Sequential Healing at Implants with Different Configuration and Modified Surfaces: An Experimental Study in the Dog

Influence of the position of the antrostomy in sinus floor elevation on the healing of mini-implants: a randomized clinical trial

AIM

To evaluate histologically the healing of mini-implants installed after sinus floor elevation using a lateral approach and placing the antrostomy at different level from the sinus floor.

MATERIAL AND METHODS

Sinus floor elevation using a lateral approach was performed in 24 healthy volunteers. The antrostomy was randomly placed either close to the base of the sinus floor (group base) or at about 3-4 mm cranially to it (group standard). After 6 months of healing, mini-implants were installed within the grafted region, through the alveolar crest. Three months later, biopsies were collected.

RESULTS

Sixteen biopsies from 16 patients were available for histological analyses. The new bone reached fractions of 40.9 ± 11.9% and 48.5 ± 20.1% at the base and standard groups, respectively (p = 0.208). Xenograft particles were found in contact with the implant surface at percentages of 12.1 ± 11.0% in the base group, and 15.9 ± 23.7% in the standard group (p = 0.674).

CONCLUSIONS

Based on the present study, the choice of one or the other position of antrostomy did not influence significantly the outcome and, therefore, should be left to the preference of the surgeon.

Healing at sites prepared using different drilling protocols. An experimental study in the tibiae of sheep

The aim of the experiment was to study the healing at implants installed in site prepared in bone type 1 using different rotation speeds and cooling strategies. The tibiae of twelve sheep were used as experimental sites. Two implant sites were prepared in each tibia using drills either at a high or a mixed speed under irrigation. At the mixed-speed sites, 60 rpm without irrigation were applied for the last drill, the countersink and during implant installation. Biopsies representing the healing after 1, 2, and 6 weeks were obtained and ground sections were prepared. At the histological analyses, after 1 week of healing, no new bone was found at both high- and mixed-speed sites. After 2 weeks of healing, small amounts of newly formed bone were observed in the cortical layer, reaching percentages of 3.6±3.0% at the mixed-speed sites, and of 2.2±1.5% at the high-speed sites. An irrelevant quantity of new bone was seen in the marrow compartments of a few specimens. After 6 weeks of healing, new bone was found in higher quantity, reaching in the cortical compartment 66.9±6.8% and 67.3±17.7% at the mixed- and high-speed sites, respectively. The respective percentages in the marrow compartment were 23.2±13.0% and 30.6±29.2%. No statistically significant differences between high- and mixed-speed groups were found. It was concluded that the use of the last drill and the installation of the implant with or without irrigation yielded similar bone healing and osseointegration.

Sequential morphometric evaluation at UnicCa® and SLActive® implant surfaces. An experimental study in the dog

AIM

To study sequential osseointegration around implants with nano-technologically modified surfaces at different periods of healing.

MATERIALS AND METHODS

After 3 months, two different implant systems with different nano-technologically modified surfaces were randomly installed in the edentulous molar regions of the mandible of 12 dogs. One surface was acid-etched surface, and subsequently modified with calcium ions (UnicCa^® ), while the other was a hydrophilic sandblasted with large grit and acid-etched (SLActive^® ) surface. The implants were fully submerged, and biopsies were obtained representing the healing after 1, 2, 4 and 8 weeks (n = 6 per period). A morphometric evaluation of densities of new soft tissues (provisional matrix and immature bone marrow), new and old bone, mature bone marrow, vessels and other tissues (bone debris/particles and clot) was performed in the spongiosa compartment of the sites of implantation.

RESULTS

After 1 week of healing, the soft tissues, mainly composed of provisional matrix, were present at 41.5 ± 23.9% and 30.1 ± 20.0% at the UnicCa^® and SLActive surfaces, respectively. These percentages were >40% at both surfaces after 2 weeks of healing, presenting greater amount of immature bone marrow. Subsequently, these percentages decreased up to disappear after 8 weeks of healing. New bone increased progressively between 1 and 8 weeks of healing from 8.2 ± 3.0% to 77.1 ± 6.4% and from 6.8 ± 2.8% to 67.9 ± 6.8% at the UnicCa^® and SLActive^® , respectively. Old bone decreased progressively over time.

CONCLUSIONS

The patterns of healing at highly hydrophilic surfaces occurred through the early formation of a provisional matrix followed by the formation of new bone and marrow at various stages of maturation. The healing was similar to those described in different animal models, anatomical sites and surgical procedures.