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Bhargava N, Perrotti V, Caponio VCA, Matsubara VH, Patalwala D, Quaranta A. Comparison of heat production and bone architecture changes in the implant site preparation with compressive osteotomes, osseodensification technique, piezoelectric devices, and standard drills: an ex vivo study on porcine ribs. Odontology 2023; 111:142-153. [PMID: 35852778 PMCID: PMC9810586 DOI: 10.1007/s10266-022-00730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
This study aimed at investigating differences in heat generation and bone architecture following four different implant site preparation techniques: compressive osteotomes, conventional drills, osseodensification (OD mode with osseodensification drills), and piezoelectric systems. Porcine rib bones were used as a model for implant surgery. Thermocouples were employed to measure temperature changes, and micro-CT to assess the bone architecture. The primary stability and insertion torque values of the implants placed in the differently prepared sites were assessed. The temperature changes were higher with Piezo. The average primary stability using the ISQ scale was the greatest for drills (76.17 ± 0.90) and the lowest for osteotomes (71.50 ± 11.09). Insertion torque was significantly higher with the osseodensification method (71.67 ± 7.99 Ncm) in comparison to drills, osteotomes, and piezo. Osteotomes showed the highest bone to implant contact percentage (39.83 ± 3.14%) and average trabecular number (2.02 ± 0.21 per mm), while drills exhibited the lowest (30.73 ± 1.65%; 1.37 ± 0.34 per mm). Total implant site bone volume was the highest with osseodensification (37.26 ± 4.13mm3) and the lowest for osteotomes (33.84 ± 3.84mm3). Statistical analysis showed a high primary stability and decrease in temperature during implant site preparation with osseodensification technique. The results support the use of osseodensification technique for implant site preparation.
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Affiliation(s)
- Nishith Bhargava
- Dental School, University of Western Australia, Perth, WA, Australia
| | - Vittoria Perrotti
- Deptartment of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy.
| | | | | | - Diana Patalwala
- Centre for Microscopy, Characterization and Analysis, The University of Western Australia, Perth, WA, Australia
| | - Alessandro Quaranta
- School of Dentistry, University of Sydney, Sydney, NSW, Australia
- Scientific and Education Director, Smile Specialists Suite, Newcastle-Sydney, NSW, Australia
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Comparison of Osseointegration of Dental Implants Placed in Rabbit Tibia Using Two Dental Laser and Implant Handpiece Systems. Bioengineering (Basel) 2022; 9:bioengineering9110681. [PMID: 36421082 PMCID: PMC9687135 DOI: 10.3390/bioengineering9110681] [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: 10/11/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to confirm the usefulness of a multi-laser handpiece system currently under development. Implants were placed in the tibia of rabbits using a conventional separate laser-implant handpiece system (control group; SurgicPro+; NSK, Kanuma, Japan and Epic 10; Biolase, Irvine, CA, USA) and a multi-laser handpiece system (experimental group; BLP 10; Saeshin, Daegu, Korea). Implants were placed in left and right tibias of five rabbits using a conventional laser-implant handpiece system and a multi-laser handpiece system (N = 5 per group). Subsequently, micro-computed tomography (micro-CT; bone-to-implant contact evaluation), implant stability quotient (ISQ) measurement, and histological evaluations were performed to confirm the implant placement results. The independent t-test and the paired t-test were used to compare the ISQ values and the results of the two implant-laser handpiece groups (α = 0.05), respectively. No statistically significant difference in micro-CT, ISQ, and histological evaluations was observed between implant placement by the two systems (p > 0.05) except implant initial stability. The use of the multi-laser handpiece system is expected to produce the same results as a conventional separate laser-implant handpiece system with the higher implant initial stability. Additionally, it will potentially make the clinical environment more pleasant and will provide convenience for the clinicians.
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Moreira AC, Fernandes CP, Oliveira MVD, Duailibi MT, Ribeiro AA, Duailibi SE, Kfouri FDÁ, Mantovani IF. The effect of pores and connections geometries on bone ingrowth into titanium scaffolds: an assessment based on 3D microCT images. Biomed Mater 2021; 16. [PMID: 34492651 DOI: 10.1088/1748-605x/ac246b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/07/2021] [Indexed: 11/11/2022]
Abstract
In order to support bone tissue regeneration, porous biomaterial implants (scaffolds) must offer chemical and mechanical properties, besides favorable fluid transport. Titanium implants provide these requirements, and depending on their microstructural parameters, the osteointegration process can be stimulated. The pore structure of scaffolds plays an essential role in this process, guiding fluid transport for neo-bone regeneration. The objective of this work was to analyze geometric and morphologic parameters of the porous microstructure of implants and analyze their influences in the bone regeneration process, and then discuss which parameters are the most fundamental. Bone ingrowths into two different sorts of porous titanium implants were analyzed after 7, 14, 21, 28, and 35 incubation days in experimental animal models. Measurements were accomplished with x-ray microtomography image analysis from rabbit tibiae, applying a pore-network technique. Taking into account the most favorable pore sizes for neo-bone regeneration, a novel approach was employed to assess the influence of the pore structure on this process: the analyses were carried out considering minimum pore and connection sizes. With this technique, pores and connections were analyzed separately and the influence of connectivity was deeply evaluated. This investigation showed a considerable influence of the size of connections on the permeability parameter and consequently on the neo-bone regeneration. The results indicate that the processing of porous scaffolds must be focused on deliver pore connections that stimulate the transport of fluids throughout the implant to be applied as a bone replacer.
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Affiliation(s)
- Anderson Camargo Moreira
- Department of Mechanical Engineering (EMC/PGMAT), Federal University of Santa Catarina (UFSC), Laboratory of Porous Media and Thermophysical Properties (LMPT), Florianópolis, Brazil
| | - Celso Peres Fernandes
- Department of Mechanical Engineering (EMC/PGMAT), Federal University of Santa Catarina (UFSC), Laboratory of Porous Media and Thermophysical Properties (LMPT), Florianópolis, Brazil
| | - Marize Varella de Oliveira
- Laboratory of Powder Technology, Division of Materials, National Institute of Technology, Rio de Janeiro, Brazil
| | - Monica Talarico Duailibi
- Tissue Engineering and Biofabrication Lab, Cellular and Molecular Technology Center, Federal University of São Paulo, CTCMol-UNIFESP, São Paulo, Brazil
| | - Alexandre Antunes Ribeiro
- Laboratory of Powder Technology, Division of Materials, National Institute of Technology, Rio de Janeiro, Brazil
| | - Silvio Eduardo Duailibi
- Tissue Engineering and Biofabrication Lab, Cellular and Molecular Technology Center, Federal University of São Paulo, CTCMol-UNIFESP, São Paulo, Brazil
| | - Flávio de Ávila Kfouri
- Tissue Engineering and Biofabrication Lab, Cellular and Molecular Technology Center, Federal University of São Paulo, CTCMol-UNIFESP, São Paulo, Brazil
| | - Iara Frangiotti Mantovani
- Department of Mechanical Engineering (EMC/PGMAT), Federal University of Santa Catarina (UFSC), Laboratory of Porous Media and Thermophysical Properties (LMPT), Florianópolis, Brazil
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Martins M, Vieira WDA, Paranhos LR, Motta RHL, da Silva CEXDSR, Rodriguez C, Ramacciato JC. Comparison of piezosurgery and conventional rotary instruments in schneider's membrane sinus lifting: A pilot randomized trial. J Clin Exp Dent 2021; 13:e802-e808. [PMID: 34512920 PMCID: PMC8412807 DOI: 10.4317/jced.57953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/15/2021] [Indexed: 12/20/2022] Open
Abstract
Background The present study aimed to evaluate and compare the postoperative effects of the piezoelectric device and conventional rotary instruments in Schneider’s membrane sinus lifting procedure.
Material and Methods Twenty patients requiring bilateral maxillary bone graft augmentation in the posterior maxillary region were selected. Piezoelectric surgery was performed on one side and conventional surgery with a rotary diamond bur on the other. Postoperative pain, swelling, edema, and mouth opening were evaluated at one hour and two and seven days after the procedures. All variables were submitted to Friedman or Wilcoxon tests at a 5% significance level.
Results The comparison between groups showed that postoperative pain after one hour and two days was significantly lower (p< 0.05) in the piezoelectric device group. Regarding the edema, the results of both techniques were similar at all times assessed (p> 0.05). Piezosurgery was statistically associated (p< 0.05) with greater mouth opening only at the 48-hour evaluation.
Conclusions Osteotomy with a piezoelectric device causes less pain and greater mouth opening postoperatively compared with the conventional technique. Key words:Piezosurgery, sinus lift, edema, pain, rotative instruments.
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Affiliation(s)
| | - Walbert-de Andrade Vieira
- Department of Restorative Dentistry, Endodontics division, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Luiz-Renato Paranhos
- Department of Community and Preventive Dentistry, School of Dentistry of Uberlândia, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Fujiwara S, Kato S, Bengazi F, Urbizo Velez J, Tumedei M, Kotsu M, Botticelli D. Healing at implants installed in osteotomies prepared either with a piezoelectric device or drills: an experimental study in dogs. Oral Maxillofac Surg 2020; 25:65-73. [PMID: 32803459 DOI: 10.1007/s10006-020-00895-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare osseointegration and marginal bone level at implants placed in osteotomies prepared with either conventional drills or a piezoelectric device. MATERIAL AND METHODS Three months after the extraction of all mandibular premolars and first molars, two recipient sites were selected. The osteotomies were randomly prepared with either conventional drills (drill sites) or a piezoelectric device (piezoelectric sites). Implants were installed and a submerged healing was allowed. The animals were euthanized in groups of six after 4 and 8 weeks of healing. Biopsies were obtained for histological preparation. Coronal level of osseointegration (bone level) and bone-to-implant contact percentage (BIC%) were evaluated. RESULTS After 4 weeks of healing, the bone level was 0.6 ± 0.9 mm for the piezoelectric sites and 1.6 ± 0.7 mm for the drill sites (p = 0.173). After 8 weeks, the respective measures were 0.9 ± 0.3 mm and 1.0 ± 1.1 mm (p = 0.917). After 4 weeks of healing, a new bone apposed onto the implant surface was found at fractions of 54.9 ± 6.7% and 55.1 ± 16.6% for the piezoelectric and the drill sites, respectively (p = 0.674). The respective total bone fractions, including new and old bone, was 64.0 ± 4.8% and 63.4 ± 20.4% (p = 0.917). After 8 weeks, a new bone increased to 67.4 ± 6.7% and 62.9 ± 12.5% for the piezoelectric and the drill sites, respectively (p = 0.463). The respective total bone fractions were 70.4 ± 5.5% and 67.8 ± 12.1% (p = 0.753). CONCLUSIONS The use of a piezoelectric device for implant site preparation is a safe procedure that allows a proper integration since the early periods of healing similar to that observed using conventional drills.
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Affiliation(s)
| | - Shingo Kato
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Nishinomiya City, Hyogo, Japan
| | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Mitsuo Kotsu
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Suita City, Osaka, Japan
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Tretto P, Fabris V, Cericato G, Sarkis-Onofre R, Bacchi A. Does the instrument used for the implant site preparation influence the bone–implant interface? A systematic review of clinical and animal studies. Int J Oral Maxillofac Surg 2019; 48:97-107. [DOI: 10.1016/j.ijom.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/27/2018] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
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Gürkan A, Tekdal GP, Bostancı N, Belibasakis GN. Cytokine, chemokine, and growth factor levels in peri‐implant sulcus during wound healing and osseointegration after piezosurgical versus conventional implant site preparation: Randomized, controlled, split‐mouth trial. J Periodontol 2018; 90:616-626. [DOI: 10.1002/jper.18-0216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Ali Gürkan
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
| | - Gözde Peker Tekdal
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
- Department of PeriodontologyKarşıyaka Oral and Dental Health Center Izmir Turkey
| | - Nagihan Bostancı
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
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Amghar-Maach S, Sánchez-Torres A, Camps-Font O, Gay-Escoda C. Piezoelectric surgery versus conventional drilling for implant site preparation: a meta-analysis. J Prosthodont Res 2018; 62:391-396. [DOI: 10.1016/j.jpor.2018.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 04/12/2018] [Accepted: 04/18/2018] [Indexed: 10/16/2022]
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Troedhan A, Mahmoud ZT, Wainwright M, Khamis MM. Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/2455-4634.000028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Peker Tekdal G, Bostanci N, Belibasakis GN, Gürkan A. The effect of piezoelectric surgery implant osteotomy on radiological and molecular parameters of peri-implant crestal bone loss: a randomized, controlled, split-mouth trial. Clin Oral Implants Res 2015; 27:535-44. [PMID: 26077862 DOI: 10.1111/clr.12620] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the effect of piezoelectric surgery (PS) implant osteotomy on biochemical and radiological parameters of crestal bone (CB) loss. MATERIAL AND METHODS In this randomized, controlled, clinical study, 38 osteotomies were prepared with PS and drilling in the posterior maxilla in a split-mouth design. Implants were placed and left for non-submerged healing. Osteotomy time, insertion torque, pain perception, probing depth, and modified gingival and plaque indices were recorded. Peri-implant sulcular fluid (PISF) was collected from four sites of each implant at 2, 4, 8, 12, and 24 weeks. PISF samples were analyzed by ELISA for receptor activator of nuclear factor kappa-B-ligand (RANKL) and osteoprotegerin. CB loss was assessed on periapical radiographs at the 12th and on cone beam computed tomography (CBCT) at the 24th weeks. The influence of time and osteotomy method on biochemical and radiological parameters of CB loss employed statistical method of Brunner-Langer. RESULTS Osteotomy time for PS group was significantly longer than the drill group (P < 0.05). Pain perception that was lower in the PS than in the drill group depended on osteotomy method (P < 0.05). PS group had lower RANKL total amount than the drill group (P < 0.05). Mean CB loss on periapical radiographs at the 12th week for PS and drill groups were 0.11 and 0.18 mm, respectively (P > 0.05). At the 24th week, PS and drill groups showed 0.11 and 0.12 mm CB losses on CBCT, respectively (P > 0.05). However, CB loss values did not depend on osteotomy modality (P > 0.05). CONCLUSION PS may modify and reduce bone-destructive inflammatory response during implant osseointegration. Therefore, on the molecular level, it might be a less traumatic osteotomy modality than drilling although this was not reflected by CB loss values in the present study.
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Affiliation(s)
- Gözde Peker Tekdal
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Nagihan Bostanci
- Section of Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Georgios N Belibasakis
- Section of Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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Temmerman A, Keestra JAJ, Coucke W, Teughels W, Quirynen M. The outcome of oral implants placed in bone with limited bucco-oral dimensions: a 3-year follow-up study. J Clin Periodontol 2015; 42:311-8. [DOI: 10.1111/jcpe.12376] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Andy Temmerman
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven - Catholic University of Leuven; Leuven Belgium
- Department of Periodontology; University Hospitals Leuven; Leuven Belgium
| | - Johan A. J. Keestra
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven - Catholic University of Leuven; Leuven Belgium
- Department of Periodontology; University Hospitals Leuven; Leuven Belgium
| | - Wim Coucke
- Department of Clinical Biology; Scientific Institute of Public Health; Brussels Belgium
| | - Wim Teughels
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven - Catholic University of Leuven; Leuven Belgium
- Department of Periodontology; University Hospitals Leuven; Leuven Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven - Catholic University of Leuven; Leuven Belgium
- Department of Periodontology; University Hospitals Leuven; Leuven Belgium
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