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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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Gomes C, Mesnard M, Ramos A. Bone density and proximal support effects on dental implant stability - Finite element analysis and in vitro experiments. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101512. [PMID: 37209971 DOI: 10.1016/j.jormas.2023.101512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/19/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES The application of dental implants presents the occurrence of implant failures associated with bone proximal support. This study aims to assess implant behavior, in particular implant stability and strain distribution in the bone at different bone densities, and the effect of proximal bone support. MATERIAL AND METHODS Three bone densities (D20, D15, and D10) were considered in the experimental in vitro study, represented by solid rigid polyurethane foam and two conditions of bone support in the proximal region. A finite element model was developed and validated experimentally and a Branemark model at a 3:1 scale was implanted in the experiments; the model was loaded and extracted. RESULTS The results of the experimental models validate the finite element models with a correlation R2 equal to 0.899 and NMSE of 7%. The implant extraction tests for the effect of bone properties in the maximum load were 2832 N for D20 and 792 N for D10. The effect of proximal bone support changes the implant stability was observed experimentally; at 1 mm less bone support decreases by 20% of stability and at 2 mm by 58% for D15 density. CONCLUSIONS Bone properties and bone quantity are important for the initial stability of the implant. A bone volume fraction of less than 24 g/cm3 exhibits poor behavior and is not indicated for implantation. Proximal bone support reduces the primary stability of the implant and the effect is critical in lower bone density.
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Affiliation(s)
- C Gomes
- University of Aveiro, Biomechanics Research Group, Department of Mechanical Engineering, Aveiro 3810-193, Portugal
| | - M Mesnard
- University de Bordeaux, Institut de Mécanique et d'Ingénierie, Department Ingénierie Mécanique et Conception, CNRS UMR 5295, Talence 33405, France
| | - A Ramos
- University of Aveiro, Biomechanics Research Group, Department of Mechanical Engineering, Aveiro 3810-193, Portugal.
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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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Insertion Torque, Removal Torque, and Resonance Frequency Analysis Values of Ultrashort, Short, and Standard Dental Implants: An In Vitro Study on Polyurethane Foam Sheets. J Funct Biomater 2022; 14:jfb14010010. [PMID: 36662057 PMCID: PMC9866818 DOI: 10.3390/jfb14010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Short implants were introduced to reduce morbidity, treatment duration, and complex bone regeneration interventions in atrophic jaws and to improve patient-reported outcomes. This study aimed to determine the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values of ultrashort (3 mm length), short (7 mm length), and standard implants (10 mm length) inserted in 1-, 2-, 3-, and 4-mm thickness polyurethane sheets with densities of 10, 20, and 30 pounds per cubic foot (PCF). Standard-length implants were the gold standard (control). Overall, short-length implant IT values were higher or similar to the control in most experimental conditions. Those inserted into a 3 mm/30 PCF lamina showed the highest IT values, whereas 5 mm diameter ultrashort-length implants inserted into 2 and 3 mm/20 PCF laminas were higher than other implants. RT values followed the same trend and RFA values were more appreciable in short- and standard-length implants in all the scenarios. However, ultrashort-length implants reached a primary stability comparable to that of standard implants in lower thicknesses. In conclusion, although further studies are needed to corroborate this in vitro model with preclinical and clinical studies, our data shed light on short- and ultrashort-length implants geometries to a potential application in critical atrophy of the posterior jaws.
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Fixture Length and Primary Stability: An In Vitro Study on Polyurethane Foam. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
(1) Background: Recently, novel dental implants that are characterized by different levels of surface roughness in the distinct parts of the fixture’s body have been introduced in the market. These surface characteristics could affect the primary stability of the implants. The aim of this in vitro study was to compare the primary stability of short and long implants, characterized by multiscale surface roughness, inserted on polyurethane blocks. The secondary aim was to understand if the implant length could be a crucial factor in the decision-making in immediate or rather than delayed loading protocol in the different bone densities. (2) Methods: A total of 20 cylindrical dental implants with a diameter of 5.0 mm were tested for the lengths 6.0 mm (short implants) versus 13.0 mm (long implants) on two different solid rigid polyurethane blocks (20 and 30 PCF). The primary stability was evaluated by measuring the insertion torque value (ITV), the removal torque (RTV), and the resonance frequency analysis RFA. (3) Results: The values of ITV, RTV, and RFA showed the same trend in all measurements. Long implants showed a significantly higher primary stability on 30 PCF blocks that present mechanical properties similar to high-density bone. On the contrary, no relevant differences were found on 20 PCF blocks, which mimic trabecular bone density. (4) Conclusions: The impact of fixture length on the primary stability of implants with multiscale surface roughness is significant in 30 PCF polyurethane corresponding to higher bone density, but not in lower ones.
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Petrini M, Pierfelice TV, D’Amico E, Di Pietro N, Pandolfi A, D’Arcangelo C, De Angelis F, Mandatori D, Schiavone V, Piattelli A, Iezzi G. Influence of Nano, Micro, and Macro Topography of Dental Implant Surfaces on Human Gingival Fibroblasts. Int J Mol Sci 2021; 22:9871. [PMID: 34576038 PMCID: PMC8464951 DOI: 10.3390/ijms22189871] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023] Open
Abstract
Current research on dental implants has mainly focused on the influence of surface roughness on the rate of osseointegration, while studies on the development of surfaces to also improve the interaction of peri-implant soft tissues are lacking. To this end, the first purpose of this study was to evaluate the response of human gingival fibroblasts (hGDFs) to titanium implant discs (Implacil De Bortoli, Brazil) having different micro and nano-topography: machined (Ti-M) versus sandblasted/double-etched (Ti-S). The secondary aim was to investigate the effect of the macrogeometry of the discs on cells: linear-like (Ti-L) versus wave-like (Ti-W) surfaces. The atomic force microscopy (AFM) and scanning electron microscopy (SEM) analysis showed that the Ti-S surfaces were characterized by a significantly higher micro and nano roughness and showed the 3D macrotopography of Ti-L and Ti-W surfaces. For in vitro analyses, the hGDFs were seeded into titanium discs and analyzed at 1, 3, and 5 days for adhesion and morphology (SEM) viability and proliferation (Cck-8 and MTT assays). The results showed that all tested surfaces were not cytotoxic for the hGDFs, rather the nano-micro and macro topography favored their proliferation in a time-dependent manner. Especially, at 3 and 5 days, the number of cells on Ti-L was higher than on other surfaces, including Ti-W surfaces. In conclusion, although further studies are needed, our in vitro data proved that the use of implant discs with Ti-S surfaces promotes the adhesion and proliferation of gingival fibroblasts, suggesting their use for in vivo applications.
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Affiliation(s)
- Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
| | - Emira D’Amico
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d’Annunzio of Chieti-Pescara, 66013 Chieti, Italy
| | - Assunta Pandolfi
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d’Annunzio of Chieti-Pescara, 66013 Chieti, Italy
| | - Camillo D’Arcangelo
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
| | - Francesco De Angelis
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
| | - Domitilla Mandatori
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d’Annunzio of Chieti-Pescara, 66013 Chieti, Italy
| | - Valeria Schiavone
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d’Annunzio of Chieti-Pescara, 66013 Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
- Research Center Fondazione Villa Serena per la Ricerca, 65013 Città Sant’Angelo, Italy
- Clinical Center, Casa di Cura Villa Serena del dott. L. Petruzzi, 65013 Città Sant’Angelo, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy; (M.P.); (T.V.P.); (E.D.); (A.P.); (C.D.); (F.D.A.); (D.M.); (V.S.); (A.P.); (G.I.)
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