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Saleh Hasani Jebelli M, Yari A, Nikparto N, Cheperli S, Asadi A, Darehdor AA, Nezaminia S, Dortaj D, Hasani Mehraban S, Hakim LK. Tissue engineering innovations to enhance osseointegration in immediate dental implant loading: A narrative review. Cell Biochem Funct 2024; 42:e3974. [PMID: 38491807 DOI: 10.1002/cbf.3974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
The demand for efficient and accelerated osseointegration in dental implantology has led to the exploration of innovative tissue engineering strategies. Immediate implant loading reduces treatment duration and necessitates robust osseointegration to ensure long-term implant success. This review article discusses the current studies of tissue engineering innovations for enhancing osseointegration in immediate dental implant loading in the recent decade. Keywords "tissue engineering," "osseointegration," "immediate implant loading," and related terms were systematically searched. The review highlights the potential of bioactive materials and growth factor delivery systems in promoting osteogenic activity and accelerating bone regeneration. The in vivo experiment demonstrates significantly improved osseointegration in the experimental group compared to traditional immediate loading techniques, as evidenced by histological analyses and biomechanical assessments. It is possible to revolutionize the treatment outcomes and patient satisfaction in dental implants by integrating bioactive materials and growth factors.
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Affiliation(s)
| | - Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Nariman Nikparto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Amirali Asadi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmohammad Arabi Darehdor
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayna Nezaminia
- Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Dorara Dortaj
- Operative Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Hasani Mehraban
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Lotfollah Kamali Hakim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
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2
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Li W, Ding Q, Sun F, Liu B, Yuan F, Zhang L, Bao R, Gu J, Lin Y. Fatigue behavior of zirconia with microgrooved surfaces produced using femtosecond laser. Lasers Med Sci 2023; 38:33. [PMID: 36598586 DOI: 10.1007/s10103-022-03679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/19/2022] [Indexed: 01/05/2023]
Abstract
Femtosecond laser is a promising surface treatment tool for zirconia implant. In this study, the fatigue behavior of zirconia specimens with microgrooved surfaces formed by femtosecond laser is reported. One hundred sixty CAD/CAM zirconia bars (20 mm × 4 mm × 1.4 mm) were evenly divided into four groups with different surface: as sintered; sandblasted with 110 μm Al2O3; femtosecond laser produced microgrooves having 50 μm width, 30 μm depth, and 100 μm pitch; microgrooves having 30 μm width, 20 μm depth, and 60 μm pitch. The femtosecond laser formed micro/nanostructured microgrooves with precise size on zirconia surfaces. XRD analysis indicated that microgrooved surface showed no obvious tetragonal-to-monoclinic phase transformation. The fatigue strength of sandblasted specimens (728 MPa) was significantly higher than that of as sintered specimens (570 MPa). However, the fatigue strength of specimens with microgrooved surface decreased to about 360-380 MPa. The results suggest femtosecond laser is an effective technique to regulate the surface microtopography of zirconia, while further investigations are needed to improve its fatigue behavior.
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Affiliation(s)
- Wenjin Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Qian Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Fengbo Sun
- School of Materials Science and Engineering, Tsinghua University, 100084, Beijing, China
| | - Binchao Liu
- School of Aeronautic Science and Engineering, Beihang University, 100191, Beijing, China
| | - Fusong Yuan
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, 100081, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
| | - Rui Bao
- School of Aeronautic Science and Engineering, Beihang University, 100191, Beijing, China
| | - Jinghua Gu
- School of Materials Science and Engineering, Beihang University, Beijing, 100191, China
| | - Yuanhua Lin
- School of Materials Science and Engineering, Tsinghua University, 100084, Beijing, China
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Rodrigues Pais Alves MF, Figueira Vaz Fernandes MH, Macário Barboza Daguano JK, Dorión Rodas AC, Vasconcelos Amarante JE, Santos CD. Effect of the surface finish on the mechanical properties and cellular adhesion in (Ce,Y)-TZP/Al 2O 3 ceramic composites for denture implants. J Mech Behav Biomed Mater 2022; 134:105363. [PMID: 35850038 DOI: 10.1016/j.jmbbm.2022.105363] [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: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/28/2022]
Abstract
Ceramic composites based on (Ce, Y)-TZP/Al2O3 system have great potential for applications as dental implants due to their unusually great balance between good mechanical properties and resistance to hydrothermal degradation. Surface roughness plays an important role in controlling these properties, but few studies have investigated the relationship between cytocompatibility and surface roughness, at levels considered moderate and low, comparable to titanium implants. In this work, bending strength, hydrothermal degradation and biological evaluation of a ceramic composite based on (Ce,Y)-TZP/Al2O3 system were investigated as a function of surface roughness. Compacted samples were sintered at 1500 °C - 2h and then submitted to different surface treatments: Group 1 composed of samples with smooth surfaces, Group 2 and Group 3 composed of rough surfaces (grinded with 15 μm or 45 μm diamond sandpaper, respectively. Samples were characterized by X-ray diffraction, scanning electron microscopy, contact angle and optical profilometry and then subjected to hydrothermal degradation tests in autoclave (134 °C - 2 bar) using artificial saliva. The Piston-on-three-balls (P-3B) testing was used to determine flexural strength. To assess indirect cytotoxicity, samples were immersed in the culture medium for NIH-3T3 cells for 72 h. Furthermore, cell adhesion and proliferation were investigated using MG63 cells (human osteosarcoma) after 3, 7, 14, and 21 days of culture. Cytotoxicity, adhesion, and cell proliferation were examined by the Methyl Tetrazolium salt (MTS) and Alizarin Red, using a confocal laser microscope. The results indicated that the materials have high resistance to degradation. Furthermore, the (Ce,Y)-TZP/Al2O3 composites are not cytotoxic. The flexural strength of the composites was 913 ± 103 MPa in samples presenting original (smooth) surface, however, a reduction in the order of 17% was observed in samples containing rough surfaces. The rougher samples show the best cellular adhesion and proliferation, leading to the formation of a mineralized matrix after 21 days. These results clearly suggest that the new (Ce,Y)-TZP/Al2O3 brand is strong and highly biocompatible and warrants further study.
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Affiliation(s)
- Manuel Fellipe Rodrigues Pais Alves
- UERJ-FAT - Faculty of Technology, Rio de Janeiro State University, Rod. Presidente Dutra, Km 298, Resende, RJ, 27537-000, Brazil; CICECO - Aveiro Institute of Materials, Department of Materials and Ceramic Engineering, University of Aveiro, Aveiro, 3810-193, Portugal
| | | | - Juliana Kelmy Macário Barboza Daguano
- CECS - Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, Alameda da Universidade, s/n - Anchieta, São Bernardo do Campo, SP, 09606-045, Brazil; CTI - Center for Information Technology Renato Archer, Dom Pedro I Highway (SP-65), Km 143,6 - Chácaras Campos dos Amarais, Campinas, SP, 13069-901, Brazil
| | - Andrea Cecilia Dorión Rodas
- CECS - Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, Alameda da Universidade, s/n - Anchieta, São Bernardo do Campo, SP, 09606-045, Brazil
| | - José Eduardo Vasconcelos Amarante
- UFF- Faculty of Dentistry of the Health Institute of Nova Friburgo, Fluminense Federal University, Rua Dr. Silvio Henrique Braune, 22 Centro, Nova Friburgo, RJ, 28625-650, Brazil
| | - Claudinei Dos Santos
- UERJ-FAT - Faculty of Technology, Rio de Janeiro State University, Rod. Presidente Dutra, Km 298, Resende, RJ, 27537-000, Brazil; CICECO - Aveiro Institute of Materials, Department of Materials and Ceramic Engineering, University of Aveiro, Aveiro, 3810-193, Portugal.
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Surface Structure of Zirconia Implants: An Integrative Review Comparing Clinical Results with Preclinical and In Vitro Data. MATERIALS 2022; 15:ma15103664. [PMID: 35629692 PMCID: PMC9143528 DOI: 10.3390/ma15103664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023]
Abstract
Background: The purpose of this review was to analyze and correlate the findings for zirconia implants in clinical, preclinical and in vitro cell studies in relation to surface structure. Methods: Electronic searches were conducted to identify clinical, preclinical and in vitro cell studies on zirconia implant surfaces. The primary outcomes were mean bone loss (MBL) for clinical studies, bone-to-implant contact (BIC) and removal torque (RT) for preclinical studies and cell spreading, cell proliferation and gene expression for cell studies. The secondary outcomes included comparisons of data found for those surfaces that were investigated in all three study types. Results: From 986 screened titles, 40 studies were included for data extraction. In clinical studies, only micro-structured surfaces were investigated. The lowest MBL was reported for sandblasted and subsequently etched surfaces, followed by a sinter and slurry treatment and sandblasted surfaces. For BIC, no clear preference of one surface structure was observable, while RT was slightly higher for micro-structured than smooth surfaces. All cell studies showed that cell spreading and cytoskeletal formation were enhanced on smooth compared with micro-structured surfaces. Conclusions: No correlation was observed for the effect of surface structure of zirconia implants within the results of clinical, preclinical and in vitro cell studies, underlining the need for standardized procedures for human, animal and in vitro studies.
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Cunha W, Carvalho O, Henriques B, Silva FS, Özcan M, Souza JCM. Surface modification of zirconia dental implants by laser texturing. Lasers Med Sci 2022; 37:77-93. [PMID: 35022871 DOI: 10.1007/s10103-021-03475-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022]
Abstract
The aim of this work was to perform an integrative literature review on the influence of laser irradiation on zirconia implants to enhance surface topographic aspects and the biological response for osseointegration. An electronic search was carried out on the PubMed database using the following search terms: "zirconia" AND "laser" AND "surface modification" OR "surface treatment" AND "dental implants" OR "bone" OR "osteoblast" OR "osseointegration." Of the identified articles, 12 studies were selected in this review. Results reported that the laser irradiation was capable of promoting changes on the zirconia surfaces regarding topographic aspects, roughness, and wettability. An increase in roughness was recorded at micro- and nano-scale and it resulted in an enhanced wettability and biological response. Also, adhesion, spreading, proliferation, and differentiation of osteogenic cells were also enhanced after laser irradiation mainly by using a femtosecond laser at 10nJ and 80 MHz. After 3 months of osseointegration, in vivo studies in dogs revealed a similar average percentage of bone-to-implant contact (BIC) on zirconia surfaces (around 47.9 ± 16%) when compared to standard titanium surfaces (61.73 ±16.27%), denoting that there is no significant difference between such different materials. The laser approach revealed several parameters that can be used for zirconia surface modification such as irradiation intensity, time, and frequency. Laser irradiation parameters can be optimized and well-controlled to reach desirable surface morphologic aspects and biological response concerning the osseointegration process.
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Affiliation(s)
- Welson Cunha
- School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal
| | - Oscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
| | - Bruno Henriques
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.,Ceramic and Composite Materials Research Group (CERMAT), Dept. of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), Florianópolis, 88040-900, Brazil
| | - Filipe S Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, 8032, Switzerland
| | - Júlio C M Souza
- School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal. .,Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.
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Schünemann FH, Galárraga-Vinueza ME, Magini R, Fredel M, Silva F, Souza JCM, Zhang Y, Henriques B. Zirconia surface modifications for implant dentistry. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:1294-1305. [PMID: 30813009 DOI: 10.1016/j.msec.2019.01.062] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Zirconia has emerged as a versatile dental material due to its excellent aesthetic outcomes such as color and opacity, unique mechanical properties that can mimic the appearance of natural teeth and decrease peri-implant inflammatory reactions. OBJECTIVE The aim of this review was to critically explore the state of art of zirconia surface treatment to enhance the biological and osseointegration behavior of zirconia in implant dentistry. MATERIALS AND METHODS An electronic search in PubMed database was carried out until May 2018 using the following combination of key words and MeSH terms without time periods: "zirconia surface treatment" or "zirconia surface modification" or "zirconia coating" and "osseointegration" or "biological properties" or "bioactivity" or "functionally graded properties". RESULTS Previous studies have reported the influence of zirconia-based implant surface on the adhesion, proliferation, and differentiation of osteoblast and fibroblasts at the implant to bone interface during the osseointegration process. A large number of physicochemical methods have been used to change the implant surfaces and therefore to improve the early and late bone-to-implant integration, namely: acid etching, gritblasting, laser treatment, UV light, CVD, and PVD. The development of coatings composed of silica, magnesium, graphene, dopamine, and bioactive molecules has been assessed although the development of a functionally graded material for implants has shown encouraging mechanical and biological behavior. CONCLUSION Modified zirconia surfaces clearly demonstrate faster osseointegration than that on untreated surfaces. However, there is no consensus regarding the surface treatment and consequent morphological aspects of the surfaces to enhance osseointegration.
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Affiliation(s)
- Fernanda H Schünemann
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - María E Galárraga-Vinueza
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Ricardo Magini
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Márcio Fredel
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil
| | - Filipe Silva
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
| | - Júlio C M Souza
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal; Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, Portugal
| | - Yu Zhang
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, NYU, New York, NY 10010, USA
| | - Bruno Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil; CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal.
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Current status of zirconia implants in dentistry: preclinical tests. J Prosthodont Res 2018; 63:1-14. [PMID: 30205949 DOI: 10.1016/j.jpor.2018.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/18/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. STUDY SELECTION An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR). RESULTS Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters. CONCLUSIONS Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.
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Viganò P, Lang NP, Cesaretti G, Bengazi F, Omori Y, Botticelli D. Immediate loading at single crowns and 2-unit bridges supported by implants installed in a healed alveolar bony ridge or immediately after tooth extraction. An experimental study in dogs. J Oral Rehabil 2018; 45:974-982. [PMID: 30074633 DOI: 10.1111/joor.12702] [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: 04/15/2018] [Revised: 07/28/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
To evaluate presumptive differences in osseointegration at implants installed in healed sites or extraction sockets, supporting either crowns or bridges that were functionally loaded or left unloaded. In six dogs, the mesial roots of the first mandibular molars were treated endodontically. Bilaterally, the teeth were hemisected, and the distal roots extracted. First and second mandibular premolars were extracted as well. After 3 months, the mandibular third and fourth distal roots were extracted after endodontic treatment of the mesial roots. Four implants were installed bilaterally, two in the healed sites corresponding to the second premolar and first molar regions, and two into the extraction sockets. Cobalt-chrome single crowns were prepared and installed in the two most anterior implants, and bridges at the two most posterior implants, bilaterally. A 3-unit bridge was applied to the premolars in the upper jaw only at the loaded sites. All prostheses had a flat occlusal surface and contacts in centric occlusion only at the loaded sites. Three months later, biopsies were retrieved for histological analysis. Higher levels of osseointegration and bone density were observed at the unloaded sites, both at implants installed in healed and post-extraction sites. However, only at implants installed in the post-extraction sites and supporting single crowns, the difference in bone-to-Implant contact was statistically significant. In implant installation immediately following extraction or delayed after three months, osseointegration and bone density were not affected by occlusal contact schemes.
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Affiliation(s)
| | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | | | - Franco Bengazi
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Yuki Omori
- ARDEC Academy, Rimini, Italy.,Department of Oral Implantology, Osaka Dental University, Osaka, Japan, ARDEC Academy Ariminum Odontologica, Rimini, Italy
| | - Daniele Botticelli
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
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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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Pieralli S, Kohal RJ, Lopez Hernandez E, Doerken S, Spies BC. Osseointegration of zirconia dental implants in animal investigations: A systematic review and meta-analysis. Dent Mater 2017; 34:171-182. [PMID: 29122237 DOI: 10.1016/j.dental.2017.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the osseointegration rate of zirconium dioxide (ZrO2) dental implants in preclinical investigations. DATA Data on the osseointegration rate was extracted considering the bone to implant contact (BIC), removal torque analysis (RTQ) and push-in tests. Meta analyses were conducted using multilevel multivariable mixed-effects linear regression models. The Šidák method was used in case of multiple testing. SOURCES An electronic screening of the literature (MEDLINE/Pubmed, Cochrane Library and Embase) and a supplementary manual search were performed. Animal investigations with a minimum sample size of 3 units evaluating implants made of zirconia (ZrO2) or its composites (ZrO2>50vol.%) were included. STUDY SELECTION The search provided 4577 articles, and finally 54 investigations were included and analyzed. Fifty-two studies included implants made from zirconia, 4 zirconia composite implants and 37 titanium implants. In total, 3435 implants were installed in 954 animals. CONCLUSIONS No significant influence of the evaluated bulk materials on the outcomes of interest could be detected. When comparing different animal models, significant differences for the evaluated variables could be found. These results might be of interest for the design of further animal investigations.
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Affiliation(s)
- Stefano Pieralli
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Straße 4-6, 14197 Berlin, Germany.
| | - Ralf-Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Emilia Lopez Hernandez
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Sam Doerken
- Medical Center - University of Freiburg, Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Faculty of Medicine - University of Freiburg, Hebelstr. 11, 79104 Freiburg, Germany
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Straße 4-6, 14197 Berlin, Germany
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Acham S, Rugani P, Truschnegg A, Wildburger A, Wegscheider WA, Jakse N. Immediate loading of four interforaminal implants supporting a locator-retained mandibular overdenture in the elderly. Results of a 3-year randomized, controlled, prospective clinical study. Clin Implant Dent Relat Res 2017; 19:895-900. [DOI: 10.1111/cid.12513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/28/2017] [Accepted: 06/03/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Stephan Acham
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics; Medical University of Graz; Austria
| | - Petra Rugani
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics; Medical University of Graz; Austria
| | - Astrid Truschnegg
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics; Medical University of Graz; Austria
| | - Angelika Wildburger
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics; Medical University of Graz; Austria
| | - Walther A. Wegscheider
- Department of Dental Medicine and Oral Health, Division of Prosthodontics; Restorative Dentistry, Periodontology and Implantology, Medical University of Graz; Austria
| | - Norbert Jakse
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics; Medical University of Graz; Austria
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Siddiqi A, Khan AS, Zafar S. Thirty Years of Translational Research in Zirconia Dental Implants: A Systematic Review of the Literature. J ORAL IMPLANTOL 2017; 43:314-325. [PMID: 28594591 DOI: 10.1563/aaid-joi-d-17-00016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Thirty years of transitional research in zirconia (Zr) ceramics has led to significant improvements in the biomedical field, especially in dental implantology. Oral implants made of yttria-tetragonal zirconia polycrystals (Y-TZP) because of their excellent mechanical properties, good biocompatibility, and esthetically acceptable color have emerged as an attractive metal-free alternative to titanium (Ti) implants. The aim of the review was to highlight the translation research in Zr dental implants that has been conducted over the past 3 decades using preclinical animal models. A computer search of electronic databases, primarily PubMed, was performed with the following key words: "zirconia ceramics AND animal trials," "ceramic implants AND animal trials," "zirconia AND animal trials," "zirconia AND in vivo animal trials," without any language restriction. However, the search was limited to animal trials discussing percentage bone-implant contact (%BIC) around zirconia implants/discs. This search resulted in 132 articles (reviews, in vivo studies, and animal studies) of potential interest. We restricted our search terms to "zirconia/ceramic," "bone-implant-contact," and "animal trials" and found 29 relevant publications, which were then selected for full-text reading. Reasons for exclusion included the article's not being an animal study, being a review article, and not discussing %BIC around Zr implants/discs. Most of the studies investigated BIC around Zr in rabbits (30%), pigs (approximately 20%), dogs, sheep, and rats. This review of the literature shows that preclinical animal models can be successfully used to investigate osseointegration around Zr ceramics. Results of the reviewed studies demonstrated excellent %BIC around Zr implants. It should be noted that most of the studies investigated %BIC/removal torque under nonloading conditions, and results would have been somewhat different in functional loading situations because of inherent limitations of Zr ceramics. Further trials are needed to evaluate the performance of Zr ceramics in clinical conditions using implants designed and manufactured via novel techniques that enhance their biomechanical properties.
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Affiliation(s)
- Allauddin Siddiqi
- 1 School of Dentistry and Health Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - Abdul Samad Khan
- 2 Department of Restorative Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia
| | - Sobia Zafar
- 3 Discipline of Paediatric Dentistry, UWA Dental School, Australia
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13
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Guo J, Liu L, Liu H, Gan K, Liu X, Song X, Niu D, Chen T. Influence of femtosecond laser on the osteogenetic efficiency of polyetheretherketone and its composite. HIGH PERFORM POLYM 2016. [DOI: 10.1177/0954008316667460] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study aimed to evaluate the effect of a femtosecond laser on the osteogenetic efficiency of polyetheretherketone (PEEK) and its composite for clinical applications. Methods: One hundred pieces of PEEK and its composite (6 × 4 × 2 mm3) were randomly divided into four groups and treated as follows: group A1, PEEK; group A2, PEEK + femtosecond laser; group B1, PEEK composite; and group B2, PEEK composite + femtosecond. The surface morphology of the pieces of each group was observed through scanning electron microscopy. The surface roughness and wettability, which were considered as the main parameters affecting cell adhesion characteristics of implants, were measured. The animals whose mandibles were implanted with the four groups of materials were killed at the end of 6 and 12 weeks. Various characterization tests, such as Cone Beam Computed Tomography (CBCT), push-out test, microscope test, and bone implant contact , were conducted to investigate the healing effect between materials and bones. Results: In group B1, the nanoparticles in PEEK were uniformly distributed. In groups A2 and B2, many periodic nanostructures were observed. The surface roughness and wettability of group B2 were significantly increased compared to those of the other groups ( p < 0.05). At each time point, the number of trabecular bones, contact strength, and BIC of group B2 were higher than those of the three other groups ( p < 0.05). Compared with those of group A1, the test results of group B1 were significantly improved. Conclusion: Femtosecond lasers can effectively enhance the biological activity of PEEK and its composite; PEEK composite exhibits better biological activity than PEEK.
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Affiliation(s)
- Jing Guo
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Lijun Liu
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Hong Liu
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Kang Gan
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Xiuju Liu
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Xiaoqing Song
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Deli Niu
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
| | - Tianjie Chen
- School and Hospital of Stomatology, Jilin University, Changchun, People’s Republic of China
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14
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Caroprese M, Soldini C, Ricci S, Rea M, Lang NP, Botticelli D. Healing at implants placed in bone of different morphology: an experimental study in dogs. Clin Oral Implants Res 2016; 28:961-965. [PMID: 27350591 DOI: 10.1111/clr.12905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To study osseointegration at implants installed using a standard bed preparation in sites of different bone morphology. MATERIAL AND METHODS In six Labrador dogs, all mandibular premolars and first molars were extracted. After 4 months of healing, flaps were elevated, and two recipient sites were prepared in each side of the mandible, one in the second premolar and the other in the molar regions. Bone morphology and final insertion torque were evaluated. Healing abutments were applied, and the flaps were sutured to allow a non-submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histomorphometric analyses. RESULTS At the premolar sites, bone morphology Class 2 and at the molar regions Class 3 or 4 were identified. The final insertion torque was 50-55 Ncm at the premolar and 30-35 Ncm at the molar sites. Mean osseointegration in percentage reached 61.5 ± 11.5% and 63.3 ± 10.1% at the premolar and molar sites, respectively. Mineralized bone density evaluated from the implant surface up to a distance of about 0.6 mm lateral to the implant surface was 63.0 ± 7.4% and 65.4 ± 17.7% at the premolar and molar sites, respectively. CONCLUSIONS Similar implant bed preparations performed at premolar and molar sites with different bone morphology, yielding insertion torque values of about 30-35 and 50-55 Ncm, respectively, did not affect osseointegration after 4 months at non-submerged implants.
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Affiliation(s)
- Marino Caroprese
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | - Sara Ricci
- Università degli Studi di Padova, Padova, Italy
| | - Massimiliano Rea
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | - Daniele Botticelli
- ARDEC Academy, Ariminum Odontologica, Rimini, Italy.,POI- Programa Odontológico Internacional, Cartagena de Indias, Colombia
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15
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Thoma DS, Benic GI, Muñoz F, Kohal R, Sanz Martin I, Cantalapiedra AG, Hämmerle CHF, Jung RE. Marginal bone-level alterations of loaded zirconia and titanium dental implants: an experimental study in the dog mandible. Clin Oral Implants Res 2015; 27:412-20. [DOI: 10.1111/clr.12595] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences; University of Santiago de Compostela; Lugo Spain
| | - Ralf Kohal
- Department of Prosthodontics; Albert-Ludwigs-University; Freiburg Germany
| | | | | | - Christoph H. F. Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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16
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Cesaretti G, Botticelli D, Renzi A, Rossi M, Rossi R, Lang NP. Radiographic evaluation of immediately loaded implants supporting 2-3 units fixed bridges in the posterior maxilla: a 3-year follow-up prospective randomized controlled multicenter clinical study. Clin Oral Implants Res 2015; 27:399-405. [DOI: 10.1111/clr.12565] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Daniele Botticelli
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
- ARDEC; Ariminum Odontologica; Rimini Italy
| | | | | | | | - Niklaus P. Lang
- Center for Dental Medicine; University of Zurich; Zurich Switzerland
- University of Bern; Bern Switzerland
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17
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Delgado-Ruiz RA, Abboud M, Romanos G, Aguilar-Salvatierra A, Gomez-Moreno G, Calvo-Guirado JL. Peri-implant bone organization surrounding zirconia-microgrooved surfaces circularly polarized light and confocal laser scanning microscopy study. Clin Oral Implants Res 2014; 26:1328-37. [DOI: 10.1111/clr.12461] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Marcus Abboud
- School of Dental Medicine; Stony Brook University; Stony Brook NY USA
| | - Georgios Romanos
- School of Medicine and Dentistry; Granada University; Granada Spain
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