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Exploring the Importance of Corticalization Occurring in Alveolar Bone Surrounding a Dental Implant. J Clin Med 2022; 11:jcm11237189. [PMID: 36498764 PMCID: PMC9738071 DOI: 10.3390/jcm11237189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Several measures describing the transformation of trabecular bone to cortical bone on the basis of analysis of intraoral radiographs are known (including bone index or corticalization index, CI). At the same time, it has been noted that after functional loading of dental implants such transformations occur in the bone directly adjacent to the fixture. Intuitively, it seems that this is a process conducive to the long-term maintenance of dental implants and certainly necessary when immediate loading is applied. The authors examined the relationship of implant design features to marginal bone loss (MBL) and the intensity of corticalization over a 10-year period of functional loading. This study is a general description of the phenomenon of peri-implant bone corticalization and an attempt to interpret this phenomenon to achieve success of implant treatment in the long term. Corticalization significantly increased over the first 5-year functional loading (CI from 200 ± 146 initially to 282 ± 182, p < 0.001) and maintained a high level (CI = 261 ± 168) in the 10-year study relative to the reference bone (149 ± 178). MBL significantly increased throughout the follow-up period—5 years: 0.83 ± 1.26 mm (p < 0.001), 10 years: 1.48 ± 2.01 mm (p < 0.001). MBL and radiographic bone structure (CI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. In the scope of the study, it can be concluded that the phenomenon of peri-implant jawbone corticalization seems an unfavorable condition for the future fate of bone-anchored implants, but it requires further research to fully explain the significance of this phenomenon.
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Gershov S, Xie J, Shah FA, Shemtov-Yona K, Rittel D. Modelling the resonant frequency associated with the spatio-temporal evolution of the bone-dental implant interface. Acta Biomater 2022; 154:302-311. [PMID: 36306984 DOI: 10.1016/j.actbio.2022.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023]
Abstract
Dental implant stability is greatly affected by the mechanical properties of the bone-implant interface (BII), and it is key to long-term successful osseointegration. Implant stability is often evaluated using the Resonant Frequency Analysis (RFA) method, and also by the quality of this interface, namely the bone-implant contact (BIC). True to this day, there is a scarcity of models tying BIC, RFA and a spatially and mechanically evolving BII. In this paper, based on the contact/distance osteogenesis concept, a novel numerical spatio-temporal model of the implant, surrounding bone and evolving interface, was developed to assess the evolution of the interfacial stresses on the one hand and the corresponding resonant frequencies on the other. We postulate that, since the BIC percentage reaches saturation over a very short time, long before densification of the interface, it becomes irrelevant as to load transmission between the implant and the bone due to the existence of an open gap. Gap closure is the factor that provides continuity between the implant and the surrounding bone. The results of the calculated RFA evolution match and provide an explanation for the multiple clinical observations of a sharp initial decline in RFA, followed by a gradual increase and plateau formation. STATEMENT OF SIGNIFICANCE: A novel three-dimensional numerical model of an evolving bone-dental implant interface (BII) is presented. The spatio-temporal evolution of the bone-implant contact (BIC) and the BII, based on contact/distance (CO/DO) osteogenesis, is modeled. A central outcome is that, until BII maturation into a solid continuous bone (no open gap between CO-DO fronts), the bone-implant load transfer is hampered, irrespective of the BIC. The resonant frequencies' evolution of the jawbone-BII-implant is calculated to reproduce the well-established implant stability analysis based on the Resonant Frequency Analysis. The results resemble those reported clinically, and here too, the determinant transition occurs only after interfacial gap closure. Those results should motivate clinicians to re-consider structural continuity of the BII rather than the BIC only.
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Affiliation(s)
- Sapir Gershov
- Technion Autonomous Systems Program, Technion - Israel Institute of Technology, Haifa 32000, Israel.
| | - Jing Xie
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Furqan A Shah
- Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Keren Shemtov-Yona
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel; The Maurice and Gabriela Goldschleger School of Dental Medicine, Department of Oral Biology, Tel Aviv University, Tel Aviv 39040, Israel
| | - Daniel Rittel
- Faculty of Mechanical Engineering, Technion - Israel Institute of Technology, Haifa 32000, Israel
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Arya G, Kumar V. Evaluation of osseintegration between traditional and modified hydrophilic titanium dental implants - Systematic analysis. Natl J Maxillofac Surg 2020; 11:176-181. [PMID: 33897177 PMCID: PMC8051648 DOI: 10.4103/njms.njms_44_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/19/2020] [Accepted: 07/04/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of the study was to conduct a systematic review to access the osseointegration between traditional and modified Hydrophilic Titanium Dental Implants for period of 10 years. PUBMed articles were searched from last ten years up to 15/12/2019 from which 24 studies included in this review. This systematic review compiles the data about osseintegration in hydrophilic titanium implants in human trials. It sheds light on the mechanism of integration of hydrophilic surfaces and numeric data to support the purpose of the review.
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Affiliation(s)
- Geeta Arya
- Department of Prosthodontics and Oral Implantology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Varun Kumar
- Department of Prosthodontics and Oral Implantology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
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Tumedei M, Piattelli A, Degidi M, Mangano C, Iezzi G. A Narrative Review of the Histological and Histomorphometrical Evaluation of the Peri-Implant Bone in Loaded and Unloaded Dental Implants. A 30-Year Experience (1988-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062088. [PMID: 32245226 PMCID: PMC7143607 DOI: 10.3390/ijerph17062088] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
Background: The aim of the present review was to assess the histological and histomorphometrical data from the paper published by our Laboratory on peri-implant bone in dental implants in different loading conditions. Methods: The papers published in different implant loading conditions, in dental implants retrieved from humans, and in the Hard Tissues Research Center of the University of Chieti-Pescara, Italy, were screened on MEDLINE/PubMed, Embase, Scopus, and other electronic databases until 31 December 2018. Only articles that reported the histological and histomorphometrical values of the Bone-Implant Contact (BIC) were selected. Results: The system selection provided a total of 155 papers. The manuscripts included for the narrative review were 57. These papers provided histological and histomorphometrical data. Conclusions: The bone remodeling around dental implants was found to be a dynamic process; loading changed the microstructure of the peri-implant bone; and implants were found to provide a successful function, over several decades, with different range of degrees of BIC in vivo (varying from a little more than 30% to a little more than 90%). Loaded implants presented a 10%-12% higher BIC values when compared to submerged, unloaded implants, and rougher surfaces had, on average, about a 10% higher BIC than machined surfaces.
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Affiliation(s)
- Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
- Correspondence: ; Tel.: +39-0871-3554083
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
- Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Av. de los Jerónimos, Guadalupe, 135 30107 Murcia, Spain
- Fondazione Villaserena per la Ricerca, 65121 Città Sant’Angelo (Pescara), Italy
| | | | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.P.); (G.I.)
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Cesaretti G, Lang NP, Viganò P, Bengazi F, Apaza Alccayhuaman KA, Botticelli D. Immediate and delayed loading of fixed dental prostheses supported by single or two splinted implants: A histomorphometric study in dogs. J Oral Rehabil 2018; 45:308-316. [PMID: 29385632 DOI: 10.1111/joor.12612] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 11/29/2022]
Abstract
To evaluate presumptive differences in osseointegration at implants supporting crowns that are physiologically loaded either immediately or 3 months after installation. All premolars and first molars were extracted bilaterally in six dogs. After 3 months of healing, three implants were installed on the premolar region and two in the molar region in one side of the mandible. Likewise, after another 3 months, five implants were installed in the contralateral side, and impressions were taken bilaterally. Within 48 hours, two single crowns were screwed bilaterally onto two implants in the premolar region, and two splinted crowns reproducing the shape of the first molar were screwed bilaterally onto the implants in the molar region. The mesial implants were used as no-loaded controls. Sacrifices were performed after 3 months, and histological analyses were performed. At the premolar sites, mineralised bone-to-implant contact (MBIC%) was 78.0 ± 4.0% and 70.9 ± 7.9% at the delayed and immediately loaded sites, respectively. This difference was statistically significant. At the control implants, MBIC% was 61.4 ± 14.7% and 63.1 ± 13.1% at the delayed and the immediately loaded sites, respectively. At the molar sites, MBIC% was 79.2 ± 10.9% and 61.1 ± 10.3% at the delayed and immediately loaded sites, respectively. Applying a delayed loading to fixed dental prostheses supported by single or two splinted implants yielded higher proportions of bone-to-implant contact (osseointegration) compared to immediately loaded implants. Moreover, both types of loading protocols yielded a higher rate of osseointegration compared to unloaded implant sites after 3 months following implant installation.
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Affiliation(s)
| | - N P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | | | - F Bengazi
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | - D Botticelli
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
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Anatomical Remodeling of Buccal Bone Plate in 35 Premaxillary Post-Extraction Immediately Restored Single TPS Implants: 10-Year Radiographic Investigation. IMPLANT DENT 2016; 25:186-92. [PMID: 26836125 DOI: 10.1097/id.0000000000000375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The anatomical remodeling technique (ART) was proposed to place postextraction implants with the aid of specific osteotomes. This study is a clinical and radiographic evaluation with 10-year follow-up of anterior postextraction single implants placed with the ART and immediately restored. MATERIALS AND METHODS Thirty-five patients, with a hopeless tooth in the anterior maxilla, were included in the study and 35 implants were inserted according to the ART. Clinical and radiographic evaluations were performed at baseline (T0), after 6 (T1) and 14 months (T2), 4 years after surgery (T3) and every other year up to the 10-year follow-up (T4, T5, and T6). Implant success, survival, and failure rates were evaluated according to the International Congress of Oral Implantologists Pisa Consensus Conference criteria. RESULTS Twenty-nine patients and 29 implants were available for the 10-year data analysis. After 10 years, the accumulated mean marginal bone loss was 2.69 ± 0.42 mm. The cumulative survival rate of the implants was 100%. CONCLUSIONS Immediately loaded postextractive implants, placed according to the ART, have been proved to be a predictable method to rehabilitate single tooth in the anterior maxilla.
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Bechara K, Dottore AM, Kawakami PY, Gehrke SA, Coelho PG, Piattelli A, Iezzi G, Shibli JA. A histological study of non-ceramic hydroxyapatite as a bone graft substitute material in the vertical bone augmentation of the posterior mandible using an interpositional inlay technique: A split mouth evaluation. Ann Anat 2015; 202:1-7. [DOI: 10.1016/j.aanat.2015.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/06/2015] [Accepted: 07/27/2015] [Indexed: 11/15/2022]
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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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Scanning electron microscopy observations of osseointegration failures of dental implants that support mandibular overdentures. IMPLANT DENT 2013; 22:645-9. [PMID: 24177277 DOI: 10.1097/01.id.0000433934.99474.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM : Investigating possible failure causes of mandibular implants after their immediate loading with an overdenture retained with bilateral bar attachments, using scanning electron microscope. PATIENTS AND METHODS Twenty edentulous male patients were included in the present study. Each patient had 2 fixtures inserted in the canine and the first molar areas on each side of the mandible. After abutments screwing, the 2 fixtures on the same side were splinted with a bar, and immediately loaded with an overdenture. Implants mobility was assessed on weekly basis. Failed implants were removed, and examined by scanning electron microscope. RESULTS The failed implants, removed after 4 weeks of treatment, showed an intimate contact of mineralized and osteoid tissues with dense collagen-rich matrix in the apical third of implants. Furthermore, newly developed bone was observed at the same area in implants removed after 7 weeks. However, there was no evidence of such growth at the middle and/or cervical thirds in either case. CONCLUSION Lack of osseointegration at the middle and cervical thirds of the root could be a possible cause of implant failure. Early loading by an overdenture retained with bilateral bars is considered a major contributing factor to incomplete osseointegration of the supporting implants.
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