Resonance frequency analysis of dental implants placed at the posterior maxilla varying the surface treatment only: A randomized clinical trial

Evaluation of Implant Stability Quotient of Sandblasted Acid-Etched (SAE) and Chemical-Modified SAE Dental Implants: A Clinical Study

Objectives

The goal of the current research was to assess the implant stability quotient (ISQ) of dental implants that were chemically changed with SAE and without SAE.

Materials and Methods

Patients in the current study had dental implants fitted with SAE (Group I) and chemically altered SAE (Group II). After implant implantation, resonance frequency analysis (RFA) was performed as soon as possible as well as one, three, six, nine, and twelve weeks later. Version 23.0 of SPSS Statistics for Windows was used to statistically analyze the results.

Result

In SAE dental implants (Group I), a highest RFA value of 84.1 and a minimum value of 42.2 were noted. In chemically modified implants, the SAE (group II) mean RFA value ranged from 30.3 to 87.1.

Conclusion

It has been noted that dental implants with surface treatment exhibit increased implant-bone osseointegration. Implants with hydrophilic surfaces osseointegrate more quickly than those with SAE areas.

Comparative clinical evaluation of the stability of implants using double acid etching treatment with and without the addition of fluoride solution: A randomized clinical trial

Background

Osseointegration depends on primary stability, and further, implant surface modifications may improve secondary stability. This randomized clinical trial evaluates whether adding a fluoride solution enhances the implant stability.

Materials and Methods

Stability of dental implants with two different types of surface treatments was compared utilizing resonance frequency analysis (RFA). Twelve patients were recruited: eight females and four males with an average age of 58.3 years and they received either double acid etched implants (control: Porus Implant, Sistema Conexão) and double acid etched implants containing fluoride on their surfaces (test: Porus Nano Implant, Sistema Conexão). Each patient received one implant from the test category and another implant from the control category, resulting in 24 implants in this study. RFA, utilizing Osstell was used to assess the implant stability, immediately after the placement of implant and 15, 30 and 45 days post-implant placement.

Results

At the initial time, there was no difference between the test and control groups regarding the ISQ. However, after 15, 30, and 45 days, ISQ values for the test group were significantly higher than the control group. When using implants without fluoride addition, it was observed that after 15 days, the ISQ values were lower than those found at the initial time, but after 30 days, values matched the initial. Concerning the test group results, the ISQ values from T0 (immediately after implant placement) to T3 (45 days after implant placement) always increased from every period of evaluation.

Conclusions

It was concluded that double acid etched implants with surfaces containing fluoride solution increases the implant stability quotient, compared to implants with fluoride-free double acid etched surfaces.

Surface Modifications of Commercial Dental Implant Systems: An Overview

The aim of this review was to perform a comprehensive overview of evidence pertaining to the influence of various surface modifications on the surface roughness, bone implant contact, and the success and complication rates of the implants. Modified sandblasted, large-grit, acid-etched (SLA) implants (SLActive implants) have a higher implant stability quotient compared with conventional SLA implants. Also, when compared between the implant surfaces from various manufacturers, Biomet 3i Nanotite implants were shown to have a relatively higher implant stability quotient compared to Straumann implants as well as the Biomet Osseotite implants. Only one study reports the insertion torque values as obtained by the various implant surfaces, with the findings being statistically similar for all the types, and a higher mean value for Biomet 3i Nanotite implants. Among SLA and SLActive surfaces, the latter was found to have a lower marginal bone loss, and among Astratech implants, the marginal bone loss levels were similar for Osseospeed and Tioblast surfaces. When Osseospeed, TiUnite and SLActive surfaces were compared, Osseospeed was found to have the minimum bone loss while TiUnite was found to have the highest. The bone implant contact percentages are similar and satisfactory for most of the implant surface modifications that are available currently. Upon assessing the recent literature on the survival rates for implants with various surface modifications, it was found that among Nobel Biocare implants, the survival rate was higher for TiUnite implants, compared with the turned surfaces. Surprisingly, among the Straumann implant surfaces, the survival rates were found to be higher for the SLA implants when compared to the modified SLA implants. Only one of the included studies evaluated the survival rate for Astratech implant surfaces and found a 100% survival rate for both the Osseospeed and Tioblast surface implants. Therefore, major advancements have been made in developing novel surfaces of dental implants. The numerous innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.

Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial

OBJECTIVE

To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year.

MATERIALS AND METHODS

In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates.

RESULTS

The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants.

CONCLUSION

Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.

Factors Affecting Implant Stability Quotients at Immediately and Conventionally Loaded Implants in the Posterior Maxilla: A Split-Mouth Randomized Controlled Trial

PURPOSE

To assess primary and secondary stability of variable-thread tapered implants in the posterior maxilla and analyze the impact of various factors on implant stability quotients (ISQs).

MATERIALS AND METHODS

Twenty-six subjects received 3-4 adjacent implants in the maxillary premolar-molar sextants to replace bilateral tooth loss. The implants on one side were immediately loaded with a provisional fixed prosthesis regardless of their primary stability. The contralateral control implants were conventionally loaded. Bone quality was subjectively recorded and primary stability was assessed by means of insertion torque values (ITVs) and ISQs in 4 directions. Secondary stability was measured by ISQ at definitive prosthesis delivery (3-3.5 months postoperatively), and 12 months after definitive loading. The impact of measurement direction, loading protocol, time, site-related (bone quality, implant position, crestal buccal bone thickness, apical cortical anchorage), and implant-related (implant dimensions, abutment height) variables on ISQs was assessed.

RESULTS

For logistic reasons, ISQs were obtained for only 18 patients with 60 test and 60 control implants. Most of the implants (82%) at baseline had their lowest ISQ on the buccal aspect. There were no significant differences between ISQs measured in the buccal and palatal directions, or between ISQs in the mesial and distal directions. The mean of buccal and palatal ISQs was significantly lower than the mean of the 2 interproximal measurements at all evaluation periods. ISQs were not significantly different between the 2 loading groups at any time point. All implants showed a time-dependent increase in ISQs. Baseline ISQ correlated weakly with bone quality and ITV. None of the variables had a significant impact on baseline ISQs, except for implants in second molar sites which showed poorer primary stability than first premolars.

CONCLUSION

Measurement direction and time are the most significant parameters affecting ISQs of variable-thread tapered implants in the posterior maxilla.

Does implant surface hydrophilicity influence the maintenance of surface integrity after insertion into low-density artificial bone?

OBJECTIVE

To evaluate the influence of hydrophilicity on the surface integrity of implants after insertion in low-density artificial bone and to determine the distribution of titanium (Ti) particles along the bone bed.

METHODS

Forty-eight dental implants with different designs (Titamax Ex, Facility, Alvim, and Drive) and surface treatments (Neoporos® and Aqua™) were inserted into artificial bone blocks with density compatible with bone type III-IV. Hydrophobic Neoporos® surfaces were obtained by sandblasting and acid etching while hydrophilic Aqua™ surfaces were obtained by sandblasting, acid etching, and storage in an isotonic 0.9% NaCl solution. The surface integrity was evaluated by Scanning Electron Microscope (SEM) and the surface roughness parameters (Sa, Sp, Ssk, Sdr, Spk, Sk, and Svk) and surface area were measured with Laser Scanning Confocal Microscopy before and after installation. Bone beds were inspected with Digital Microscopy and micro X-Ray Fluorescence (μ-XRF) to analyze the metallic element distribution along the bone bed.

RESULTS

Acqua™ implants had higher initial Sa and a pronounced reduction of Sa and Sp during insertion, compared to NeoPoros® implants. After insertion, Sa and Sp of Acqua™ and NeoPoros® implants equalized, differing only between designs of Acqua™ implants. Surface damage was observed after insertion, mainly in the apical region. Facility implants that are made of TiG5 released fewer debris particles, while the highest Ti intensity was detected in the cervical region of the Titamax Ex Acqua™ and Drive Acqua™ implants.

SIGNIFICANCE

Physicochemical modifications to achieve surface hydrophilicity created a rougher surface that was more susceptible to surface alterations, resulting in more Ti particle release into the bone bed during surgical insertion. The higher Ti intensities detected in the cervical region of bone beds may be related to peri-implantitis and marginal bone resorption.

Implant stability and survival rates of a hydrophilic versus a conventional sandblasted, acid-etched implant surface: Systematic review and meta-analysis

BACKGROUND

Modifying the implant surface via enhancing the wettability (hydrophilicity) improves osseointegration, reducing the healing period. In this study, the authors aimed to evaluate the stability and survival rates of implants with a hydrophilic surface compared with those with a sandblasted, acid-etched surface.

TYPES OF STUDIES REVIEWED

The included studies (randomized controlled trials) were identified through searches of PubMed, ScienceDirect, and Cochrane Library databases without date of publication restrictions. Quality assessment was performed using the Cochrane Collaboration tool. For primary outcome, confidence intervals were set at 95%; weighted means across the studies were calculated using a fixed-effects model or risk ratios and their 95% confidence intervals for secondary outcome.

RESULTS

The authors included 5 randomized controlled trials (246 dental implants) in the systematic review, which compared a hydrophilic with conventional sandblasted, acid-etched implant surface. The implant stability (primary outcome) was measured at baseline and 3, 6, and 8 weeks, and implant survival rates were measured as a secondary outcome. Overall, compared with the control groups, no clinically significant differences in implant stability or survival rates were identified for the hydrophilic surface groups.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The results did not show any clinically significant effect of a hydrophilic surface on improving implant stability or survival rates. However, these findings must be analyzed carefully owing to the limitations of this review, such as the small samples size and some differences among the included studies.

Evaluation of osseintegration between traditional and modified hydrophilic titanium dental implants - Systematic analysis

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.

Effects of novel non-thermal atmospheric plasma treatment of titanium on physical and biological improvements and in vivo osseointegration in rats

Titanium (Ti) has achieved extensive applications due to its excellent biocompatibility and mechanical properties. Plasma can enhance surface hydrophilia of Ti with decreased carbon contamination. The traditional conditions using a single gas plasma was for longer treatment time and more prone to being contaminated. We designed and developed novel and universal apparatus and methods with a special clamping device of non-thermal atmospheric plasma (NTAP) treatment using mixed gas for Ti surface activation. We systematically and quantitatively investigated the effective effects of NTAP-Ti. The surface water contact angle decreased by 100%, the carbon content decreased by 80% and oxygen content increased by 50% in the novel NTAP-Ti surfaces. NTAP treatment accelerated the attachment, spread, proliferation, osteogenic differentiation and mineralization of MC3T3-E1 mouse preosteoblasts in vitro. The percentage of bone-to-implant contact increased by 25–40%, and the osteoclasts and bone resorption were suppressed by 50% in NTAP-Ti in vivo. In conclusion, NTAP-Ti substantially enhanced the physical and biological effects and integration with bone. The novel and universal apparatus and methods with a special clamping device using gas mixtures are promising for implant activation by swiftly and effectively changing the Ti surface to a hydrophilic one to enhance dental and orthopedic applications.

A reduced healing protocol for sinus floor elevation in a staged approach with deproteinized bovine bone mineral alone: A randomized controlled clinical trial of a 5-month healing in comparison to the 8-month healing

PURPOSE

To investigate the feasibility of reducing the healing time of maxillary sinus floor elevation (MSFE) by a two-stage approach using deproteinized bovine bone mineral (DBBM) alone, based on clinical, histomorphometric, and microradiographic evaluations.

MATERIALS AND METHODS

Twenty consecutive cases with an atrophic posterior edentulous maxilla were randomly assigned to two groups at a ratio of 1:1. The lateral window approach to MSFE with DBBM alone was followed by an 8-month bone-healing period in the control group compared to 5 months in the test group. During implant placement, bone biopsies were harvested from implant osteotomy sites for micro-computed tomography (CT), histological, and histomorphometric evaluations. Cone beam CT (CBCT) scans were performed before and immediately after MSFE and after the bone-healing periods. The implant stability quotient (ISQ) was measured sequentially at implant placement and 1, 3, and 6 months thereafter.

RESULTS

The histomorphometric and microradiographic results showed no significant differences in new bone formation on the augmented sinus floor between the two groups (all Ps > .05), except that trabecular thickness was significantly reduced and trabecular separation significantly increased in the test group (both Ps < .05). The ISQs of both groups increased continuously after implant placement, but the difference was not significant between the groups at each time point. CBCT analyses showed that the extent of volumetric loss was comparable after bone healing for 5 and 8 months (P > .05).

CONCLUSIONS

Within the limitations of this study, the bone-healing time of MSFE with DBBM alone for staged implant placement could be reduced to 5 months instead of 8 or 9 months, based on the histomorphometric, microradiographic, and clinical outcomes; however, impact on long-term implant survival remains unknown and needs further investigation with long-term follow-ups.

Sandblasted and Acid Etched Titanium Dental Implant Surfaces Systematic Review and Confocal Microscopy Evaluation

The field of dental implantology has made progress in recent years, allowing safer and predictable oral rehabilitations. Surely the rehabilitation times have also been reduced, thanks to the advent of the new implant surfaces, which favour the osseointegration phases and allow the clinician to rehabilitate their patients earlier. To carry out this study, a search was conducted in the Pubmed, Embase and Elsevier databases; the articles initially obtained according to the keywords used numbered 283, and then subsequently reduced to 10 once the inclusion and exclusion criteria were applied. The review that has been carried out on this type of surface allows us to fully understand the features and above all to evaluate all the advantages or not related. The study materials also are supported by a manufacturing company, which provided all the indications regarding surface treatment and confocal microscopy scans. In conclusion, we can say that, thanks to these new surfaces, it has been possible to shorten the time necessary to obtain osseointegration and, therefore, secondary stability on the part of implants. The surfaces, therefore, guarantee an improved cellular adhesion and thanks to the excellent wettability all the biological processes that derive from it, such as increases in the exposed implant surface, resulting in an increase in bone-implant contact (BIC).

A Clinical and Radiographic Evaluation of Resonance Frequency Analysis of Sand Blasted Acid Etched (SAE) and Chemical Modified Sae Dental Implants

Aims and Objective:

Chemically modified and sandblasted acid-etched (SAE) mechanism leads to wettability of surfaces of dental implants which helps in osseointegration. The present study was conducted to determine the implant stability quotient (ISQ) of SAE and SAE chemically modified dental implants.

Materials and Methods:

The present study was conducted on 210 patients with 120 males and 90 females. Dental implants (Adin) with SAE (Group A) and SAE chemically modified (Group B) were inserted in patients. RFA was done immediately after implant insertion and after 1 week, 2 weeks, 6 weeks, 10 weeks, and 14 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 21.0, IBM Corp., Armonk, NY, USA.

Results:

Maximum patients were in the age group of 25–35 years (males – 65, females – 48), followed by 35–45 years (males – 40, females – 32) and 45–55 years (males – 15, females – 10). Maximum dental implants were given in the right side (88) in males than females (56). On the left side, maximum implants were given in females (62) than males (56). Maximum RFA value of 86.2 and minimum value of 44.6 were observed in SAE dental implants (A). The maximum mean RFA value in chemically modified implants SAE (B) was 89.4 and minimum was 32.5.

Conclusion:

It was observed that surface treatment of dental implants shows higher implant–bone osseointegration. There is fastest osseointegration in implants with hydrophilic surfaces than those with SAE surfaces. ISQ was higher than 75 in both groups, which indicate higher implant stability.

Can implant surfaces affect implant stability during osseointegration? A randomized clinical trial

This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson's correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.

Resonance frequency analysis of dental implants placed at the posterior maxilla varying the surface treatment only: A randomized clinical trial

BACKGROUND

Chemical modifications of the dental implant surface that improve the wettability result in a faster and better osseointegration.

PURPOSE

The aim of this randomized clinical trial was to evaluate the implant stability quotient (ISQ) of implants with similar designs, treated with 2 surfaces, sandblasted acid-etched (SAE) and hydrophilic SAE, within the initial 16 weeks of healing.

MATERIAL AND METHODS

A total of 64 implants (32 SAE-control group and 32 modified SAE-test group) with the same design, length, and diameter (conical and compressive, 4.3 × 10 mm) were inserted into the posterior maxillae of 21 patients partially edentulous. The ISQ values were collected at post-surgery (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), 5 weeks (T4), 8 weeks (T5), 12 weeks (T6), and 16 weeks (T7).

RESULTS

None of the implants failed. Test group presented ISQ values higher than the control group (ANOVA-P < .01) from T5 to T7. When comparing groups regarding the amount of time required to achieve ISQ ≥ 70 as a reference, there was a statistically significant difference (cox regression-P < .01), and a hazard ratio of 2.24 (CI 1.62-3.11). At the 1-year follow-up, there was a drop out of 1 patient, and 2 implants were no longer evaluated. Survival rate for both groups was 100% at the 1-year follow-up.

CONCLUSIONS

The current study suggests that implants with hydrophilic surface (modified SAE) integrate faster than implants with SAE surface. The stability gain of the test group was 2.24 times faster than the control group after 5 weeks of evaluation at the posterior region of the edentulous maxillae.