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Pacheco-Vergara MJ, Benalcázar-Jalkh EB, Nayak VV, Bergamo ETP, Cronstein B, Zétola AL, Weiss FP, Grossi JRA, Deliberador TM, Coelho PG, Witek L. Employing Indirect Adenosine 2 A Receptors (A 2AR) to Enhance Osseointegration of Titanium Devices: A Pre-Clinical Study. J Funct Biomater 2023; 14:308. [PMID: 37367272 DOI: 10.3390/jfb14060308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/20/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
The present study aimed to evaluate the effect of dipyridamole, an indirect adenosine 2A receptors (A2AR), on the osseointegration of titanium implants in a large, translational pre-clinical model. Sixty tapered, acid-etched titanium implants, treated with four different coatings ((i) Type I Bovine Collagen (control), (ii) 10 μM dipyridamole (DIPY), (iii) 100 μM DIPY, and (iv) 1000 μM DIPY), were inserted in the vertebral bodies of 15 female sheep (weight ~65 kg). Qualitative and quantitative analysis were performed after 3, 6, and 12 weeks in vivo to assess histological features, and percentages of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO). Data was analyzed using a general linear mixed model analysis with time in vivo and coating as fixed factors. Histomorphometric analysis after 3 weeks in vivo revealed higher BIC for DIPY coated implant groups (10 μM (30.42% ± 10.62), 100 μM (36.41% ± 10.62), and 1000 μM (32.46% ± 10.62)) in comparison to the control group (17.99% ± 5.82). Further, significantly higher BAFO was observed for implants augmented with 1000 μM of DIPY (43.84% ± 9.97) compared to the control group (31.89% ± 5.46). At 6 and 12 weeks, no significant differences were observed among groups. Histological analysis evidenced similar osseointegration features and an intramembranous-type healing pattern for all groups. Qualitative observation corroborated the increased presence of woven bone formation in intimate contact with the surface of the implant and within the threads at 3 weeks with increased concentrations of DIPY. Coating the implant surface with dipyridamole yielded a favorable effect with regard to BIC and BAFO at 3 weeks in vivo. These findings suggest a positive effect of DIPY on the early stages of osseointegration.
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Affiliation(s)
- Maria Jesus Pacheco-Vergara
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Ernesto Byron Benalcázar-Jalkh
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Edmara T P Bergamo
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
| | - Bruce Cronstein
- Department of Medicine, New York University Langone Medical Center, New York, NY 10016, USA
| | - André Luis Zétola
- Oral and Maxillofacial Surgeon, Chairman of Implantology, SOEPAR, Curitiba 80730-000, PR, Brazil
| | | | | | | | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lukasz Witek
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
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Olmedo-Gaya MV, Romero-Olid MN, Ocaña-Peinado FM, Vallecillo-Rivas M, Vallecillo C, Reyes-Botella C. Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04962-y. [PMID: 36977760 DOI: 10.1007/s00784-023-04962-y] [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: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. MATERIAL AND METHODS This randomized controlled clinical trial enrolled 108 patients (n=108 implants) distributed in three study groups: group 1 (n=36) underpreparation technique, group 2 (n=36) expander technique, and group 3 (n=36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. RESULTS ISQ values were associated with the patient's bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences (p<0.0001). Lower stability results were obtained when conventional drilling (69.31) was used compared to the use of underpreparation (74.29) or expanders (73.99) with a level of significance of p=0.008 and p=0.005, respectively. CONCLUSIONS The surgical technique influences the PS when there is low-quality bone. In low-quality bones, conventional drilling obtains lower ISQ values. CLINICAL RELEVANCE Replace the conventional drilling technique for an alternative, underpreparation or expanders, in low-quality bone in order to achieve greater primary stability.
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Affiliation(s)
| | | | | | | | - Cristina Vallecillo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.
- Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071, Granada, Spain.
| | - Candela Reyes-Botella
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
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Canullo L, Iacono R, Pires Godoy E, Punzo A, Cavicchia A, Gianfreda F, Bollero P. Hybrid Funnel Technique: A Novel Approach for Implant Site Preparation: A Pilot Study. Dent J (Basel) 2022; 10:dj10090157. [PMID: 36135152 PMCID: PMC9497956 DOI: 10.3390/dj10090157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Different techniques and tools have been developed for implant site preparation. In this clinical scenario, Hybrid Funnel Technique (HFT), a novel osteotomy procedure, has been proposed. (2) Aim: The aim of this retrospective observational study was to consider the different responses to compression of the histological bony compartments (cancellus and cortical). HFT involves the use of multiple drills for the cortical layer preparation and of an osteotome for the osteocompaction of the cancellous bone. (3) Materials and Methods: Following computer-supported implant planning and guided surgery, 10 osteotomies with HFT were performed and 10 implants with the same length and diameter were placed in seven healthy and no daily smoking patients. Periapical X-ray and intraoral photographs were performed at baseline and after 12 months of follow-up to evaluate marginal bone level (MBL) changes and aesthetic results obtained from implant prosthetic rehabilitation. (4) Results: At 1 year of follow-up, 100% of the implants were successfully integrated, MBL change mean value was 0.17 mm ± 0.21. No differences in terms of MBL were noted between thin and thick biotypes. Pink esthetic score (PES) and white esthetic score (WES), assessed one year after definitive restoration placement, were 7.5 ± 2.3 and 8.5 ± 1.1, respectively. (5) Conclusions: Based on the findings of this preliminary clinical study, HFT has led to stability of peri-implant tissues and could represent a reliable technique for surgical preparation of the implant site.
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Affiliation(s)
- Luigi Canullo
- Department of Periodontology, University of Bern, 3012 Bern, Switzerland
| | - Roberta Iacono
- F.A.S Screening for Prevention and Oral Health, Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil
| | | | - Alessio Cavicchia
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence:
| | - Patrizio Bollero
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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Yang B, Irastorza-Landa A, Heuberger P, Ploeg HL. Analytical model for dental implant insertion torque. J Mech Behav Biomed Mater 2022; 131:105223. [DOI: 10.1016/j.jmbbm.2022.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 11/26/2022]
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Cochran DL, Jones AA, Sugita R, Brown MC, Prasad H, Kay GW. Twelve Month Evaluation of a Novel Mineral Organic Adhesive Material Used to Stabilize Dental Implants Placed in Oversized Osteotomies in Vivo in an Animal Model. Clin Oral Implants Res 2022; 33:391-404. [PMID: 35132693 DOI: 10.1111/clr.13899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate long-term in vivo stability of dental implants stabilized at time of placement in oversized osteotomies with a novel, self-setting, mineral-organic bone adhesive. MATERIALS/METHODS Canine (26) mandibular teeth were removed, and 3 oversized osteotomies prepared bilaterally. Implants were placed with either adhesive, particulate xenograft or with blood clot filling the implant/osteotomy gaps. Removal torque and histology were assessed. RESULTS The adhesive provided significant and clinically relevant immediate implant stability of 22.2N-cm (95%CI 5.3; 39.0) which continued throughout the early postoperative course and persisted through the nine- (155N-cm 95%CI 113; 197) and twelve-month (171N-cm 95%CI 134.2; 209.4) time points. This is in comparison to the blood clot of 1.4N-cm (95%CI 0.7; 2.1), 128.6N-cm (95%CI 66.8; 190.4), and 140.7N-cm (95%CI 78.8; 202.5) and particulate xenograft, 1.3N-cm (95%CI 0.6; 2.0), 132.1N-cm (95%CI 94.5; 169.7), and 101.5 (95%CI 59.5; 143.5) respectively. Histological examination shows the adhesive establishes intimate contact with the implant and bony walls and is replaced with new bone without compromising stability. Soft tissue does not penetrate the adhesive and marginal bone/biomaterial level is maintained. Control sites filled with xenograft or blood clot heal with reduced bone levels and, in some cases, xenograft particles were encapsulated in connective tissue. CONCLUSIONS Implants placed in oversized osteotomies and lacking primary stability can be stabilized at placement with a novel, highly osteoconductive and resorbable adhesive. Gradual replacement of the biomaterial allows osseointegration without loss of stability through 12 months of follow-up. This novel adhesive has the potential to stabilize implants placed in sites with inadequate bony support.
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Affiliation(s)
- David L Cochran
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | - Archie A Jones
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | - Ryushiro Sugita
- Department of Periodontics, UT Health Science Center, San Antonio, TX, USA
| | | | - Hari Prasad
- Hard Tissue Research Laboratory, University of Minnesota, Minneapolis, Minnesota, USA
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Gocmen G, Aslan U, Ozkan Y, Ozkan Y. Does shelf preparation have efficacy on immediate loading of 4 implants supporting screw-retained full-arch dental prosthesis? Niger J Clin Pract 2022; 25:1083-1087. [DOI: 10.4103/njcp.njcp_1630_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review. MATERIALS 2021; 14:ma14237183. [PMID: 34885335 PMCID: PMC8658728 DOI: 10.3390/ma14237183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022]
Abstract
Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
- Private Practitioner, 20132 Milan, Italy
| | | | - Paolo Capparè
- Department of Dentistry, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-0226433619
| | - Silvia Barbon
- Section of Human Anatomy, Department of Neurosciences, Padua University, 35121 Padua, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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Cohen O, Bosshardt DD, Weinberg E, Slutzkey G, Moses O. The Effect of Coronal Implant Design and Drilling Protocol on Bone-to-Implant Contact: A 3-Month Study in the Minipig Calvarium. MATERIALS 2021; 14:ma14102645. [PMID: 34070127 PMCID: PMC8158354 DOI: 10.3390/ma14102645] [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: 04/01/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 11/19/2022]
Abstract
Background: Stress concentrated at an implant’s neck may affect bone-to-implant contact (BIC). The objective of this study was to evaluate four different implant neck designs using two different drilling protocols on the BIC. Methods: Ninety-six implants were inserted in 12 minipigs calvarium. Implants neck designs evaluated were: type 1–6 coronal flutes (CFs), 8 shallow microthreads (SMs); type 2–6 CFs,4 deep microthreads (DMs); type 3–4 DMs; type 4–2 CFs, 8 SMs. Two groups of forty-eight implants were inserted with a final drill diameter of 2.8 mm (DP1) or 3.2 mm (DP2). Animals were sacrificed after 1 and 3 months, total-BIC (t-BIC) and coronal-BIC (c-BIC) were evaluated by nondecalcified histomorphometry analysis. Results: At 1 month, t-BIC ranged from 85–91% without significant differences between implant types or drilling protocol. Flutes on the coronal aspect impaired the BIC at 3 m. c-BIC of implant types with 6 CFs was similar and significantly lower than that of implant types 3 and 4. c-BIC of implant type 4 with SMs was highest of all implant types after both healing periods. Conclusions: BIC was not affected by the drilling protocol. CFs significantly impaired the -BIC. Multiple SMs were associated with greater c-BIC.
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Affiliation(s)
- Omer Cohen
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (E.W.); (G.S.); (O.M.)
- Correspondence: ; Tel.: +972-54-6922393
| | - Dieter D. Bosshardt
- Laboratory of Oral Histology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland;
| | - Evegeny Weinberg
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (E.W.); (G.S.); (O.M.)
| | - Gil Slutzkey
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (E.W.); (G.S.); (O.M.)
| | - Ofer Moses
- Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel; (E.W.); (G.S.); (O.M.)
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10
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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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11
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Liddell RS, Ajami E, Li Y, Bajenova E, Yang Y, Davies JE. The influence of implant design on the kinetics of osseointegration and bone anchorage homeostasis. Acta Biomater 2021; 121:514-526. [PMID: 33271359 DOI: 10.1016/j.actbio.2020.11.043] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/05/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Titanium implants have shown considerable success in terms of achieving quick and long-lasting stability in bone through the process of osseointegration. Further work aims to improve implant success rates by modifying implant design on the nano-, micro-, and macro- scales with the goal of achieving higher levels of bone anchorage more quickly. However, the most frequently used methods of analysis do not investigate bone anchorage as a whole but as a series of discrete points, potentially missing relevant insight which could inform the effects of topography on these 3 scale ranges. Herein we utilize an asymptotic curve fitting method to obtain a biologically relevant description of reverse torque data and compare the anchorage of 12 different implant groups. Implant surface topography had a significant effect on the rate and degree of anchorage achieved during the initial bone formation period of osseointegration but was not found to influence the relative change in anchorage during bony remodeling. Threaded implants significantly decreased the time required to reach peak anchorage compared to non-threaded implants and implants with micro-topographically complex surfaces required greater torque to be removed than implants without such features. Nanotopography increased overall anchorage and decreased the time required to reach peak anchorage but to a lesser degree than microtopography or macrogeometry respectively. The curve fitting method utilized in the present study allows for a more integrated analysis of bone anchorage and permits investigation of osseointegration with respect to time, which may lead to a more targeted approach to implant design.
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Affiliation(s)
- Robert S Liddell
- Dental Research Institute, Faculty of Dentistry, University of Toronto 124 Edward Street, Toronto, Ontario, Canada, M5G 1G6
| | - Elnaz Ajami
- Zimmer Biomet Dental, Palm Beach Gardens, Florida, United States of America, 33410
| | - Yunqing Li
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, Canada, M5S 3G9
| | - Elena Bajenova
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, Canada, M5S 3G9
| | - Yuan Yang
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, Canada, M5S 3G9
| | - John E Davies
- Dental Research Institute, Faculty of Dentistry, University of Toronto 124 Edward Street, Toronto, Ontario, Canada, M5G 1G6; Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, Canada, M5S 3G9.
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12
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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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Evaluation of Insertion Energy as Novel Parameter for Dental Implant Stability. J Clin Med 2020; 9:jcm9092977. [PMID: 32942697 PMCID: PMC7565125 DOI: 10.3390/jcm9092977] [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: 08/21/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/17/2022] Open
Abstract
Insertion energy has been advocated as a novel measure for primary implant stability, but the effect of implant length, diameter, or surgical protocol remains unclear. Twenty implants from one specific bone level implant system were placed in layered polyurethane foam measuring maximum insertion torque, torque–time curves, and primary stability using resonance frequency analysis (RFA). Insertion energy was calculated as area under torque–time curve applying the trapezoidal formula. Statistical analysis was based on analysis of variance, Tukey honest differences tests and Pearson’s product moment correlation tests (α = 0.05). Implant stability (p = 0.01) and insertion energy (p < 0.01) differed significantly among groups, while maximum insertion torque did not (p = 0.17). Short implants showed a significant decrease in implant stability (p = 0.01), while reducing implant diameter did not cause any significant effect. Applying the drilling protocol for dense bone resulted in significantly increased insertion energy (p = 0.02) but a significant decrease in implant stability (p = 0.04). Insertion energy was not found to be a more reliable parameter for evaluating primary implant stability when compared to maximum insertion torque and resonance frequency analysis.
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14
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Coyac BR, Salvi G, Leahy B, Li Z, Salmon B, Hoffmann W, Helms JA. A novel system exploits bone debris for implant osseointegration. J Periodontol 2020; 92:716-726. [PMID: 32829495 DOI: 10.1002/jper.20-0099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Bone debris generated during site preparation is generally evacuated with irrigation; here, we evaluated whether retention of this autologous material improved the rate of peri-implant bone formation. METHODS In 25 rats, a miniature implant system composed of an osseo-shaping tool and a tri-oval-shaped implant was compared against a conventional drill and round implant system. A split-mouth design was used, and fresh extraction sockets served as implant sites. Histology/histomorphometry, immunohistochemistry, and microcomputed tomography (μCT) imaging were performed immediately after implant placement, and on post-surgery days 3, 7, 14, and 28. RESULTS Compared with a conventional drill design, the osseo-shaping tool produced a textured osteotomy surface and viable bone debris that was retained in the peri-implant environment. Proliferating osteoprogenitor cells, identified by PCNA and Runx2 expression, contributed to faster peri-implant bone formation. Although all implants osseointegrated, sites prepared with the osseo-shaping tool showed evidence of new peri-implant bone sooner than controls. CONCLUSION Bone debris produced by an osseo-shaping tool directly contributed to faster peri-implant bone formation and implant osseointegration.
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Affiliation(s)
- Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Giuseppe Salvi
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Brian Leahy
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Zhijun Li
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Benjamin Salmon
- Dental Medicine Department, Bretonneau Hospital, Montrouge, France, University of Paris, Paris, France
| | | | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
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15
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Effect of insertion factors on dental implant insertion torque/energy-experimental results. J Mech Behav Biomed Mater 2020; 112:103995. [PMID: 32882675 DOI: 10.1016/j.jmbbm.2020.103995] [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: 04/21/2020] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
Anchorage of dental implants is quantified with a mechanical engagement to insertion, for example maximum insertion torque (MIT) and insertion energy (IE). Good anchorage of dental implants highly correlates to positive clinical outcomes. However, it is still unclear how bone density, drill protocol, surface finish and cutting flute affect anchorage. In this study, effects of the insertion factors on both MIT and IE were investigated using a full-factorial experiment at two levels: bone surrogate density (0.32 g/cm3 versus 0.48 g/cm3), drill protocol (Ø2.4/2.8 versus Ø2.8/3.2 mm), implant surface finish (machined versus anodized surface) and cutting flute (with versus without). Osteotomies were prepared on rigid polyurethane foam blocks with dimensions of 40 × 40 × 8 mm. Screw shaped dental implants with variable tapered body were consecutively inserted into and removed from the polyurethane foam blocks three times under constant axial displacement and rotational speed. Axial force and torque were recorded synchronously. Insertion energy was calculated from the area under the torque-displacement curve. In this study, we found the main insertion mechanics were thread forming for the first insertion. For the second and third insertions, the main mechanics shifted to thread tightening. Maximum insertion torque (MIT) responded differently to the four insertion factors in comparison to IE. Bone surrogate density, drill protocol and surface finish had the largest main effects for first MIT. For the first IE, drill protocol, surface finish and cutting flute were significant contributors. These results suggest that MIT and IE are influenced by different mechanics: the first MIT and the first IE were sensitive to thread tighten and forming, respectively. Together MIT and IE provide a complete assessment of dental implant anchorage.
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16
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Kotsu M, Urbizo Velez J, Bengazi F, Tumedei M, Fujiwara S, Kato S, Botticelli D. Healing at implants installed from ~ 70- to < 10-Ncm insertion torques: an experimental study in dogs. Oral Maxillofac Surg 2020; 25:55-64. [PMID: 32725574 DOI: 10.1007/s10006-020-00890-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate histologically the early healing at implants installed with different insertion torques MATERIAL AND METHODS: Three months after the extraction of the mandibular premolars and of the first molars, two implants were installed monolaterally in the premolar and two in the molar regions of the edentulous alveolar ridge of twelve dogs. The recipient sites were prepared using drills of different diameter to obtain insertion torque of different values, i.e., 30 Ncm (control) or ~ 70 Ncm (test) in the premolar region, and < 10 Ncm (test) or ~ 50 Ncm (control) in the molar region. Six animals were euthanized after 4 weeks and six after 8 weeks of healing. Histological analyses were performed, and the Wilcoxon test was applied for statistical analyses. RESULTS After 4 weeks of healing, in the premolar region, the new bone in contact with the implant surface was 65.0 ± 4.6% and 53.9 ± 13.5% at the ~ 30-Ncm and ~ 70-Ncm sites, respectively (p = 0.075). In the premolar region, new bone proportions were 51.4 ± 17.0% and 67.3 ± 7.0% at the < 10-Ncm and ~ 50-Ncm sites, respectively (p = 0.046). After 8 weeks of healing, in the premolar region, new bone reached fractions of 77.7 ± 16.2% at the ~ 30-Ncm sites, and 68.3 ± 12.1% at the ~ 70-Ncm sites (p = 0.028). In the molar region, new bone presented proportions of 70.2 ± 6.4% at the < 10-Ncm sites and 76.2 ± 9.4% at the ~ 50-Ncm sites (p = 0.173). CONCLUSIONS The insertion torque influenced the osseointegration of implants. Higher values of bone-to-implant contact percentages were registered for insertion torques of ~ 30 Ncm and ~ 50 Ncm. Implants inserted with torque < 10 Ncm became integrated with an optimal osseointegration.
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Affiliation(s)
- Mitsuo Kotsu
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
| | | | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, Havana, Cuba
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | | | - Shingo Kato
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
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17
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Tabassum A, Meijer GJ, Cuijpers VMJI, Frank Walboomers X. Combined effect of undersized surgical technique and axial compression on the primary implant stability and host bone architecture. Saudi Dent J 2020; 33:283-291. [PMID: 34194192 PMCID: PMC8236550 DOI: 10.1016/j.sdentj.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/05/2020] [Accepted: 03/08/2020] [Indexed: 12/11/2022] Open
Abstract
Aim The aim of this study was to investigate the combined effect of the lateral-compression of host-bone (undersized-osteotomy-preparation) and axial-compression of host-bone (not drilling the full length of the implant) on the primary-implant-stability and the host-bone-architecture. Materials and Methods In this experimental-study, 44 dental implants (diameter-4.2 mm; length-10 mm; Dyna®) were installed in the femoral-condyles of four cadaver-goats using four different surgical approaches (11 implant/surgical approach; n = 11). Approach-1: Standard preparation according to the manufacturer's guidelines. The bone-cavity was prepared up to 10 mm in depth and 4 mm in diameter. Approach-2: Preparation up to 8 mm in depth and 4 mm in diameter. Approach-3: Preparation up to 10 mm in depth. Approach-4: The bone-cavity was prepared up to 8 mm in depth and 3.6 mm in diameter. Insertion torque (n = 11), removal torque (n = 7) and % bone-implant contact (n = 4) measurements were recorded. Bone architecture was assessed by micro-computer tomography and histological analysis (n = 4). Results For approaches 2, 3, and 4 (P < .05), insertion-torque values were significantly higher as compared to approach 1. Regarding the bone-implant-contact percentage (%BIC), approach 3 and 4 were significantly higher compared to approach 1 and 2 (P<.05). For approach 2, the %bone volume (%BV) was significantly higher as compared to approach 1 (P<.05) for the most the inner zone of host bone in proximity of the implant. Conclusion Lateral and axial compression improved the primary-implant-stability and therefore this new surgical-technique should be considered as an alternative approach especially for placing implants in low-density bone. Nevertheless, additional in vivo studies should be performed.
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Affiliation(s)
- Afsheen Tabassum
- Department of Preventive Dentistry, Imam Abdulrahman Bin Faisal University, College of Dentistry Dammam, Saudi Arabia
| | - Gert J Meijer
- Department of Implantology & Periodontology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Vincent M J I Cuijpers
- Department of Biomaterials, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - X Frank Walboomers
- Department of Biomaterials, Radboud University Medical Centre, Nijmegen, the Netherlands
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18
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Naghshbandi J. The influence of local and systemic factors upon dental implant osseointegration: A critical review. SAUDI JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.4103/sjos.sjoralsci_79_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Ren L, Pan S, Li H, Li Y, He L, Zhang S, Che J, Niu Y. Effects of aspirin-loaded graphene oxide coating of a titanium surface on proliferation and osteogenic differentiation of MC3T3-E1 cells. Sci Rep 2018; 8:15143. [PMID: 30310118 PMCID: PMC6181949 DOI: 10.1038/s41598-018-33353-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Abstract
Graphene oxide (GO) has attracted considerable attention for biomedical applications such as drug delivery because of its two-dimensional structure, which provides a large surface area on both sides of the nanosheet. Here, a new method for titanium (Ti) surface modification involving a GO coating and aspirin (A) loading (A/Ti-GO) was developed, and the bioactive effects on mouse osteoblastic MC3T3-E1 cells were preliminarily studied. The X-ray photoelectron spectrometry indicated new C-O-N, C-Si-O-C, and C-N=C bond formation upon GO coating. Remarkably, the torsion test results showed stable bonding between the GO coating and Ti under a torsional shear force found in clinical settings, in that, there was no tearing or falling off of GO coating from the sample surface. More importantly, through π-π stacking interactions, the release of aspirin loaded on the surface of Ti-GO could sustain for 3 days. Furthermore, the A/Ti-GO surface displayed a significantly higher proliferation rate and differentiation of MC3T3-E1 cells into osteoblasts, which was confirmed by a water-soluble tetrazolium salt-8 (WST-8) assay and alkaline phosphatase activity test. Consequently, Ti surface modification involving GO coating and aspirin loading might be a useful contribution to improve the success rate of Ti implants in patients, especially in bone conditions.
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Affiliation(s)
- Liping Ren
- Department of Prosthodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Shuang Pan
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China.,Oral Biomedical Research institute of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Haiqing Li
- Department of Stomatology, Hospital of Heilongjiang Province, No. 82 Zhongshan Street, Xiangfang District, Harbin, 150036, China
| | - Yanping Li
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Lina He
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Shuang Zhang
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Jingyi Che
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China. .,Oral Biomedical Research institute of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China.
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20
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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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21
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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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22
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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: 16] [Impact Index Per Article: 2.7] [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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Marheineke N, Scherer U, Rücker M, von See C, Rahlf B, Gellrich NC, Stoetzer M. Evaluation of accuracy in implant site preparation performed in single- or multi-step drilling procedures. Clin Oral Investig 2017; 22:2057-2067. [DOI: 10.1007/s00784-017-2312-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/12/2017] [Indexed: 01/06/2023]
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24
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Sierra-Rebolledo A, Allais-Leon M, Maurette-OʼBrien P, Gay-Escoda C. Primary Apical Stability of Tapered Implants Through Reduction of Final Drilling Dimensions in Different Bone Density Models: A Biomechanical Study. IMPLANT DENT 2017; 25:775-782. [PMID: 27540846 DOI: 10.1097/id.0000000000000479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE A biomechanical study of the primary apical stability obtained in tapered implants through the reduction of final drilling dimensions in different bone density models. MATERIAL AND METHODS An in vitro study of maximum insertion torque and primary stability based on the resonance frequency analysis (RFA) of 24 conical implants measuring 13 mm in length and 3.75 and 4.20 mm in diameter, randomly inserted in 10-mm sockets prepared in 4 polyurethane blocks with a density of 15, 20, 30, and 40 pounds per cu ft, respectively, reducing the diameter of the final drill at constant speed (400 rpm) to obtain exclusive 4 mm anchoring of the apical third of each implant. RESULTS The decrease in drilling diameter resulted in an increase in the insertion torque and implant stability quotient (ISQ) values in all implants, although without reaching statistical significance. In turn, a significant direct correlation was found between increasing bone analog block density and the insertion torque and ISQ values. CONCLUSIONS Under the conditions of this study, the primary apical stability obtained may be more dependent on bone density than on reduction of the final drilling diameter.
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Affiliation(s)
- Alejandro Sierra-Rebolledo
- *Associate Professor of Oral Surgery and Implantology and Biotechnology Coordinator of Unit of Morphopathological Research, University of Carabobo Dental School, Valencia, Venezuela. †Professor-in-Chief of Oral and Maxillofacial Surgery, Santa Maria University Dental School, Caracas, Venezuela. ‡Assistant Professor of Oral and Maxillofacial Surgery and Dental Research, Dr. Raul Vicentelli Institute, Central of Venezuela Dental School, Caracas, Venezuela. §Cathedratic of Oral and Maxillofacial Surgical Pathology, Chairman of Oral and Maxillofacial Surgery, University of Barcelona Dental School; Coordinator of the Research Group of Maxillofacial Pathology and Dental Therapeutics, IDIBELL, Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, TEKNON Medical Center, Barcelona, Spain
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The Effect of Osteotomy Dimension on Implant Insertion Torque, Healing Mode, and Osseointegration Indicators: A Study in Dogs. IMPLANT DENT 2017; 25:739-743. [PMID: 27513163 DOI: 10.1097/id.0000000000000476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the effect of the osteotomy diameter for implant placement torque and its effect on the osseointegration. MATERIALS AND METHODS Eight male beagle dogs received 48 implants (3.75 mm × 10 mm) in their right and left radius, 3 implants per side and allowed to heal for 3 weeks. Three experimental groups were evaluated. Group 1: implant with an undersized osteotomy of 3.0 mm; group 2: osteotomy of 3.25 mm, and group 3: osteotomy of 3.5 mm. The insertion torque was recorded for all implants. Histological sectioning and histometric analysis were performed evaluating bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS Implants of group 1 presented statistically higher insertion torque than those of groups 2 and 3 (P < 0.01). No differences in BIC or BAFO were observed between the groups. From a morphologic standpoint, substantial deviations in healing mode were observed between groups. CONCLUSION Based on the present methodology, the experimental alterations of surgical technic can be clinically used with no detrimental effect over the osseointegration process.
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Piezoelectric Trapezoidal Osteotomy for the Retrieval of a Displaced Dental Implant in the Osteoporotic Mandibular Body. IMPLANT DENT 2017; 25:703-6. [PMID: 27571351 DOI: 10.1097/id.0000000000000464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A female patient in her mid-seventies was referred to our department for the removal of a displaced implant within the right posterior mandible. A trapezoidal window was made using a piezoelectric device. The implant was extracted, and the osteotomized window was replaced without fixation. Caution should be exercised during implant placement in patients with osteoporosis because of the risk of implant displacement. Displaced implants can be easily retrieved by piezoelectric trapezoidal osteotomy.
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The Effects of High Insertion Torque Versus Low Insertion Torque on Marginal Bone Resorption and Implant Failure Rates: A Systematic Review With Meta-Analyses. IMPLANT DENT 2017; 25:532-40. [PMID: 27129002 DOI: 10.1097/id.0000000000000422] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVES The aim was to analyze the data about the effects on marginal bone resorption and implant failure rates between implants inserted with high or low insertion torque values. MATERIALS AND METHODS A systematic literature search until July 2015 was conducted. Data were summarized qualitatively in descriptive tables and quantitatively by performing random effects meta-analyses of effect sizes (ESs) for bone resorption and bone-to-implant contact (BIC) and relative risks (RRs) for implant failures. Risk of bias assessments were performed using the Cochrane tool for human studies and the SYRCLE's tool for animal studies. RESULTS Four studies in humans and 6 quasirandomized animal studies were included. A total of 591 implants were evaluated qualitatively: 348 installed with high insertion torque (>25 Ncm, up to 176 Ncm) and 243 implants inserted with low torque values (<30-35 Ncm). No significant differences were detected for bone resorption (ES, 0.13; 95% confidence interval [CI], -0.12 to 0.38 in human studies; ES predictive interval from 35.03 to 34.50 in animal studies), implant failure (RR, 0.39; 95% CI, 0.01-20.77 in human studies; RR, 2.05; 95% CI, 0.19-21.71 in animal studies), or BIC (ES predictive interval from -3.84 to 5.13 in animal studies). CONCLUSION The current review indicated that there is no significant difference in marginal bone resorption and implant failure rate between implants inserted with high or low insertion torque values.
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New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep. IMPLANT DENT 2017; 25:24-31. [PMID: 26584202 PMCID: PMC4770273 DOI: 10.1097/id.0000000000000358] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate a new surgical technique for implant site preparation that could allow to enhance bone density, ridge width, and implant secondary stability. MATERIALS AND METHODS The edges of the iliac crests of 2 sheep were exposed and ten 3.8 × 10-mm Dynamix implants (Cortex) were inserted in the left sides using the conventional drilling method (control group). Ten 5 × 10-mm Dynamix implants (Cortex) were inserted in the right sides (test group) using the osseodensification procedure (Versah). After 2 months of healing, the sheep were killed, and biomechanical and histological examinations were performed. RESULTS No implant failures were observed after 2 months of healing. A significant increase of ridge width and bone volume percentage (%BV) (approximately 30% higher) was detected in the test group. Significantly better removal torque values and micromotion under lateral forces (value of actual micromotion) were recorded for the test group in respect with the control group. CONCLUSION Osseodensification technique used in the present in vivo study was demonstrated to be able to increase the %BV around dental implants inserted in low-density bone in respect to conventional implant drilling techniques, which may play a role in enhancing implant stability and reduce micromotion.
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Cohen O, Ormianer Z, Tal H, Rothamel D, Weinreb M, Moses O. Differences in crestal bone-to-implant contact following an under-drilling compared to an over-drilling protocol. A study in the rabbit tibia. Clin Oral Investig 2016; 20:2475-2480. [PMID: 26931772 DOI: 10.1007/s00784-016-1765-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The objective of this study is to compare bone-to-implant contact (BIC) between implants inserted at high torque due to under-drilling of the crestal bone to those inserted at low torque due to over-drilling of the crestal bone. MATERIALS AND METHODS Forty implants with diameters of 3.75 mm (group A) or 3.55 mm (group B) were inserted in the proximal tibiae of NZW rabbits in two separate surgeries on day 0 or 21. Osteotomy of the crestal bone was finalized with a 3.65-mm drill. In group A, implants were inserted at torque ≥35 Ncm (under-drilling) and in group B with torque <10 Ncm (over-drilling). Implants and their surrounding bone were retrieved on day 42, thus creating 3- and 6-week observation periods, processed for non-decalcified histology and stained with toluidine blue. Crestal BIC (c-BIC) and total BIC (t-BIC) were measured. Wilcoxon test was used to evaluate differences between groups. RESULTS Three weeks post-surgery, the mean c-BIC in group A was 16.3 ± 3.3 vs 31.5 ± 3.4 % in group B (P < 0.05). At 6 weeks, a similar trend was observed (group A: 28.7 ± 3.6 %; group B: 38.4 ± 4.9 %) (P > 0.05). No differences in t-BIC were noted at 3 weeks and at 6 weeks between the groups. CONCLUSIONS Insertion of implants with an over-drilling protocol of the crestal aspect of the osteotomy resulted in increased short-term crestal bone-to-implant contact. CLINICAL RELEVANCE Insertion of implants with a high torque following an under-drilling protocol, commonly used for immediate loading, may reduce crestal bone-to-implant contact at early healing stages.
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Affiliation(s)
- Omer Cohen
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Zeev Ormianer
- Department of Oral Rehabilitation, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Tal
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Rothamel
- Department of Oral and Maxillo-facial Plastic Surgery, University of Cologne, Cologne, Germany
| | - Miron Weinreb
- Department of Oral Biology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Moses
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. Validation of value of actual micromotion as a direct measure of implant micromobility after healing (secondary implant stability). An in vivo
histologic and biomechanical study. Clin Oral Implants Res 2016; 27:1423-1430. [DOI: 10.1111/clr.12756] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Paolo Trisi
- Biomaterial Clinical Research Association; Pescara Italy
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Baires-Campos FE, Jimbo R, Bonfante EA, Fonseca-Oliveira MT, Moura C, Zanetta-Barbosa D, Coelho PG. Drilling dimension effects in early stages of osseointegration and implant stability in a canine model. Med Oral Patol Oral Cir Bucal 2015; 20:e471-9. [PMID: 25858087 PMCID: PMC4523249 DOI: 10.4317/medoral.20557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 02/21/2015] [Indexed: 11/21/2022] Open
Abstract
Background This study histologically evaluated two implant designs: a classic thread design versus another specifically designed for healing chamber formation placed with two drilling protocols. Material and Methods Forty dental implants (4.1 mm diameter) with two different macrogeometries were inserted in the tibia of 10 Beagle dogs, and maximum insertion torque was recorded. Drilling techniques were: until 3.75 mm (regular-group); and until 4.0 mm diameter (overdrilling-group) for both implant designs. At 2 and 4 weeks, samples were retrieved and processed for histomorphometric analysis. For torque and BIC (bone-to-implant contact) and BAFO (bone area fraction occupied), a general-linear model was employed including instrumentation technique and time in vivo as independent. Results The insertion torque recorded for each implant design and drilling group significantly decreased as a function of increasing drilling diameter for both implant designs (p<0.001). No significant differences were detected between implant designs for each drilling technique (p>0.18). A significant increase in BIC was observed from 2 to 4 weeks for both implants placed with the overdrilling technique (p<0.03) only, but not for those placed in the 3.75 mm drilling sites (p>0.32). Conclusions Despite the differences between implant designs and drilling technique an intramembranous-like healing mode with newly formed woven bone prevailed. Key words:
Histomorphometry, biomechanical, in vivo, initial stability, insertion torque, osseointegration.
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Assessment of the Correlation between the Implant Distance and Primary Stability by Resonance Frequency Analysis. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/568715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. The aim of this study was to assess the influence of the interimplant distance on the implant primary stability (ISQ) by Resonance Frequency Analysis (RFA). Method. Forty-five implants were placed in the mandible of human cadavers and 108 in artificial bone substrates in the form of polyurethane foam blocks. Primary implant stability was successively measured first by RFA immediately after the placement of the first implant (A) and then after two other implants (B and C) proximal and distal to the first implant. The interimplant distances were defined from 1 to 6 mm and the three primary stability values measured were compared. Results. On the mandibles, no correlation was observed between the interimplant distances and primary stability. On the polyurethane foam block, the primary stability of implant A increased significantly (p<0.001) after the placement of implant B but remained constant after placement of implant C. Conclusion. Reducing the interimplant distance does not affect the primary stability on dry bone or artificial substrate.
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Osseointegration of Plateau Root Form Implants: Unique Healing Pathway Leading to Haversian-Like Long-Term Morphology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 881:111-28. [PMID: 26545747 DOI: 10.1007/978-3-319-22345-2_7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Endosteal dental implants have been utilized as anchors for dental and orthopedic rehabilitations for decades with one of the highest treatment success rates in medicine. Such success is due to the phenomenon of osseointegration where after the implant surgical placement, bone healing results into an intimate contact between bone and implant surface. While osseointegration is an established phenomenon, the route which osseointegration occurs around endosteal implants is related to various implant design factors including surgical instrumentation and implant macro, micro, and nanometer scale geometry. In an implant system where void spaces (healing chambers) are present between the implant and bone immediately after placement, its inherent bone healing pathway results in unique opportunities to accelerate the osseointegration phenomenon at the short-term and its maintenance on the long-term through a haversian-like bone morphology and mechanical properties.
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Coelho PG, Jimbo R. Osseointegration of metallic devices: Current trends based on implant hardware design. Arch Biochem Biophys 2014; 561:99-108. [DOI: 10.1016/j.abb.2014.06.033] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 12/18/2022]
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Implants Placed Simultaneously With Lateral Window Sinus Augmentation Using a Putty Alloplastic Bone Substitute for Increased Primary Implant Stability. IMPLANT DENT 2014; 23:496-501. [DOI: 10.1097/id.0000000000000117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calvo-Guirado JL, Delgado-Peña J, Maté-Sánchez JE, Mareque Bueno J, Delgado-Ruiz RA, Romanos GE. Novel hybrid drilling protocol: evaluation for the implant healing--thermal changes, crestal bone loss, and bone-to-implant contact. Clin Oral Implants Res 2014; 26:753-60. [PMID: 24502654 DOI: 10.1111/clr.12341] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo. MATERIALS AND METHODS Temperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10 mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P2, P3, P4, and first molar M1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75 mm diameter and 10 mm length were inserted. The dogs were euthanized at 30 and 90 days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated. RESULTS The control group showed maximum temperatures of 35.3 °C ± 1.8 °C, ΔT of 10.4 °C, and a mean time of 100 s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 °C ± 1.2 °C, ΔT of 8.1 °C, and a mean time of 240 s/procedure. After 30 days, CBL values for both groups (test: 1.168 ± 0.194 mm; control: 1.181 ± 0.113 mm) and BIC values (test: 43 ± 2.8%; control: 45 ± 1.3%) were similar, without significant differences (P > 0.05). After 90 days, CBL (test: 1.173 ± 0.187 mm; control: 1.205 ± 0.122 mm) and BIC (test: 64 ± 3.3%; control: 64 ± 2.4%) values were similar, without significant differences (P > 0.05). The BIC values were increased at 90 days in both groups compared with the 30-day period (P < 0.05). CONCLUSIONS Within the limitations of this study, the new hybrid protocol for the preparation of the implant bed without irrigation, increase the temperature similarly to the incremental conventional protocol, and requires twice the time for the completion of the drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo.
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Duyck J, Roesems R, Cardoso MV, Ogawa T, De Villa Camargos G, Vandamme K. Effect of insertion torque on titanium implant osseointegration: an animal experimental study. Clin Oral Implants Res 2013; 26:191-6. [PMID: 24325598 DOI: 10.1111/clr.12316] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2013] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the effect of implant insertion torque on the peri-implant bone healing and implant osseointegration. MATERIAL AND METHODS Bilaterally in the tibia of five adult New Zealand white rabbits, 20 implants were installed, subdivided into four groups, corresponding to two insertion torque conditions (low, < 10 Ncm vs. high > 50 Ncm) and 2 experimental periods (2 weeks vs. 4 weeks of healing). The implant insertion torque was determined by the surgical drill diameter relative to the implant diameter. Implant osseointegration was evaluated by quantitative histology (bone-to-implant contact with host bone [BIC-host], with neoformed bone [BIC-de novo], with both bone types [BIC-total], and peri-implant bone [BA/TA]). Every response was modelled over time using GEE (general estimation equation) with an unstructured variance-covariance matrix to correct for dependency between the measurements from one animal. The statistical significance level of α = 0.05 was applied. RESULTS Significantly, more BIC-host and BIC-total were recorded for H implants compared with L implants after 2 week of healing (P = 0.010 and P = 0.0001, respectively). However, this result was no longer found for the extended healing period. Furthermore, BIC-total significantly increased over time for L implants (P < 0.00001). In contrast, the significant increase in BA/TA over time was found for H implants (P < 0.01). Finally, H insertion torque led to an increased BA/TA after 4 week of healing (P < 0.02) compared with the L insertion protocol. CONCLUSION L insertion torque implants installed in the rabbit tibial bone osseointegrate with considerable de novo bone formation. This bone neoformation enables L implants to catch up, already during the early osseointegration stage, the initial inferior amount BIC contact compared with that of H implants. A negative impact of the created strain environment accompanying H insertion torque implant installation on the biological process of osseointegration could not be observed, at least not at tissue level.
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Affiliation(s)
- Joke Duyck
- Department of Oral Health Sciences & Dental Clinic, KU Leuven & University Hospitals Leuven, BIOMAT KU Leuven & Prosthetics Unit, Leuven, Belgium
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Jimbo R, Janal MN, Marin C, Giro G, Tovar N, Coelho PG. The effect of implant diameter on osseointegration utilizing simplified drilling protocols. Clin Oral Implants Res 2013; 25:1295-1300. [PMID: 25040139 DOI: 10.1111/clr.12268] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To observe and to compare histologically and histomorphometrically, the combined effect of drilling sequence and implant diameter in vivo. MATERIAL AND METHODS A total of 72 alumina-blasted and acid-etched Ti-6Al-4V implants with three different diameters (3.75, 4.2, and 5 mm, n = 24 for each group) were placed in the right and left tibiae of 12 beagle dogs. Within the same diameter group, half of the implants were inserted after a simplified drilling procedure (pilot drill + final diameter drill) on one tibia and the other half were placed using the conventional drilling procedure on the other tibia. After 1 week, half of the animals (n = 6) were sacrificed, and the other half was sacrificed after 5 weeks (n = 6). The retrieved bone-implant samples were subjected to non-decalcified histologic sectioning, and the bone-to-implant contact (BIC) and the bone area fraction occupancy (BAFO) were analyzed. Primary statistical analysis used a mixed model analysis of variance with significance level set at P < 0.05. RESULTS Histologic observation showed that at 1 week, immature woven bone formed in vicinity of the implant, whereas at 5 weeks, the woven bone was replaced by lamellar bone, which formed in proximity with the implant. Histomorphometrically, the simplified technique was associated with significantly greater BIC and BAFO after 1 week. Differences between techniques were not longer apparent after 5 weeks, but BAFO was inversely and significantly associated with implant diameter at that time. CONCLUSIONS The simplified technique did not impair either early or late bone formation for any tested implant diameter; however, wider diameters were associated with less bone formation at longer healing times for both techniques.
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Affiliation(s)
- Ryo Jimbo
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, New York University, New York, NY, USA
| | - Charles Marin
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, Universidade Federal de Santa Catarina, Brazil
| | - Gabriela Giro
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
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