Alsabeeha
- Ras Al-Khaimah Dental Center, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
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21
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Sierra-Rebolledo A, Tariba-Forero D, Rios-Calvo MD, Gay-Escoda C. Effect of undersized drilling on the stability of immediate tapered implants in the anterior maxillary sector. A randomized clinical trial. Med Oral Patol Oral Cir Bucal 2021; 26:e187-e194. [PMID: 33395401 PMCID: PMC7980290 DOI: 10.4317/medoral.24107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022] Open
Abstract
Background To evaluate the effect of undersized drilling on the primary and secondary stability of immediate implants placed in the anterior maxilla.
Material and Methods A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty tapered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately after anterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis (RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation. The results were compared using parametric statistical tests.
Results All implants showed adequate stability during follow-up. At implant placement, the undersized drilling group exhibited greater insertion torque values than the conventional drilling group, but stability assessed by RFA showed greater mean values in the conventional group. After 6 and 12 weeks of follow-up, both groups showed improved stability, though the RFA values remained comparatively higher in the conventional group. The differences were not statistically significant.
Conclusions Based on the results obtained, undersized drilling does not appear to afford significantly improved stability of immediate implants placed in the anterior zone of the maxilla during the osseointegration period. Key words:Insertion torque, RFA, undersized drilling, immediate implants, primary stability, secondary stability.
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Affiliation(s)
- A Sierra-Rebolledo
- Departamento de Estomatoquirúrgica Unidad de Investigaciones Morfo-Patológicas (UNIMPA), Pabellon 11 Campus Barbula, Facultad de Odontología, Universidad de Carabobo Valencia, Venezuela
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22
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Witek L, Parra M, Tovar N, Alifarag A, Lopez CD, Torroni A, Bonfante EA, Coelho PG. Effect of Surgical Instrumentation Variables on the Osseointegration of Narrow- and Wide-Diameter Short Implants. J Oral Maxillofac Surg 2020; 79:346-355. [PMID: 33137302 DOI: 10.1016/j.joms.2020.09.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the present study was to systematically analyze how a multifactorial surgical instrumentation approach affects osseointegration on both narrow-diameter and wide-diameter short implants. MATERIALS AND METHODS Twelve skeletally mature female sheep were used in the study along with 144 plateau-root-form healing chamber titanium (Ti-6Al-4V) implants (Bicon LLC, Boston, MA), evenly distributed between narrow (3.5 mm) and wide (6.0 mm) diameters. The presence or the absence of irrigation, different drilling speeds, and 2 time points quantifying bone-implant contact (BIC) and bone area fraction occupancy (BAFO) to evaluate the osteogenic parameters around the implants. RESULTS There were no signs of inflammation, infection, or failure of the implants observed at either healing period. The narrow 3.5-mm implant, at 6 weeks, yielded significant differences in terms of BIC at a drilling speed of 50 rotations per minute (RPM), with higher values of the samples using irrigation (30.6 ± 6.1%) compared with those without (19.7 ± 6.1%). No statistical differences were detected for 500 and 1,000 RPM with or without irrigation. The wide 6-mm diameter implant showed differences with respect to drilling speed, 500 and 1,000 RPM, with higher values associated with samples subjected to irrigation. BAFO results, for both diameters, only detected statistical differences between the 2 times (3 vs 6 weeks); no statistical differences were detected when evaluating as a function of time, drilling speed, and irrigation. CONCLUSIONS Surgical instrumentation variables (ie, drilling speed [RPM] and irrigation) yielded to be more of an effect for BIC at longer healing time (6 weeks) for the wider implants. Furthermore, deploying narrow or wide plateau-root-form implants, where conditions allow, has shown to be a safe alternative, considering the high BIC and BAFO values observed, independent of irrigation.
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Affiliation(s)
- Lukasz Witek
- Assistant Professor, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY and Assistant Professor, Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY.
| | - Marcelo Parra
- Graduate Student, PhD Program in Morphological Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; and Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Nick Tovar
- Research Fellow, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY; and OMFS Resident, Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY
| | - Adham Alifarag
- Research Fellow, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; and Surgical Resident Fellow, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Christopher D Lopez
- Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD
| | - Andrea Torroni
- Associate Professor, Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY
| | - Estevam A Bonfante
- Assistant Professor, Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Paulo G Coelho
- Professor, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Professor, Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA; and Professor, Department of Mechanical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY
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Gaikwad AM, Joshi AA, Nadgere JB. Biomechanical and histomorphometric analysis of endosteal implants placed by using the osseodensification technique in animal models: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:61-70. [PMID: 33139057 DOI: 10.1016/j.prosdent.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Osseodensification, a counterclockwise drilling technique for the placement of endosseous implants is a popular clinical technique. However, the effect of the osseodensification technique on primary implant stability, bone-implant contact, and bone area frequency occupancy is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification technique in animal models. MATERIAL AND METHODS An electronic search through Medline/PubMed, Lilacs, and Science Direct databases, and an additional manual search of the reference list of included articles was conducted by using specific keywords and Medical Subject Headings (MeSH) terms for articles in the English language and published up to April 31, 2020. Only animal studies comparing the biomechanical and histomorphometric outcomes of endosteal implants placed by using the osseodensification and conventional drilling protocol were included. The SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using Animal Research: Reporting in Vivo Experiments (ARRIVE) guidelines. RESULTS Nine studies were included. The results of the meta-analysis showed that the pooled weighted mean difference of the insertion torque value for the primary implant stability of endosseous dental implants placed by using the osseodensification technique was 2.270 (95% confidence interval [CI]=1.147 to 3.393; P<.001), the weighted mean difference of the percentage of bone-implant contact at 3 weeks was 0.487 (95% CI=0.220 to 0.754; P=.114), the weighted mean difference of the percentage of bone-implant contact at 6 weeks was 0.565 (95% CI=0.219 to 0.911; P=.448), the weighted mean difference of the percentage of bone area frequency occupancy at 3 weeks was 0.679 (95% CI=0.265 to 1.093; P=.073), and the weighted mean difference of the percentage of bone area frequency occupancy at 6 weeks was 0.391 (95% CI=-0.204 to 0.986; P=.027). CONCLUSIONS Limited data from animal studies suggest that the primary implant stability, bone-implant contact, and bone area frequency occupancy significantly improved for the endosteal implants placed by using the osseodensification technique compared with conventional drilling protocol. However, additional laboratory and clinical studies are recommended to provide stronger evidence.
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Affiliation(s)
- Amit M Gaikwad
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Amruta A Joshi
- Tutor, Department of Periodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B Nadgere
- Professor and HOD, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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24
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Cáceres F, Troncoso C, Silva R, Pinto N. Effects of osseodensification protocol on insertion, removal torques, and resonance frequency analysis of BioHorizons® conical implants. An ex vivo study. J Oral Biol Craniofac Res 2020; 10:625-628. [PMID: 32983856 DOI: 10.1016/j.jobcr.2020.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/22/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Objective Quantify the effect of the osseodensification Densah® protocol on the insertion torque, ISQ, and the removal torque of conical BioHorizons® implants. Materials and methods An ex vivo model over fresh pig tibia bone was used. Test group (TG) included 50 osteotomies using Densah® osseodensification protocol, and the control group (CG), 50 osteotomies using BioHorizons®'s recommended procedure. Conical BioHorizons® implants (3.8 × 10.5 mm) were implanted, verifying the insertion torque with a manual torque meter. ISQ values were registered with Ostell® device. Finally, implants were removed with manual reverse torque registering the values. Results were analyzed and compared with the Mann-Whitney test and t-test. Results Median and interquartile range per group were as follows: insertion torque, CG: 26 (12) Ncm; TG: 42 (26) Ncm, removal torque, CG: 25 (20) Ncm; TG: 40 (28) Ncm, ISQ value, CG: 69.25 (5.5); TG: 71.5 (4). All variables were significantly higher (p ≤ 0.05) in the osseodensification group. Conclusions The Osseodensification technique may improve primary stability in the clinical scenario on tapered implants. Further human RCTs are necessary to validate this.
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Affiliation(s)
- Felipe Cáceres
- Department of Implant Dentistry, Facultad de Odontología, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, 7620001, Santiago, Chile
| | - Cristian Troncoso
- Department of Implant Dentistry, Facultad de Odontología, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, 7620001, Santiago, Chile
| | - Ramón Silva
- Department of Implant Dentistry, Facultad de Odontología, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, 7620001, Santiago, Chile
| | - Nelson Pinto
- Department of Implant Dentistry, Facultad de Odontología, Universidad de los Andes, Monseñor Álvaro del Portillo 12455, Las Condes, 7620001, Santiago, Chile
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Staedt H, Kämmerer PW, Goetze E, Thiem DGE, Al-Nawas B, Heimes D. Implant primary stability depending on protocol and insertion mode - an ex vivo study. Int J Implant Dent 2020; 6:49. [PMID: 32880030 PMCID: PMC7468011 DOI: 10.1186/s40729-020-00245-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned protocol. Dental implant stability was measured via resonance frequency analysis (RFA), insertion torque (IT), and torque out (TO). Results Statistically significant higher IT and TO values were seen after standard protocol insertion (p < 0.05), whereas manual and machine-driven insertion mode showed equivalent values. Conclusions The over-dimensioned protocol exceeded the primary stability values recommended for immediate implant insertion; therefore, it could be recommended as well.
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Affiliation(s)
- Henning Staedt
- Private Practice and Department of Prosthodontics and Materials Science, University Medical Center Rostock, Strempelstraße 13, 18057, Rostock, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Elisabeth Goetze
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Folkman M, Becker A, Meinster I, Masri M, Ormianer Z. Comparison of bone-to-implant contact and bone volume around implants placed with or without site preparation: a histomorphometric study in rabbits. Sci Rep 2020; 10:12446. [PMID: 32709971 PMCID: PMC7381624 DOI: 10.1038/s41598-020-69455-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 07/10/2020] [Indexed: 11/09/2022] Open
Abstract
The objective of this in vivo study was to compare bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) values of a new implant, designed to be inserted without bone preparation, using two different preparation protocols: no site preparation and prior limited cortical perforation, versus the values of a control implant using a conventional drilling protocol. Forty-one implants were inserted in 13 rabbits. Thirteen test implants with a new thread design were inserted using no bone preparation (NP), 14 test implants were inserted with limited cortical perforation (CP), and 14 conventional implants served as control. Five animals were sacrificed after 21 days and eight animals after 42 days. Histomorphometric analysis was performed and percentage of BIC and BAFO values were measured. ANOVA with Tukey post hoc and Mann-Whitney nonparametric tests were calculated to compare between the groups. Statistical analysis showed no significant difference in the measured values between any of the groups, neither compered by implant nor by compered day. The results demonstrated that biological osseointegration parameters of implant that was inserted without any bone preparation was non-inferior compared to conventional preparation. The clinical relevance is that novel implant designs may not require bone preparation prior to placement.
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Affiliation(s)
- Merav Folkman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Alina Becker
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Isabelle Meinster
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Mahmoud Masri
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel
| | - Zeev Ormianer
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
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Gehrke SA, Aramburú J, Pérez-Díaz L, do Prado TD, Dedavid BA, Mazon P, N. De Aza P. Can changes in implant macrogeometry accelerate the osseointegration process?: An in vivo experimental biomechanical and histological evaluations. PLoS One 2020; 15:e0233304. [PMID: 32407416 PMCID: PMC7224560 DOI: 10.1371/journal.pone.0233304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/01/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The propose was to compare this new implant macrogeometry with a control implant with a conventional macrogeometry. MATERIALS AND METHODS Eighty-six conical implants were divided in two groups (n = 43 per group): group control (group CON) that were used conical implants with a conventional macrogeometry and, group test (group TEST) that were used implants with the new macrogeometry. The new implant macrogeometry show several circular healing cambers between the threads, distributed in the implant body. Three implants of each group were used to scanning electronic microscopy (SEM) analysis and, other eighty samples (n = 40 per group) were inserted the tibia of ten rabbit (n = 2 per tibia), determined by randomization. The animals were sacrificed (n = 5 per time) at 3-weeks (Time 1) and at 4-weeks after the implantations (Time 2). The biomechanical evaluation proposed was the measurement of the implant stability quotient (ISQ) and the removal torque values (RTv). The microscopical analysis was a histomorphometric measurement of the bone to implant contact (%BIC) and the SEM evaluation of the bone adhered on the removed implants. RESULTS The results showed that the implants of the group TEST produced a significant enhancement in the osseointegration in comparison with the group CON. The ISQ and RTv tests showed superior values for the group TEST in the both measured times (3- and 4-weeks), with significant differences (p < 0.05). More residual bone in quantity and quality was observed in the samples of the group TEST on the surface of the removed implants. Moreover, the %BIC demonstrated an important increasing for the group TEST in both times, with statistical differences (in Time 1 p = 0.0103 and in Time 2 p < 0.0003). CONCLUSIONS Then, we can conclude that the alterations in the implant macrogeometry promote several benefits on the osseointegration process.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Biotecnos, Montevideo, Uruguay
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), Murcia, Spain
- * E-mail:
| | | | - Leticia Pérez-Díaz
- Laboratorio de Interacciones Molecular, Facultad de Ciencias, Universidad de la Republica, Montevideo, Uruguay
| | - Tales Dias do Prado
- Department of Surgery, Faculty of Medicine Veterinary, University of Rio Verde, Rio Verde, Goiás, Brazil
| | - Berenice Anina Dedavid
- Department of Materials Engineering, Pontificial Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patricia Mazon
- Departamento de Materiales, Óptica y Tecnologia Electrónica, Universidad Miguel Hernández, Elche, (Alicante), Spain
| | - Piedad N. De Aza
- Instituto de Bioingenieria, Universidad Miguel Hernández, Elche, (Alicante), Spain
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Hsieh MC, Huang CH, Lin CL, Hsu ML. Effect of implant design on the initial biomechanical stability of two self-tapping dental implants. Clin Biomech (Bristol, Avon) 2020; 74:124-130. [PMID: 32361012 DOI: 10.1016/j.clinbiomech.2020.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 02/02/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study evaluated the effect of two self-tapping implants on implant stability in immediate implantation. METHODS Two types of self-tapping implants, straight flute (STF) and spiral flute (SPF) designs, were studied. Two synthetic bone blocks with varying densities (0.32 g/cm3 and 0.16 g/cm3) were chosen to simulate the bone quality of the anterior maxilla. Insertion torque values were measured by a torque testing machine during implant insertion. Four biomechanical tests were performed: resonance frequency analysis was conducted using the Osstell device, and the strengths of screw push-in, lateral bending, and pull-out were evaluated using an MTS machine. The strength for each design feature was obtained by averaging the results of 10 trials. In total, 40 specimens were tested for each bone density. Statistical difference was determined by one-way analysis of variance followed by Bonferroni post hoc multiple tests between groups. FINDINGS The STF and SPF groups exhibited similar insertion torque values (p = 0.525 in low-density bone, and p = 0.99 in high-density bone). A significant difference (p < 0.001) was observed in the push-in test between the two groups when low-density bone was tested. The SPF group exhibited a significantly higher lateral bending force (p = 0.001) and a higher stiffness (p < 0.001) than the STF group in high-density bone. The SPF design attained higher (p < 0.001) ISQ numbers than the STF design, but all numbers were below 60. INTERPRETATION Implant stability can be influenced by the apical fixture design of self-tapping implants in immediate implantation.
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Affiliation(s)
- Min-Chieh Hsieh
- Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chang-Hung Huang
- Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Li Lin
- School of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
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Sultana A, Makkar S, Saxena D, Wadhawan A, Kusum CK. To compare the stability and crestal bone loss of implants placed using osseodensification and traditional drilling protocol: A clinicoradiographical study. J Indian Prosthodont Soc 2020; 20:45-51. [PMID: 32089598 PMCID: PMC7008626 DOI: 10.4103/jips.jips_133_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/19/2019] [Accepted: 11/22/2019] [Indexed: 11/04/2022] Open
Abstract
Aim The present study was done to evaluate and compare the stability of the implant and the loss of crestal bone in the implants placed using OD drilling and traditional drilling technique. Setting and Design In vivo-comparative study. Materials and Methods A total of 20 implants were placed in the anterior maxilla, and the patients were divided into two groups. In Group I, the implants were placed using traditional drilling technique, and in Group II, implant placement was done using OD drilling technique. Primary stability was measured in both the groups at baseline (immediate postoperative), and at an interval of 6 months, while crestal bone levels were measured at baseline, 6, and 8 months. Statistical Analysis Used The data obtained were subjected to unpaired t-test to make intergroup comparisons, while one-way ANOVA F-test was used to make intragroup comparisons. Results The primary stability of implant placed using OD drills was found to be slightly higher than implant placed with traditional drilling; however, there was no statistical significance (P > 0.05). When the data obtained for crestal bone levels were statistically analyzed, no significant difference between the two groups was obtained (P > 0.05). Conclusion Within the limitations of this study following conclusions were drawn: there was no statistically significant difference in implant stability between the traditional drilling and OD drilling (P < 0.05). On comparison of crestal bone levels between OD and traditional drilling, no statistically significant difference was found between the two groups (P < 0.05).
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Affiliation(s)
- Anjum Sultana
- Department of Prosthodontics, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Sumit Makkar
- Department of Prosthodontics, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Deepesh Saxena
- Department of Prosthodontics, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Amit Wadhawan
- Department of Periodontics, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Chandan Kumar Kusum
- Department of Prosthodontics, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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Bone Tissue Engineering in the Growing Calvaria Using Dipyridamole-Coated, Three-Dimensionally-Printed Bioceramic Scaffolds: Construct Optimization and Effects on Cranial Suture Patency. Plast Reconstr Surg 2020; 145:337e-347e. [PMID: 31985634 DOI: 10.1097/prs.0000000000006483] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Three-dimensionally-printed bioceramic scaffolds composed of β-tricalcium phosphate delivering the osteogenic agent dipyridamole can heal critically sized calvarial defects in skeletally mature translational models. However, this construct has yet to be applied to growing craniofacial models. In this study, the authors implanted three-dimensionally-printed bioceramic/dipyridamole scaffolds in a growing calvaria animal model and evaluated bone growth as a function of geometric scaffold design and dipyridamole concentration. Potential adverse effects on the growing suture were also evaluated. METHODS Bilateral calvarial defects (10 mm) were created in 5-week-old (approximately 1.1 kg) New Zealand White rabbits (n = 16 analyzed). Three-dimensionally-printed bioceramic scaffolds were constructed in quadrant form composed of varying pore dimensions (220, 330, and 500 μm). Each scaffold was coated with collagen and soaked in varying concentrations of dipyridamole (100, 1000, and 10,000 μM). Controls consisted of empty defects. Animals were killed 8 weeks postoperatively. Calvariae were analyzed using micro-computed tomography, three-dimensional reconstruction, and nondecalcified histologic sectioning. RESULTS Scaffold-induced bone growth was statistically greater than bone growth in empty defects (p = 0.02). Large scaffold pores, 500 μm, coated in 1000 μM dipyridamole yielded the most bone growth and lowest degree of scaffold presence within the defect. Histology showed vascularized woven and lamellar bone along with initial formation of vascular canals within the scaffold lattice. Micro-computed tomographic and histologic analysis revealed patent calvarial sutures without evidence of ectopic bone formation across all dipyridamole concentrations. CONCLUSION The authors present an effective pediatric bone tissue-engineering scaffold design and dipyridamole concentration that is effective in augmentation of calvarial bone generation while preserving cranial suture patency.
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Modified surgical drilling protocols influence osseointegration performance and predict value of implant stability parameters during implant healing process. Clin Oral Investig 2020; 24:3445-3455. [PMID: 31989368 DOI: 10.1007/s00784-020-03215-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of three different surgical drilling protocols on changes of implant stability parameters and osseointegration performance during the healing period in rabbit femoral condyles. MATERIAL AND METHODS Thirty New Zealand white rabbits were used in this study. Three experimental groups according to different surgical drilling protocols (undersized, standard and oversized preparation) were designed. Measurements of implant stability parameters were performed immediately after implant insertion and then at 1, 2, 4, and 8 weeks after the operation. After the animals were sacrificed, the bone blocks with implant were prepared for histological evaluation and histomorphometric analysis. RESULTS The results demonstrated that the ISQ values of each group increased gradually through the whole healing period, while the damping factor showed the opposite tendency. The histomorphometric analysis revealed that BIC (bone-implant contact) values gradually increased with time until 8 weeks of healing at each group. In addition, the undersized group has the highest initial BIC (25.16% ± 7.25%) and the lowest values were found in oversized group (9.13% ± 5.89%). Moreover, a higher correlation (R2 = 0. 9817) between ISQ and BIC values in oversized group and moderate correlations between DF and BIC values in undersized group (R2 = 0.823) were demonstrated. CONCLUSIONS The undersized drilling protocol group presented the highest implant stability and BIC values in the whole healing period, while the similar tendency of results was found between standard and oversized drilling protocol groups. CLINICAL RELEVANCE These results suggested that undersized drilling protocol is mechanically and biologically beneficial in low-density bone. The modifications of surgical drilling protocols would influence the predictive value of implant stability parameters for osseointegration performance.
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Gvetadze RS, Dmitrieva NA, Voronin AN. [Adhesion of microorganisms to various dental materials used to form a gum contour in implant-retained restorations]. STOMATOLOGII︠A︡ 2019; 98:118-123. [PMID: 31701941 DOI: 10.17116/stomat201998051118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article the literature review on dental materials for the manufacture of gum formers used in dental implantology. Adhesion of microorganisms to titanium, PMMA and PEEK resins is discussed. According to published studies PEEK polymer is characterized by a similar bacterial contamination compared to titanium but shows lower degree of contamination when compared to acrylic resins in equal conditions.
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Affiliation(s)
- R Sh Gvetadze
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N A Dmitrieva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A N Voronin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Witek L, Alifarag AM, Tovar N, Lopez CD, Gil LF, Gorbonosov M, Hannan K, Neiva R, Coelho PG. Osteogenic parameters surrounding trabecular tantalum metal implants in osteotomies prepared via osseodensification drilling. Med Oral Patol Oral Cir Bucal 2019; 24:e764-e769. [PMID: 31655837 PMCID: PMC6901143 DOI: 10.4317/medoral.23108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/20/2019] [Indexed: 12/30/2022] Open
Abstract
Background Surgical fixation of implants into bone for the correction of bone deformities or defects is a traditional approach for skeletal stabilization. Important measures of efficacy of implants include implant stability and osseointegration—the direct interaction between living bone and an implant. Osseointegration depends on successful implant placement and subsequent bone remodeling. This study utilized osseodensification drilling (OD) in a low bone density model using trabecular metal (TM) implants.
Material and Methods Three osteotomy sites, Regular, OD-CW (clockwise), and OD-CCW (counterclockwise), were prepared in each ilium of three female sheep. Drilling was performed at 1100rpm with saline irrigation. Trabecular metal (TM) (Zimmer®, Parsippany, NJ, USA) implants measuring 3.7mm in diameter x 10mm length were placed into respective osteotomies. A three-week period post-surgery was given to allow for healing to take place after which all three sheep were euthanized and the ilia were collected. Samples were prepared, qualitatively and quantitatively analyzed using histology micrographs and image analysis software (ImageJ, NIH, Bethesda, MD). Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were quantified to evaluate the osseointegration parameters.
Results All implants exhibit successful bone formation in the peri-implant environment as well as within the open spaces of the trabecular network. Osseointegration within the TM (quantified by %BIC) as a function of drilling technique was more pronounced in OD samples(p>0.05). The %BAFO however shows a significant difference (p=0.036) between the CCW and R samples. Greater bone volume and frequency of bone chips are observed in OD samples.
Conclusions The utilization of OD as a design for improved fixation of hardware was supported by increased levels of stability, both primary and secondary. Histological data with OD provided notably different results from those of the regular drilling method. Key words:Osseodensification drilling, trabecular tantalum metal, osteotomies, implants, subtractive drilling.
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Affiliation(s)
- L Witek
- 433 1st Ave, Room 842 New York University College of Dentistry Department of Biomaterials and Biomimetics New York, NY
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Alveolar Ridge Expansion by Osseodensification-Mediated Plastic Deformation and Compaction Autografting: A Multicenter Retrospective Study. IMPLANT DENT 2019; 28:349-355. [PMID: 31274667 DOI: 10.1097/id.0000000000000898] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Osseodensification preserves bone bulk, facilitates compaction autografting, and deforms trabecular bone in an outward strain, which result in alveolar ridge plastic expansion. The aim of this retrospective study was to evaluate ridge expansion after osseodensification. MATERIALS AND METHODS Patients treated with implant placement through osseodensification were evaluated. The alveolar ridge width was measured at the level of the crest and 10 mm apical to the crest before and after osseodensification. Insertion torque and implant stability quotient (ISQ) values were recorded at implant placements. Expansion values were grouped into the following 3 groups according to the initial alveolar ridge width: group 1: 3 to 4 mm (n = 9), group 2: 5 to 6 mm (n = 12), and group 3: 7 to 8 mm (n = 7). RESULTS Twenty-one patients who received 28 implants were included. Twenty-six implants were integrated, resulting in a survival rate of 92.8%. There was a significant difference in the mean expansion value at the coronal aspect of the ridge between group 1, group 2, and group 3 (2.83 ± 0.66 mm, 1.5 ± 0.97 mm, 1.14 ± 0.89 mm, P < 0.05). The mean torque and ISQ values were 61.2 ± 13.9 Ncm and 77 ± 3.74. CONCLUSION Osseodensification can alter ridge dimensions and allow for ridge expansion. Greater expansion can be expected at the crest in narrow ridges with adequate trabecular bone volume.
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Biomechanical Effects of a New Macrogeometry Design of Dental Implants: An In Vitro Experimental Analysis. J Funct Biomater 2019; 10:jfb10040047. [PMID: 31731451 PMCID: PMC6963387 DOI: 10.3390/jfb10040047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 12/25/2022] Open
Abstract
The purpose of the present study was to measure and compare the insertion torque, removal torque, and the implant stability quotient by resonance frequency analysis in different polyurethane block densities of two implant macrogeometries. Four different polyurethane synthetic bone blocks were used with three cortical thickness: Bone 1 with a cortical thickness of 1 mm, Bone 2 with a cortical thickness of 2 mm, Bone 3 with a cortical thickness of 3 mm, and Bone 4, which was totally cortical. Four groups were created in accordance with the implant macrogeometry (n = 10 per group) and surface treatment: G1—regular implant design without surface treatment; G2—regular implant design with surface treatment; G3—new implant design without surface treatment; G4—new implant design with surface treatment. All implants used were 4 mm in diameter and 10 mm in length and manufactured in commercially pure titanium (grade IV) by Implacil De Bortoli (São Paulo, Brazil). The implants were installed using a computed torque machine, and following installation of the implant, the stability quotient (implant stability quotient, ISQ) values were measured in two directions using Osstell devices. The data were analyzed by considering the 5% level of significance. All implant groups showed similar mean ISQ values without statistical differences (p > 0.05), for the same synthetic bone block: for Bone 1, the value was 57.7 ± 3.0; for Bone 2, it was 58.6 ± 2.2; for Bone 3, it was 60.6 ± 2.3; and for Bone 4, it was 68.5 ± 2.8. However, the insertion torque showed similar higher values for the regular macrogeometry (G1 and G2 groups) in comparison with the new implant macrogeometry (G3 and G4 groups). The analysis of the results found that primary stability does not simply depend on the insertion torque but also on the bone quality. In comparison with the regular implant macrogeometry, the new implant macrogeometry decreased the insertion torque without affecting the implant stability quotient values.
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New Implant Macrogeometry to Improve and Accelerate the Osseointegration: An In Vivo Experimental Study. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9153181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A new implant design with healing chambers in the threads was analyzed and compared with a conventional implant macrogeometry, both implants models with and without surface treatment. Eighty conical implants were prepared using commercially pure titanium (grade IV) by the company Implacil De Bortoli (São Paulo, Brazil). Four groups were performed, as described below: Group 1 (G1), traditional conical implants with surface treatment; group 2 (G2), traditional conical implants without surface treatment (machined surface); group 3 (G3), new conical implant design with surface treatment; group 4 (G4), new conical implant design without surface treatment. The implants were placed in the two tibias (n = 2 implants per tibia) of twenty New Zealand rabbits determined by randomization. The animals were euthanized after 15 days (Time 1) and 30 days (Time 2). The parameters evaluated were the implant stability quotient (ISQ), removal torque values (RTv), and histomorphometric evaluation to determine the bone to implant contact (%BIC) and bone area fraction occupancy (BAFO%). The results showed that the implants with the macrogeometry modified with healing chambers in the threads produced a significant enhancement in the osseointegration, accelerating this process. The statistical analyses of ISQ and RTv showed a significative statistical difference between the groups in both time periods of evaluation (p ≤ 0.0001). Moreover, an important increase in the histological parameters were found for groups G3 and G4, with significant statistical differences to the BIC% (in the Time 1 p = 0.0406 and in the Time 2 p < 0.0001) and the BAFO% ((in the Time 1 p = 0.0002 and in the Time 2 p = 0.0045). In conclusion, the result data showed that the implants with the new macrogeometry, presenting the healing chambers in the threads, produced a significant enhancement in the osseointegration, accelerating the process.
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Gehrke SA, Eliers Treichel TL, Pérez-Díaz L, Calvo-Guirado JL, Aramburú Júnior J, Mazón P, de Aza PN. Impact of Different Titanium Implant Thread Designs on Bone Healing: A Biomechanical and Histometric Study with an Animal Model. J Clin Med 2019; 8:jcm8060777. [PMID: 31159286 PMCID: PMC6616501 DOI: 10.3390/jcm8060777] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 01/01/2023] Open
Abstract
Threads of dental implants with healing chamber configurations have become a target to improve osseointegration. This biomechanical and histometric study aimed to evaluate the influence of implant healing chamber configurations on the torque removal value (RTv), percentage of bone-to-implant contact (BIC%), bone fraction occupancy inside the thread area (BAFO%), and bone and osteocyte density (Ost) in the rabbit tibia after two months of healing. Titanium implants with three different thread configurations were evaluated: Group 1 (G1), with a conventional “v” thread-shaped implant design; Group 2 (G2), with square threads; and Group 3 (G3), the experimental group with longer threads (healing chamber). Ten rabbits (4.5 ± 0.5 kg) received three implants in each tibia (one per group), distributed in a randomized manner. After a period of two months, the tibia blocks (implants and the surrounding tissue) were removed and processed for ground sectioning to evaluate BIC%, BAFO%, and osteocyte density. The ANOVA one-way statistical test was used followed by the Bonferoni’s multiple comparison test to determine individual difference among groups, considering a statistical difference when p < 0.05. Histometric evaluation showed a higher BAFO% values and Ost density for G3 in comparison with the other two groups (G1 and G2), with p < 0.05. However, the RTv and BIC% parameters were not significantly different between groups (p > 0.05). The histological data suggest that the healing chambers in the implant macrogeometry can improve the bone reaction in comparison with the conventional thread design.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Biotecnos CP 11100-Montevideo, Uruguay.
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n, 03202 Elche (Alicante), Spain.
| | - Tiago Luis Eliers Treichel
- Department of Anatomy, Faculty of Veterinary, Universidade de Rio Verde, 104, Rio Verde-GO 75901-970, Brazil.
| | - Letícia Pérez-Díaz
- Laboratorio de Interacciones Molecular, Facultad de Ciencias, Universidad de la Republica, Calle Iguá 4225, 11400 Montevideo, Uruguay.
| | - Jose Luis Calvo-Guirado
- Department of Oral and Implant Surgery, Faculty of Health Sciences, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain.
| | | | - Patricia Mazón
- Departamento de Materiales, Óptica y Tecnologia Electrónica, Universidad Miguel Hernández, Avda. Universidad s/n, 03202 Elche (Alicante), Spain.
| | - Piedad N de Aza
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n, 03202 Elche (Alicante), Spain.
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Kulakov AA, Kasparov AS, Porfenchuk DA. [Factors affecting osteointegration and the use of early functional load to reduce the duration of treatment in dental implantation]. STOMATOLOGIIA 2019; 98:107-115. [PMID: 31513161 DOI: 10.17116/stomat201998041107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The article presents literature data on the impact of the surface and shape of dental implants and early functional load with aesthetic and functional rehabilitation on osteointegration and stability of implants at various implantation terms.
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Affiliation(s)
- A A Kulakov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A S Kasparov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - D A Porfenchuk
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Alifarag AM, Lopez CD, Neiva RF, Tovar N, Witek L, Coelho PG. Atemporal osseointegration: Early biomechanical stability through osseodensification. J Orthop Res 2018. [PMID: 29537128 DOI: 10.1002/jor.23893] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Osseointegration, the direct functional and structural connection between device and bone is influenced by multiple factors such as implant macrogeometry and surgical technique. This study investigated the effects of osseodensification drilling techniques on implant stability and osseointegration using trabecular metal (TM) and tapered-screw vent (TSV) implants in a low-density bone. Six skeletally mature sheep were used where six osteotomy sites were prepared in each of the ilia, (n = 2/technique: Regular [R] (subtractive), clockwise [CW], and counterclockwise [CCW]). One TM and one TSV implant was subsequently placed with R osteotomy sites prepared using a conventional (subtractive) drilling protocol as recommended by the implant manufacturer for low density bone. CW and CCW drilling sites were subjected to osseodensification (OD) (additive) drilling. Evaluation of insertion torque as a function of drilling technique showed implants subjected to R drilling yielded a significant lower insertion torque relative to samples implanted in OD (CW/CCW) sites (p < 0.05). Histomorphometric analysis shows that the osseodensification demonstrates significantly greater values for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Histological analysis shows the presence of bone remnants, which acted as nucleating surfaces for osteoblastic bone deposition, facilitating the bridging of bone between the surrounding native bone and implant surface, as well as within the open spaces of the trabecular network in the TM implants. Devices that were implanted via OD demonstrated atemporal biomechanical stability and osseointegration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2516-2523, 2018.
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Affiliation(s)
- Adham M Alifarag
- College of Medicine, SUNY Upstate Medical University, Syracuse, New York.,Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave, Room 862, New York, New York 10010
| | - Christopher D Lopez
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave, Room 862, New York, New York 10010.,Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Comparative Medicine, New York University School of Medicine, New York, New York.,Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
| | - Rodrigo F Neiva
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave, Room 862, New York, New York 10010
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave, Room 862, New York, New York 10010
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 1st Ave, Room 862, New York, New York 10010.,Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York
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Lahens B, Lopez CD, Neiva RF, Bowers MM, Jimbo R, Bonfante EA, Morcos J, Witek L, Tovar N, Coelho PG. The effect of osseodensification drilling for endosteal implants with different surface treatments: A study in sheep. J Biomed Mater Res B Appl Biomater 2018; 107:615-623. [PMID: 30080320 DOI: 10.1002/jbm.b.34154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 04/18/2018] [Accepted: 04/22/2018] [Indexed: 01/04/2023]
Abstract
This study investigated the effects of osseodensification drilling on the stability and osseointegration of machine-cut and acid-etched endosteal implants in low-density bone. Twelve sheep received six implants inserted into the ilium, bilaterally (n = 36 acid-etched, and n = 36 as-machined). Individual animals received three implants of each surface, placed via different surgical techniques: (1) subtractive regular-drilling (R): 2.0 mm pilot, 3.2 and 3.8 mm twist drills); (2) osseodensification clockwise-drilling (CW): Densah Bur (Versah, Jackson, MI) 2.0 mm pilot, 2.8, and 3.8 mm multifluted tapered burs; and (3) osseodensification counterclockwise-drilling (CCW) Densah Bur 2.0 mm pilot, 2.8 mm, and 3.8 mm multifluted tapered burs. Insertion torque was higher in the CCW and CW-drilling compared to the R-drilling (p < 0.001). Bone-to-implant contact (BIC) was significantly higher for CW (p = 0.024) and CCW-drilling (p = 0.006) compared to the R-drilling technique. For CCW-osseodensification-drilling, no statistical difference between the acid-etched and machine-cut implants at both time points was observed for BIC and BAFO (bone-area-fraction-occupancy). Resorbed bone and bone forming precursors, preosteoblasts, were observed at 3-weeks. At 12-weeks, new bone formation was observed in all groups extending to the trabecular region. In low-density bone, endosteal implants inserted via osseodensification-drilling presented higher stability and no osseointegration impairments compared to subtractive regular-drilling technique, regardless of evaluation time or implant surface. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 615-623, 2019.
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Affiliation(s)
- Bradley Lahens
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Christopher D Lopez
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Rodrigo F Neiva
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, Florida, 32610
| | - Michelle M Bowers
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Ryo Jimbo
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Jonathan Morcos
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York, 10010.,Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, New York, 10016
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Stocchero M, Toia M, Jinno Y, Cecchinato F, Becktor JP, Naito Y, Halldin A, Jimbo R. Influence of different drilling preparation on cortical bone: A biomechanical, histological, and micro-CT study on sheep. Clin Oral Implants Res 2018; 29:707-715. [DOI: 10.1111/clr.13262] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/18/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Michele Stocchero
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Marco Toia
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Yohei Jinno
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology; Malmö University; Malmö Sweden
| | | | - Jonas P. Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Yoshihito Naito
- Department of Biomaterials and Bioengineering, Graduate School of Oral Science; Tokushima University; Tokushima Japan
| | | | - Ryo Jimbo
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
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Atieh MA, Alsabeeha N, Duncan WJ. Stability of tapered and parallel-walled dental implants: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:634-645. [PMID: 29761846 DOI: 10.1111/cid.12623] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Clinical trials have suggested that dental implants with a tapered configuration have improved stability at placement, allowing immediate placement and/or loading. The aim of this systematic review and meta-analysis was to evaluate the implant stability of tapered dental implants compared to standard parallel-walled dental implants. MATERIALS AND METHODS Applying the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, randomized controlled trials (RCTs) were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analyzed using statistical software. RESULTS A total of 1199 studies were identified, of which, five trials were included with 336 dental implants in 303 participants. Overall meta-analysis showed that tapered dental implants had higher implant stability values than parallel-walled dental implants at insertion and 8 weeks but the difference was not statistically significant. Tapered dental implants had significantly less marginal bone loss compared to parallel-walled dental implants. No significant differences in implant failure rate were found between tapered and parallel-walled dental implants. CONCLUSIONS There is limited evidence to demonstrate the effectiveness of tapered dental implants in achieving greater implant stability compared to parallel-walled dental implants. Superior short-term results in maintaining peri-implant marginal bone with tapered dental implants are possible. Further properly designed RCTs are required to endorse the supposed advantages of tapered dental implants in immediate loading protocol and other complex clinical scenarios.
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Affiliation(s)
- Momen A Atieh
- Senior Lecturer in Periodontology, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Alsabeeha
- Head of Prosthetic Section, Ras Al-Khaimah Dental Center, Ministry of Health, Ras Al-Khaimah, United Arab Emirates
| | - Warwick J Duncan
- Professor in Periodontology, Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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The impact of different torques for the insertion of immediately loaded implants on the peri-implant levels of angiogenesis- and bone-related markers. Int J Oral Maxillofac Surg 2018; 47:651-657. [DOI: 10.1016/j.ijom.2017.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/31/2017] [Accepted: 11/03/2017] [Indexed: 11/23/2022]
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Oliveira PGFPD, Bergamo ETP, Neiva R, Bonfante EA, Witek L, Tovar N, Coelho PG. Osseodensification outperforms conventional implant subtractive instrumentation: A study in sheep. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 90:300-307. [PMID: 29853095 DOI: 10.1016/j.msec.2018.04.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/12/2017] [Accepted: 04/17/2018] [Indexed: 01/02/2023]
Affiliation(s)
| | - Edmara T P Bergamo
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Rodrigo Neiva
- Department of Periodontology, University of Florida, 1395 Center Drive, D1-11, Gainesville, FL 32610, USA.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Al. Otávio Pinheiro Brisola 9-75, Bauru, SP 17.012-901, Brazil.
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA.
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University, 433 1st Avenue, New York, NY 10010, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, 550 First Avenue, New York 10016, NY, USA; Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, 6 MetroTech Center, New York, NY 11201, USA.
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Muktadar AK, Gangaiah M, Chrcanovic BR, Chowdhary R. Evaluation of the effect of self-cutting and nonself-cutting thread designed implant with different thread depth on variable insertion torques: An histomorphometric analysis in rabbits. Clin Implant Dent Relat Res 2018; 20:507-514. [PMID: 29659124 DOI: 10.1111/cid.12611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/08/2018] [Accepted: 02/15/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate of the effect of self-cutting and nonself-cutting thread designed implant with different thread depth on variable insertion torques. To evaluate the bone volume (BV) and bone to implant contact (BIC) in these variables MATERIALS AND METHODS: Mainly two thread design, V-shaped thread which is self-cutting and power thread design, which is nonself-cutting implants were considered for this study with a variation in thread depth of 0.4 and 0.6 mm for both the designs, respectively. A total of 32 CAD designed machined surface implant prototypes were manufactured of 4 mm in diameter and 8 mm in length were made, which were machined surfaced, which was placed in the femur of 16 New Zealand white rabbits. These were categorized under 2 groups; Group 1 and Group 2 with insertion torques of <30 and >50 Ncm, respectively. After 4 weeks of healing, rabbits were sacrificed and histomophometric and histologic analyses were done to evaluate the bone response. RESULTS Significantly, more BIC was recorded for high torque implants compared with low torque in power-shaped thread design (P value = .01*). BV for new bone formation was statistically significant for V-shaped thread design in high torque when compared with low torque (P value = .02*). CONCLUSION The effect of the depth of the thread design was significant for the power-shaped design in enhancing BIC when compared with V-shaped thread design. With high torque V-shaped thread design had more new bone formation as compared with power-shaped thread design.
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Affiliation(s)
- Anand Kumar Muktadar
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bangalore, , 560074, India
| | - Makam Gangaiah
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bangalore, , 560074, India
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, , 20506, Sweden
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bangalore, , 560074, India
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Marconcini S, Giammarinaro E, Toti P, Alfonsi F, Covani U, Barone A. Longitudinal analysis on the effect of insertion torque on delayed single implants: A 3-year randomized clinical study. Clin Implant Dent Relat Res 2018; 20:322-332. [DOI: 10.1111/cid.12586] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/19/2017] [Accepted: 01/04/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Simone Marconcini
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Enrica Giammarinaro
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Paolo Toti
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Fortunato Alfonsi
- Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Ugo Covani
- Department of Surgical, Medical, Molecular and Critical Area Pathology; University of Pisa; Pisa Italy
| | - Antonio Barone
- Unit of Oral Surgery and Implantology, University-Hospital at Geneva, Department of Surgery; School of Dental Medicine; Geneva Switzerland
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Pai UY, Rodrigues SJ, Talreja KS, Mundathaje M. Osseodensification - A novel approach in implant dentistry. J Indian Prosthodont Soc 2018; 18:196-200. [PMID: 30111907 PMCID: PMC6070852 DOI: 10.4103/jips.jips_292_17] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/24/2018] [Indexed: 11/04/2022] Open
Abstract
Primary stability in dental implants is an essential factor for achieving successful osseointegration. Surgical procedure and bone quality are among the most common factors that affect primary stability. It is also crucial to achieve high-insertion torque which is important for obtaining primary stability. Maintaining sufficient bone bulk and density is essential to achieve necessary bone-to-implant contact for obtaining a biomechanically stable implant. A new concept for osteotomy called osseodensification (OD) has been at the forefront of changes in surgical site preparation in implantology. This relatively new concept with universally compatible drills has been proposed to help in better osteotomy preparation, bone densification, and indirect sinus lift and also achieve bone expansion at different sites of varying bone densities. This procedure has also shown improvement in achieving better implant primary stability and better osteotomy than conventional implant drills. A systematic review was undertaken to analyze if OD procedure had any advantages over conventional osteotomy on bone density and primary stability. An electronic database search was conducted in PubMed using keywords such as "OD," "implant primary stability," "implant bone density," and "implant osteotomy." A total of 195 articles were collected and subjected to screening using inclusion and exclusion criteria. A literature review was done, following which it was seen that the use of versah drills for bone OD resulted in undersized osteotomy compared to conventional drills. It also resulted in improved bone density and increase in percentage bone volume and bone-to-implant contact, thereby improving implant stability.
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Affiliation(s)
- Umesh Y Pai
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Shobha J Rodrigues
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Karishma S Talreja
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Mahesh Mundathaje
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
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Bekisz JM, Flores RL, Witek L, Lopez CD, Runyan CM, Torroni A, Cronstein BN, Coelho PG. Dipyridamole enhances osteogenesis of three-dimensionally printed bioactive ceramic scaffolds in calvarial defects. J Craniomaxillofac Surg 2017; 46:237-244. [PMID: 29292126 DOI: 10.1016/j.jcms.2017.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/11/2017] [Accepted: 11/13/2017] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The objective of this study was to test the osteogenic capacity of dipyridamole-loaded, three-dimensionally printed, bioactive ceramic (3DPBC) scaffolds using a translational, skeletally mature, large-animal calvarial defect model. MATERIALS AND METHODS Custom 3DPBC scaffolds designed to present lattice-based porosity only towards the dural surface were either coated with collagen (control) or coated with collagen and immersed in a 100 μM concentration dipyridamole (DIPY) solution. Sheep (n = 5) were subjected to 2 ipsilateral trephine-induced (11-mm diameter) calvarial defects. Either a control or a DIPY scaffold was placed in each defect, and the surgery was repeated on the contralateral side 3 weeks later. Following sacrifice, defects were evaluated through microcomputed tomography and histologic analysis for bone, scaffold, and soft tissue quantification throughout the defect. Parametric and non-parametric methods were used to determine statistical significance based on data distribution. RESULTS No exuberant or ectopic bone formation was observed, and no histologic evidence of inflammation was noted within the defects. Osteogenesis was higher in DIPY-coated scaffolds compared to controls at 3 weeks (p = 0.013) and 6 weeks (p = 0.046) in vivo. When bone formation was evaluated as a function of defect radius, average bone formation was higher for DIPY relative to control scaffolds at both time points (significant at defect central regions at 3 weeks and at margins at 6 weeks, p = 0.046 and p = 0.031, respectively). CONCLUSION Dipyridamole significantly improves the calvarial bone regeneration capacity of 3DPBC scaffolds. The most significant difference in bone regeneration was observed centrally within the interface between the 3DPBC scaffold and the dura mater.
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Affiliation(s)
- Jonathan M Bekisz
- New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.
| | - Roberto L Flores
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, 307 East 33rd Street, New York, NY 10016, USA.
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 First Avenue, New York, NY 10010, USA.
| | - Christopher D Lopez
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 First Avenue, New York, NY 10010, USA; Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA.
| | - Christopher M Runyan
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, 307 East 33rd Street, New York, NY 10016, USA.
| | - Andrea Torroni
- Department of Oral and Maxillofacial Surgery, New York University Langone Medical Center, 530 First Avneue, New York, NY 10016, USA.
| | - Bruce N Cronstein
- Department of Medicine, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA.
| | - Paulo G Coelho
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, 307 East 33rd Street, New York, NY 10016, USA; Department of Biomaterials and Biomimetics, New York University College of Dentistry, 433 First Avenue, New York, NY 10010, USA.
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Laleman I, Cortellini S, De Winter S, Rodriguez Herrero E, Dekeyser C, Quirynen M, Teughels W. Subgingival debridement: end point, methods and how often? Periodontol 2000 2017; 75:189-204. [DOI: 10.1111/prd.12204] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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50
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Wilson TG, Miller RJ, Trushkowsky R, Dard M. Tapered Implants in Dentistry: Revitalizing Concepts with Technology: A Review. Adv Dent Res 2017; 28:4-9. [PMID: 26927482 DOI: 10.1177/0022034516628868] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The most common approach to lessen treatment times is by decreasing the healing period during which osseointegration is established. Implant design parameters such as implant surface, primary stability, thread configuration, body shape, and the type of bone have to be considered to obtain this objective. The relationship that exists between these components will define the initial stability of the implant. It is believed implant sites using a tapered design and surface modification can increase the primary stability in low-density bone. Furthermore, recent experimental preclinical work has shown the possibility of attaining primary stability of immediately loaded, tapered dental implants without compromising healing and rapid bone formation while minimizing the implant stability loss at compression sites. This may be of singular importance with immediate/early functional loading of single implants placed in poor-quality bone. The selection of an implant that will provide adequate stability in bone of poor quality is important. A tapered-screw implant design will provide adequate stability because it creates pressure on cortical bone in areas of reduced bone quality. Building on the success of traditional tapered implant therapy, newer tapered implant designs should aim to maximize the clinical outcome by implementing new technologies with adapted clinical workflows.
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Affiliation(s)
| | | | - R Trushkowsky
- New York University College of Dentistry, Department of Cariology and Comprehensive Care, New York City, NY, USA
| | - M Dard
- New York University College of Dentistry, Department of Periodontology and Implant Dentistry, New York City, NY, USA Institut Straumann, Basel, Switzerland
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