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Yuvashree CS, Rajasekar A. Prevalence and Association between Primary Stability and Bone Quality in Implants Placed in Edentulous Dental Arches: A Retrospective Analysis. J Long Term Eff Med Implants 2024; 34:9-15. [PMID: 38305366 DOI: 10.1615/jlongtermeffmedimplants.2023045549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. The dental implants have gained immense popularity. A secure implant primary stability is positively associated with a successful implant integration and long term successful clinical outcome. The main aim of this study was to find the association between primary stability and bone density in implants placed in maxilla and mandible. A total of 1263 patients who had undergone implant placement from March 2020-March 2021 in Saveetha Dental College and Hospitals, Chennai, India were chosen for the study. The primary stability and bone density of these patients were collected from the hospital records. The collected data was compiled, reviewed, tabulated in Microsoft Excel sheet and entered in SPSS software for statistical analysis. In the present study, the patient aged between 28 and 37 years had undergone more implant placement (31%) with male predilection (53%). The most commonly associated primary stability was found to be 30-40 Ncm (51.37%) predominantly with D2 type of bone density (52.69%). A Chi-squared statistical test was done for primary stability and bone density and the P was found to be 0.00 (Chi-squared P < 0.05, statistically significant). The most predominant bone density was D2 associated with primary stability of 30-40 Ncm. The association between bone density and primary stability was found to be statistically significant. The present study shows a strong relationship between bone density and primary implant stability.
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Affiliation(s)
- C S Yuvashree
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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Thread shape, cortical bone thickness, and magnitude and distribution of stress caused by the loading of orthodontic miniscrews: finite element analysis. Sci Rep 2022; 12:12367. [PMID: 35859046 PMCID: PMC9300621 DOI: 10.1038/s41598-022-16662-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Cortical bone thickness is assumed to be a major factor regulating miniscrew stability. We investigated stress distribution in two miniscrews with different thread shapes (type A and B) and in cortical bone of three different thicknesses using three-dimensional (3D) finite element (FE) models. More specifically, 3D FE models of two different miniscrews were created and placed obliquely or vertically into a cylindrical bone model representing different cortical bone thicknesses. When force was applied to the miniscrew, the stress distribution on the screw surface and in the peri-implant bone was assessed using FE methodology. Miniscrew safety was evaluated using a modified Soderberg safety factor. Screw head displacement increased with a decrease in cortical bone thickness, irrespective of screw type. The smallest minimum principal stresses on the screw surfaces remained constant in type A miniscrews on changes in cortical bone thickness. Minimum principal stresses also appeared on the cortical bone surface. Lower absolute values of minimum principal stresses were seen in type A miniscrews when placed vertically and with upward traction in obliquely placed type B miniscrews. Both miniscrews had acceptable safety factor values. Taken together, orthodontists should select and use the suitable miniscrew for each patient in consideration of bone properties.
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Manni A, Drago S, Migliorati M. Success rate of surface-treated and non-treated orthodontic miniscrews as anchorage reinforcement in the lower arch for the Herbst appliance: A single-centre, randomised split-mouth clinical trial. Eur J Orthod 2022; 44:452-457. [PMID: 35028669 DOI: 10.1093/ejo/cjab081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Surface treatment of miniscrews was implemented to determine whether its application increased bone-to-surface contact and enhanced the interlock between the device and the surrounding bone. OBJECTIVES To compare the success rate of surface-treated and non-treated orthodontic miniscrews used as reinforcement of anchorage during treatment with the Herbst appliance. TRIAL DESIGN Split-mouth design with an allocation ratio of 1:1. METHODS Eligibility criteria to enrol patients were skeletal and dental class II patients with a retrusive chin, use of the Herbst appliance to correct malocclusion, need for skeletal anchorage using a miniscrew both in the left and right side of the mouth, absence of systemic diseases, absence of using drugs that alter bone metabolism, and good oral hygiene. Patients received self-drilling miniscrews without surface treatment and with surface treatment. Both types presented a 1.4 or 1.2 mm diameter. Miniscrews were inserted between the first molar and second premolars or between the two premolars. The force applied to the screws was an elastic chain from the head of the miniscrews to a direct button applied on the canines. The success rate of each type of miniscrew was considered the primary outcome, and the association of success with demographical, clinical, and geometrical characteristics was investigated. Differences were tested by the generalised linear mixed effects model for the split-mouth design. Differences with a P-value < 0.05 were selected as significant. RANDOMISATION A randomisation list was created for the mouth side assignment. BLINDING The study was single blinded with regard to the statistical analysis. RESULTS Thirty-nine miniscrews of the non-treated type and 39 miniscrews of the surface-treated type were inserted in 39 patients (23 female and 16 male, mean age: 15.55 ± 7.91) recruited between March 2018 and December 2020 with a split-mouth study design. The mean therapy duration was 9.3 months (SD = 1.31). No differences in failure rate were observed between miniscrew types. No serious harm was observed. CONCLUSIONS The success rate of surface-treated and non-treated miniscrews showed no significant differences. REGISTRATION This trial was not registered.
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Affiliation(s)
| | - Sara Drago
- Orthodontics Department, School of Dentistry, Univesity of Genova , Genova, Italy
| | - Marco Migliorati
- Orthodontics Department, School of Dentistry, Univesity of Genova , Genova, Italy
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Dekker H, Schulten EAJM, Ten Bruggenkate CM, Bloemena E, van Ruijven LJ, Bravenboer N. Regional differences in microarchitecture and mineralization of the atrophic edentulous mandible: A microcomputed tomography study. Arch Oral Biol 2021; 133:105302. [PMID: 34773733 DOI: 10.1016/j.archoralbio.2021.105302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 10/15/2021] [Accepted: 10/28/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The aim of the present study was to assess mineralization and trabecular microarchitecture in atrophic edentulous mandibles and to identify regional differences and relations with the extent of resorption. METHODS Cortical and trabecular bone volumes in anterior, premolar and molar regions of 10 edentulous cadaveric mandibles (5 males and 5 females; mean age ± SD: 85.4 ± 8.3 years) were assessed by microcomputed tomography. Mandibular height and Cawood & Howell classes were recorded. Concerning trabecular volumes, bone mineral density (BMD), bone volume fraction, trabecular tissue volume fraction, connectivity density, trabecular number, trabecular thickness, trabecular separation, degree of anisotropy, and structural model index were measured; concerning cortical volumes porosity, BMD and cortical thickness were measured. RESULTS In molar regions, the bone volume fraction and trabecular number were lower, whereas trabecular separation, degree of anisotropy and cortical BMD were higher compared to anterior regions. In premolar regions, mandibular height correlated negatively with trabecular number (Spearman's correlation r = 0.73, p = 0.017) and connectivity density (Spearman's correlation r = 0.82, p = 0.004), and correlated positively with trabecular separation (Spearman's correlation r = - 0.65, p = 0.04). Cortical BMD was higher at bucco-inferior cortex of molar and inferior border of premolar region and lower at anterior cranial buccal and lingual surface. CONCLUSIONS In the premolar region, increased resorption coincides with local impairment of trabecular bone quality. Cortical bone BMD is higher in areas with highest strains and lower in areas with most mandibular resorption. Trabecular bone volume and quality is superior in the anterior region of the edentulous mandible, which might explain improved primary stability of dental implants in this region.
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Affiliation(s)
- Hannah Dekker
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Engelbert A J M Schulten
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Christiaan M Ten Bruggenkate
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Leo J van Ruijven
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nathalie Bravenboer
- Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA, Tareen SUK, Awinashe V. Influence of Inter-Radicular Septal Bone Quantity in Primary Stability of Immediate Molar Implants with Different Length and Diameter Placed in Mandibular Region. A Cone-Beam Computed Tomography-Based Simulated Implant Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S484-S491. [PMID: 34447139 PMCID: PMC8375907 DOI: 10.4103/jpbs.jpbs_818_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/04/2022] Open
Abstract
AIM The purpose of this in vitro study was to investigate the influence of length and width of implant on primary stability in immediate implants in mandibular first molar. MATERIALS AND METHODS The study was carried out on 40 cone-beam computed tomography scans selected with defined inclusion and exclusion criteria. According to the diameter and length of implants, they were divided into nine groups (G1 to G9). The virtual implants of different diameters and length were placed in mandibular first molar and measurements were done for peri-implant horizontal and vertical gap defect, peri-implant interradicular bone support and apical bone support for all the groups. RESULTS The study groups Diameter, (D-7 mm) showed least horizontal gap defect (Buccal-1.30 ± 0.56 mm, lingual-1.30 ± 0.56 mm, mesial-1.20 ± 0.51 mm, and distal-1.05 ± 0.59 mm) as compared to regular implant diameter (D-4.7) groups (Buccal-2.35 ± 0.483 mm, lingual-2.10 mm ± 0.44 mm, mesial-2.30 ± 0.64 mm, and distal-2.25 ± 0.43 mm). The unsupported Vertical implant gap defect at the coronal part of the socket was 2.80 mm ± 0.83 mm for all groups in both horizontal and vertical direction. The vertical peri-implant interradicular bone support showed increased bone support with increase in implant length (L). The buccal and lingual inter-radicular bone-support was least for Length (L-8.5 mm), moderate for L-11.5 mm, and highest for L-13.5 mm groups, respectively. The mesial inter-radicular bone support was least for G4G7, moderate for G1G2G5G8, and maximum for G3G6G9 groups. Similarly, the distal inter-radicular bone support was least for G4G7, moderate for G1G5G8, and maximum for G2G3G6G9 groups, respectively. There was no apical bone support in L-8.5 mm group as the tip of implant was 3.5-4 mm within the socket tip. Whereas, L-11.5 mm had decent (0.9-1 mm) and L-13.5 mm had Good (1.35-1.95 mm) apical bone support as the implant tip was beyond the socket tip. CONCLUSION All the groups showed good interradicular bone support on buccal and lingual surfaces. Regular width implants with longer length showed satisfactory interradicular bone support on mesial and distal surfaces. Longer implants showed good apical bone support in all the four surfaces and hence good apical primary stability expected.
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Affiliation(s)
- Arshad Jamal Sayed
- Department of Preventive Dentistry, College of Dentistry in Alrass, Qassim University, Saudi Arabia
| | - Safia Shoeb Shaikh
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Saudi Arabia
| | - Shoeb Yakub Shaikh
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Saudi Arabia
| | | | | | - Vaibhav Awinashe
- Department of Prosthodontics. College of Dentistry in Alrass, Qassim University, Saudi Arabia
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Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study. MATERIALS 2021; 14:ma14071728. [PMID: 33915933 PMCID: PMC8036940 DOI: 10.3390/ma14071728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/14/2023]
Abstract
(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.
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Hong JY, Shin EY, Herr Y, Chung JH, Lim HC, Shin SI. Implant survival and risk factor analysis in regenerated bone: results from a 5-year retrospective study. J Periodontal Implant Sci 2020; 50:379-391. [PMID: 33350178 PMCID: PMC7758304 DOI: 10.5051/jpis.2002140107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/15/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose The aims of this study were to evaluate the 5-year cumulative survival rate (CSR) of implants placed with guided bone regeneration (GBR) compared to implants placed in native bone, and to identify factors contributing to implant failure in regenerated bone. Methods This retrospective cohort study included 240 patients who had implant placement either with a GBR procedure (regenerated bone group) or with pristine bone (native bone group). Data on demographic features (age, sex, smoking, and medical history), location of the implant, implant-specific features, and grafting procedures and materials were collected. The 5-year CSRs in both groups were estimated using Kaplan-Meier analysis. Risk factors for implant failure were analyzed with a Cox proportional hazards model. Results In total, 264 implants in the native bone group and 133 implants in the regenerated bone group were analyzed. The 5-year CSRs were 96.4% in the regenerated bone group and 97.5% in the native bone group, which was not a significant difference. The multivariable analysis confirmed that bone status was not an independent risk factor for implant failure. However, smoking significantly increased the failure rate (hazard ratio, 10.7; P=0.002). Conclusions The 5-year CSR of implants placed in regenerated bone using GBR was comparable to that of implants placed in native bone. Smoking significantly increased the risk of implant failure in both groups.
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Affiliation(s)
- Ji Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Eun Young Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yeek Herr
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jong Hyuk Chung
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Hyun Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seung Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea.
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The Effects of Smoking Cigarettes on Immediate Dental Implant Stability—A Prospective Case Series Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Smoking tobacco significantly affects the biology of periodontal tissues and contributes to the increased risk of peri-implant diseases. The aim of the study was to investigate whether smoking cigarettes affects the primary and secondary stability of maxillary dental implants, inserted into fresh sockets immediately after extraction. Methods: The study was conducted on 164 patients between the ages of 27–71 years old. 67 individuals smoked more than 20 cigarettes daily and 97 were non-smokers. 190 immediate implants were inserted in the maxilla. Immediate implantations were performed with simultaneous augmentation of the socket with xenogenic bone grafting material. In the posterior region, implants were inserted into the palatal alveolus. The stability of the implants was measured using Insertion Torque Value (ITV) and two types of devices: Periotest (PT) and Osstell (ISQ). Marginal bone loss was evaluated on cone beam computed tomography scans. Results: In an aesthetic area, the PT values at 6 months post-implantation were higher for smokers than non-smokers (p < 0.05), respectively. The ISQ values were significantly lower in smokers compared to non-smokers at 6 months post-implantation (p = 0.0226), respectively. In the posterior region PT values were higher in smokers both on the day of implantation (p = 0.0179), 6 months after surgery (p = 0.0003) as well as 24 months after surgery (p < 0.0001), as compared to non-smokers, respectively. Smokers revealed lower ISQ values than non-smokers (p = 0.0047) on the day of implantation, as well as 6 months after implantation (p = 0.0002), respectively. There were no significant differences in marginal bone loss after 18 months of loading between smokers and non-smokers in the aesthetic, as well as posterior regions (p > 0.05). ITV measurements were lower in smokers than non-smokers in the aesthetic (16.3 vs. 17.5 Ncm) and posterior area (16.8 vs. 17.9 Ncm). Conclusions: This study indicate that smoking cigarettes has a negative effect on the stability of immediate implants in the maxilla. Primary stability of immediate implants may be lower in the posterior area of the maxilla in smokers when compared to non-smokers, which may eliminate smokers from immediate implants in this region. Secondary stability of immediate implants may be lower in both the aesthetic and posterior areas in smokers compared to non-smokers, which may encourage the postponement of final crowns delivery at 6 months post op and the extension of the occlusaly temporary crowns use in some smoker cases.
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Migliorati M, Drago S, Amorfini L, Nucera R, Silvestrini-Biavati A. Maximum insertion torque loss after miniscrew placement in orthodontic patients: A randomized controlled trial. Orthod Craniofac Res 2020; 24:386-395. [PMID: 33274528 DOI: 10.1111/ocr.12449] [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: 09/01/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare torque recordings of immediately loaded orthodontic miniscrews between insertion time and different post-placement timepoints (2 weeks, 4 weeks and removal time, respectively). SETTING AND SAMPLE POPULATION Parallel trial with an allocation ratio of 1:1. Eligibility criteria were needs of fixed orthodontic treatment, no systemic disease and absence of using drugs altering bone metabolism. MATERIAL AND METHODS Patients received miniscrews, 2.0 mm diameter and 10 mm length. All miniscrews underwent inter-radicular placement, and they were placed in the maxilla or in the mandible, palatally or buccally. No pre-drilling was performed. Miniscrews were loaded immediately after the insertion and were used for distalization, intrusion, extrusion, mesialization or indirect anchorage. Patients were randomly divided into three groups. For each patient, Maximum Insertion Torque (MIT) was evaluated at baseline. MIT was measured again after 2 weeks and after 4 weeks by tightening the screw a quarter of turn in Groups 1 and 2, respectively. At the end of the treatment, maximal removal torque was evaluated in Group 3. Torque variation with respect to insertion time was considered as the primary outcome. Baseline and longitudinal differences were tested using the linear mixed-effects (LME) model. RESULTS Forty seven patients and 74 miniscrews were followed up. An association existed between maximum insertion torque and the observation time. A torque decrease of 26.9% and 30% after 2 weeks was observed for mandibular and maxillary miniscrews, respectively. After 1 month, torque values were similar to the baseline records. The overall success rate was 79.7%. No serious harm was observed. CONCLUSIONS Maximum insertion torque undergoes a loss during the first 2 weeks, and its values may depend on the insertion site and the anchorage purpose. Removal torque value is almost the same as the initial torque after 1 month.
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Affiliation(s)
- Marco Migliorati
- Orthodontics Department, School of Dentistry, University of Genova, Genova, Italy
| | - Sara Drago
- Orthodontics Department, School of Dentistry, University of Genova, Genova, Italy
| | | | - Riccardo Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Staedt H, Kämmerer PW, Goetze E, Thiem DGE, Al-Nawas B, Heimes D. Implant primary stability depending on protocol and insertion mode - an ex vivo study. Int J Implant Dent 2020; 6:49. [PMID: 32880030 PMCID: PMC7468011 DOI: 10.1186/s40729-020-00245-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned protocol. Dental implant stability was measured via resonance frequency analysis (RFA), insertion torque (IT), and torque out (TO). Results Statistically significant higher IT and TO values were seen after standard protocol insertion (p < 0.05), whereas manual and machine-driven insertion mode showed equivalent values. Conclusions The over-dimensioned protocol exceeded the primary stability values recommended for immediate implant insertion; therefore, it could be recommended as well.
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Affiliation(s)
- Henning Staedt
- Private Practice and Department of Prosthodontics and Materials Science, University Medical Center Rostock, Strempelstraße 13, 18057, Rostock, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Elisabeth Goetze
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Arosio P, Arosio F, Di Stefano DA. Implant Diameter, Length, and the Insertion Torque/Depth Integral: A Study Using Polyurethane Foam Blocks. Dent J (Basel) 2020; 8:dj8020056. [PMID: 32512762 PMCID: PMC7345030 DOI: 10.3390/dj8020056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/21/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022] Open
Abstract
The amount of energy necessary to place an implant in its seat, described as the integral of the torque-depth curve at insertion (I), has been validated as a reliable measure of primary stability. This study aimed to investigate whether (I) may detect the variations in primary stability caused by changes in the implant length or diameter better than the insertion torque (IT). Cylindric implants featuring a double-etched, sandblasted surface with different diameters or lengths were placed into monolithic polyurethane foam blocks with different densities that mimicked human bone. (I)-, (I)*-, IT-, IT*-diameter and -length plots ((I)* and IT* were the derived values corrected for undersizing) were drawn and the relation between (I), (I)*, IT, and IT* and the fixture diameter or length was investigated with correlation analysis. (I)* and IT* correlated better than (I) and IT with the fixture diameter; (I), (I)*, IT, and IT* correlated equally well with the fixture length. In all cases, the slopes of the lines best fitting the experimental data were greater for (I) or (I)* than IT or IT*, respectively. (I) or (I)* were better detectors than IT or IT* of the changes in primary stability that can be achieved by increasing the fixture diameter or length.
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Affiliation(s)
- Paolo Arosio
- Private Practitioner, Vimercate, 20871 Monza-Brianza, Italy;
| | | | - Danilo Alessio Di Stefano
- Adjunct Professor, Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Private Practitioner, 20148 Milan, Italy
- Correspondence: ; Tel.: +39-02-48705703
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Sghaireen MG, Alzarea BK, Alam MK, Rahman SA, Ganji KK, Alhabib S, Shrivastava D, Dar-Odeh N, Hasegawa M, Kamiya K, Nagaya Y, Sugita Y, Maeda H. Implant Stability, Bone Graft Loss and Density with Conventional and Mineralized Plasmatic Matrix Bone Graft Preparations - A Randomized Crossover Trial. J HARD TISSUE BIOL 2020. [DOI: 10.2485/jhtb.29.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Bader K Alzarea
- Prosthodontic Department, College of Dentistry, Jouf University
| | | | | | | | - Silham Alhabib
- Prosthodontic Department, College of Dentistry, Jouf University
| | | | - Najla Dar-Odeh
- Oral Basic and Clinical Sciences Department, College of Dentistry, Taibah University
| | - Masakazu Hasegawa
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Kei Kamiya
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshitaka Nagaya
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Yoshihiko Sugita
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
| | - Hatsuhiko Maeda
- Department of Oral Pathology, School of Dentistry, Aichi Gakuin University
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Xu HD, Miron RJ, Zhang XX, Zhang YF. Allogenic tooth transplantation using 3D printing: A case report and review of the literature. World J Clin Cases 2019; 7:2587-2596. [PMID: 31559297 PMCID: PMC6745321 DOI: 10.12998/wjcc.v7.i17.2587] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/25/2019] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The history of allogenic tooth transplantation can be traced back to the 16th century. Although there have been many successful cases, much needs to be better understood and researched prior to the technique being translated to everyday clinical practice.
CASE SUMMARY In the present report, we describe a case of allogenic tooth transplantation between a mother and her daughter. The first left maxillary molar of the mother was diagnosed with residual root resorption and needed to be extracted. The 3rd molar of the daughter was used as a donor tooth. Prior to transplantation, a 3D printing system was introduced to fabricate an individualized reamer drill specifically designed utilizing the donor’s tooth as a template. The specific design of our 3D printed bur allowed for the recipient site to better match the donor tooth. With the ability to 3D print in layers, even the protuberance of the root can be matched and 3D printed, thereby minimizing unnecessary bone loss.
CONCLUSION Our study is a pioneering case combining 3D printing with allogenic tooth transplantation, which could be able to minimize unnecessary bone loss and improve the implant stability. This article aims to enhance our understanding of allogenic tooth transplantation and 3D printing, and may potentially lead to tooth transplantation being utilized more frequently - especially since transplantations are so commonly utilized in many other fields of medicine with high success rates.
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Affiliation(s)
- Hu-Di Xu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Richard J Miron
- Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314-7796, United States
| | - Xiao-Xin Zhang
- Department of Oral Implantology, School of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Yu-Feng Zhang
- Department of Oral Implantology, School of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
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Juboori MJA, Attas MAA, Gomes RZ, Alanbari BF. Using Resonance Frequency Analysis to Compare Delayed and Immediate Progressive Loading for Implants Placed in the Posterior Maxilla: A Pilot Study. Open Dent J 2018; 12:801-810. [PMID: 30450138 PMCID: PMC6198410 DOI: 10.2174/1745017901814010801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/05/2018] [Accepted: 09/25/2018] [Indexed: 11/24/2022] Open
Abstract
Objective: Implants placed in the posterior region of the maxilla have a high incidence of implant failure due to poor bone quality, especially when immediate implant loading is needed. Immediate Progressive Loading (IPL) can enhance bone quality and may offer an alternative solution when Immediate Implant loading is needed. Methods: Six patients (one male and five females; 34-62 years old) were included in this study. Twelve implants were inserted in the posterior region of the maxilla. Resonance Frequency Analysis (RFA) was performed at the time of implant placement and after 1, 2, 3 and 6 months. ISQ (Implant Stability Quotient) values were compared between the Delayed Loading (DL) group after 2 months and the Progressive Loading (PL) group and between different time points for each group. Results: At implant placement, the mean ISQ values for PL and DL implants were 63 and 57, respectively. One month after implant placement, the mean ISQ value for PL implants was 73. Two months after implant placement, the mean ISQ value for PL implants was 75. Three months after implant placement, the mean ISQ values for PL and DL implants were 76 and 69, respectively. Six months after implant placement, the mean ISQ values for PL and DL implants were 79 and 76, respectively. Conclusion: Despite its limitations, this pilot study indicated that compared to DL, PL can enhance bone density and implant stability, resulting in greater early functionality and fewer surgery sessions.
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Affiliation(s)
| | - Mohammed Ahmed Al Attas
- Department of Prosthodontic and Dental Implant, Riyadh Dental Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Raquel Zita Gomes
- Department of Oral Surgery, Faculty of Dental Medicine, University of Porto, Porto, Portugal
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15
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Risk factors for post-operative complications after procedures for autologous bone augmentation from different donor sites. J Craniomaxillofac Surg 2018; 46:312-322. [DOI: 10.1016/j.jcms.2017.11.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/09/2017] [Accepted: 11/14/2017] [Indexed: 11/20/2022] Open
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Faria PEP, Masalskas B, Heyden A, Rasmusson L, Salata LA. Immediate loading of implants in the edentulous mandible: a multicentre study. Oral Maxillofac Surg 2016; 20:385-390. [PMID: 27638643 DOI: 10.1007/s10006-016-0577-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/08/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The aim of this prospective study was to investigate the two-year outcomes following immediate loading of mono-cortically engaged implants. MATERIALS AND METHODS Thirty healthy mandible edentulous patients with an average age of 67.3 years and presenting with sufficient bony ridge at the mandible symphysis were included in the study. Four Astra Tech, Ti-Oblast® implants were installed between the mental foramina using the mono-cortical anchorage technique. The primary stability of the implants was assessed by resonance frequency analysis (RFA). After uni-abutments were placed, a temporary bridge was constructed and fixed the same day. The definitive bridges were installed 6 weeks after implant surgery. Five of 120 placed implants were lost in four patients during the first 6 weeks and these patients were excluded from the follow-up. The changes in marginal bone level (n = 20) were evaluated in Brazilian and Swedish groups at baseline, 6 weeks, 6 months, 12 months and 24 months. The RFA (n = 30) was evaluated at baseline, 6 weeks, 6 months, 12 months and 24 months postoperatively. RESULTS Compared with baseline measurements, the postoperative values for marginal bone level (6 weeks, 6 months, 12 months and 24 months) were significantly reduced (p < 0.05), while no differences were observed in the RFA analysis (12 months and 24 months). CONCLUSIONS The immediate loading of mono-cortically engaged implants in the edentulous mandible is safe and predictable and implant stability remains excellent after 2-year follow-up.
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Affiliation(s)
| | - Bárbara Masalskas
- Department of Oral and Maxillofacial Surgery, University of Ribeirão Preto, São Paulo, Brazil
| | | | - Lars Rasmusson
- Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Luiz Antonio Salata
- Department of Oral & Maxillofacial Surgery and Periodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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17
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Aivazi M, Hossein Fathi M, Nejatidanesh F, Mortazavi V, HashemiBeni B, Matinlinna JP, Savabi O. The evaluation of prepared microgroove pattern by femtosecond laser on alumina-zirconia nano-composite for endosseous dental implant application. Lasers Med Sci 2016; 31:1837-1843. [PMID: 27677478 DOI: 10.1007/s10103-016-2059-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 08/22/2016] [Indexed: 11/27/2022]
Abstract
Ceramic dental materials, especially alumina (20 %vol)-yttrium stabilized tetragonal zirconia poly crystal (A-Y-TZP20), have been considered as alternatives to metals for endosseous dental implant application. For increasing the bone-to-implant contact as well as the speed of bone formation, a new surface modification can be effective. The aim of this study was to design microgroove patterns by femtosecond laser on A-Y-TZP20 nano-composite disks for endosseous dental implant application. The phase composition and the morphology of the A-Y-TZP20 nano-composite samples were characterized using X-ray diffraction and Scanning electron microscopy equipped with energy dispersive X-ray spectroscopy techniques. Statistical analysis was submitted to Kolmogorov-Smirnov test and Student's t test for independent variables, with a 5 % significance level. EDAX analysis revealed a significant decrease in the relative content of contaminants like carbon (p < 0.05) in laser surface-treated group as compared to non surface-treated group. X-ray diffraction did not show any change in the crystalline structure induced by laser processing. It was concluded that the femtosecond laser is a clean and safe method for surface modification of A-Y-TZP20.
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Affiliation(s)
- Moluk Aivazi
- Biomaterials Research Group, Department of Materials Engineering, Isfahan University of Technology, Isfahan, 841568, Iran.
| | - Mohammad Hossein Fathi
- Biomaterials Research Group, Department of Materials Engineering, Isfahan University of Technology, Isfahan, 841568, Iran.,Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
| | - Farahnaz Nejatidanesh
- Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
| | - Vajihesadat Mortazavi
- Torabinejad Dental Research Center, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
| | - Batoul HashemiBeni
- Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, 81746-73461, Iran
| | - Jukka Pekka Matinlinna
- Faculty of Dentistry, The University of Hong Kong, 4/F Dental Material Science, The Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Omid Savabi
- Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
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Shiffler K, Lee D, Rowan M, Aghaloo T, Pi-Anfruns J, Moy PK. Effect of length, diameter, intraoral location on implant stability. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e193-e198. [PMID: 27601347 DOI: 10.1016/j.oooo.2016.06.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/26/2016] [Accepted: 06/05/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To quantitatively compare stability of dental implants with varying lengths, diameters, and intraoral locations. STUDY DESIGN Retrospectively, 200 consecutive NobelReplace Tapered Groovy implants of varying lengths and diameters were evaluated via implant stability quotient readings at placement (T1) and follow-up (T2). Data were analyzed by analysis of variance and simple linear regression tests. RESULTS Intraoral location was statistically significant at T1 and T2. Although implant diameter was not statistically significant, implant length resulted in T1 (P = .08) and T2 (P = .09), which may have a clinically relevant effect on implant stability. An overall implant survival rate of 98% was achieved. Gender and age did not seem to affect implant stability quotient values at placement, follow-up, or implant survival. CONCLUSIONS Intraoral location is an important factor in implant stability, with implants placed in the mandible being more stable than implants placed in the maxilla both at T1 and T2. Length may have a clinically relevant effect on implant stability.
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Affiliation(s)
- Kyle Shiffler
- UCLA School of Dentistry, Oral and Maxillofacial Surgery, Los Angeles, CA, USA
| | - David Lee
- UCLA School of Dentistry, Oral and Maxillofacial Surgery, Los Angeles, CA, USA
| | - Mark Rowan
- UCLA School of Dentistry, Oral and Maxillofacial Surgery, Los Angeles, CA, USA
| | - Tara Aghaloo
- UCLA School of Dentistry, Oral and Maxillofacial Surgery, Los Angeles, CA, USA
| | - Joan Pi-Anfruns
- UCLA School of Dentistry, Oral and Maxillofacial Surgery, Los Angeles, CA, USA
| | - Peter K Moy
- Nobel Biocare Endowed Chair, UCLA School of Dentistry, Los Angeles, CA, USA.
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Migliorati M, Drago S, Barberis F, Schiavetti I, Dalessandri D, Benedicenti S, Biavati AS. Torque Loss After Miniscrew Placement: An In-Vitro Study Followed by a Clinical Trial. Open Dent J 2016; 10:251-60. [PMID: 27386011 PMCID: PMC4911753 DOI: 10.2174/1874210601610010251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 12/18/2022] Open
Abstract
To evaluate torque loss a week after insertion, both in an in vivo and an in vitro experimental setup were designed. In the in vivo setup a total of 29 miniscrews were placed in 20 patients who underwent orthodontic treatment. Maximum insertion torque (MIT) was evaluated at insertion time (T1). A week later, insertion torque was measured again by applying a quarter turn (T2); no load was applied on the screw during the first week. In the in vitro setup a total of 20 miniscrews were placed in pig rib bone samples. MIT was evaluated at insertion time (T1). Bone samples were kept in saline solution and controlled environment for a week during which the solution was refreshed every day. Afterwards, torque was measured again by applying a quarter turn (T2). The comparison of MIT over time was done calculating the percentage difference of the torque values between pre- and post-treatment and using the parametric two independent samples t-test or the non-parametric Mann–Whitney test. After a week unloaded miniscrews showed a mean loss of rotational torque of 36.3% and 40.9% in in vitro and in in vivo conditions, respectively. No statistical differences were found between the two different setups. Torque loss was observed after the first week in both study models; in vitro experimental setup provided a reliable study model for studying torque variation during the first week after insertion.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Sara Drago
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering (DICCA), University of Genova, Via Montallegro 1, 16145 Genova, Italy
| | - Irene Schiavetti
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genova, Italy
| | - Domenico Dalessandri
- Department of Orthodontics, School of Dentistry, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Integrated Sciences, University of Genova, Largo Benzi 8, 16132 Genova, Italy
| | - Armando Silvestrini Biavati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
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20
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Romanos GE, Delgado-Ruiz RA, Sacks D, Calvo-Guirado JL. Influence of the implant diameter and bone quality on the primary stability of porous tantalum trabecular metal dental implants: an in vitro biomechanical study. Clin Oral Implants Res 2016; 29:649-655. [PMID: 26916451 DOI: 10.1111/clr.12792] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the primary, initial stability of Porous Tantalum Trabecular Metal™ implants (TM) compared with Tapered Screw Vent® implants (TSV) with different diameters, inserted in two bone densities. METHODS A total of 160 implants (80 TM and 80 TSV) with narrow (3.7 mm) and conventional (4.1 mm) diameters and the same length (10 mm) were placed in artificial bone blocks representing bone qualities II and IV. The implant stability was evaluated by insertion torque (IT) and Resonance Frequency Analysis. Statistical analysis was performed with non-parametric Kruskal-Wallis test with Dunn post-test for the differences between groups. RESULTS The results showed higher ISQ values in dense bone compared with soft bone for all the groups (P < 0.05). Conventional-diameter implants (TSV and TM) showed higher ISQ and IT values compared with narrow implants (TSV and TM) in dense and soft bone (P < 0.05). Tapered TSV implants showed higher stability in soft bone compared with TM implants (P < 0.05). In dense bone, differences were not observed between narrow TSV 3.7 mm and TM 3.7 mm implants (P > 0.05). CONCLUSIONS Within the limitations of this study, it can be concluded: In dense bone blocks, the wider diameter implants are more stable than narrow implants. In soft bone blocks, the tapered TSV implants are more stable than TM implants.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Danielle Sacks
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Josè Luis Calvo-Guirado
- Department of International Dentistry Research, Faculty of Medicine and Dentistry, San Antonio Catholic University of Murcia (UCAM), Murcia, Spain
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21
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Migliorati M, Drago S, Gallo F, Amorfini L, Dalessandri D, Calzolari C, Benedicenti S, Silvestrini-Biavati A. Immediate versus delayed loading: comparison of primary stability loss after miniscrew placement in orthodontic patients-a single-centre blinded randomized clinical trial. Eur J Orthod 2016; 38:652-659. [PMID: 26728036 DOI: 10.1093/ejo/cjv095] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The aim of this randomized clinical trial was to compare torque recordings at insertion time and 1 week post-placement between immediately loaded orthodontic miniscrews and an unloaded control group. TRIAL DESIGN This RCT was designed as parallel with an allocation ratio of 1:1. METHODS Eligibility criteria to enroll patients were: needs of fixed orthodontic treatment, no systemic disease, absence of using drugs altering bone metabolism. All patients were consecutively treated in a private practice and the miniscrews were placed by the same author. Patients received ORTHOImplant (3M Unitek) miniscrews and they were blindly divided in two groups: group 1 screws were unloaded between T0 and T1, group 2 received immediately loaded screws with NiTi coil. For each patient, maximum insertion torque (MIT) was evaluated at T0. After 1 week, without loading, the screw torque was measured again (T1) and at the end of the treatment maximal removal torque was evaluated (T2). Torque variation in the first week was considered as the primary outcome. RANDOMIZATION A randomization list was created for the group assignment, with an allocation ratio of 1:1. BLINDING The study was single blinded in regard of the statistical analysis. RESULTS Patients enrolled in the clinical trial were 51 for a total of 81 miniscrews. The recruitment started in November 2012 and the observation period ended in August 2014. Twenty-six and twenty-five patients were analysed in group 1 and 2, respectively. The MIT mean in each placement time was 18.25 Ncm (SD = 3.00), 11.41 Ncm (SD = 3.51) and 10.52 Ncm (SD = 5.14) at T0, T1, and T2 time, respectively. In group 1, the torque decrease between T1 and T0 was statistically higher compared to group 2 (P value = 0.003). Statistically significant effects of the placement times on MIT were found (P value <0.0001). No serious harm was observed. LIMITATIONS This study was performed using only direct force on the miniscrew and not using the miniscrew as an indirect anchorage. It was not possible to obtain quantitative data on bone quality or root proximity to miniscrews. CONCLUSIONS A significant stability loss was observed in the first week in both groups; Group 1 showed a statistically higher torque loss in the first week when compared to the immediately loaded group. There were statistically significant effects of the measurement times on MIT and of the miniscrew location on MIT. The overall failure rate was 7.4%. TRIAL REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement.
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Affiliation(s)
- Marco Migliorati
- *Orthodontics Department, School of Dentistry, University of Genova, Italy,
| | - Sara Drago
- *Orthodontics Department, School of Dentistry, University of Genova, Italy
| | - Fabio Gallo
- **Section of Biostatistics, Department of Health Sciences, University of Genova, Italy
| | | | - Domenico Dalessandri
- ****Department of Orthodontics, School of Dentistry, University of Brescia, Italy, and
| | - Chiara Calzolari
- *Orthodontics Department, School of Dentistry, University of Genova, Italy
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Tabuchi M, Ikeda T, Nakagawa K, Hirota M, Park W, Miyazawa K, Goto S, Ogawa T. Ultraviolet photofunctionalization increases removal torque values and horizontal stability of orthodontic miniscrews. Am J Orthod Dentofacial Orthop 2015; 148:274-82. [PMID: 26232836 DOI: 10.1016/j.ajodo.2015.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The objective of this study was to examine the effects of ultraviolet-mediated photofunctionalization of miniscrews and the in-vivo potential of bone-miniscrew integration. METHODS Self-drilling orthodontic miniscrews made from a titanium alloy were placed in rat femurs. Photofunctionalization was performed by treating the miniscrews with ultraviolet light for 12 minutes with a photo device immediately before implantation. Maximum insertion torque (week 0), removal torque (weeks 0 and 3), and resistance to lateral tipping force (week 3) were examined. RESULTS The removal torque at 3 weeks of healing was higher for the photofunctionalized screws than for the untreated screws. The regenerated bone tissue was more intact and contiguous around the photofunctionalized miniscrews than around the untreated ones. The miniscrew-bone complex seemed to produce interface failure, not cohesive fracture, in both groups. The displacement of untreated screws under a lateral tipping force was greater than that of photofunctionalized miniscrews. CONCLUSIONS These results suggest that photofunctionalization increases the bioactivity of titanium-alloy miniscrews and improves the anchoring capability of orthodontic miniscrews, even without modification of the surface topography.
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Affiliation(s)
- Masako Tabuchi
- Visiting scholar, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif; associate professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Takayuki Ikeda
- Visiting scholar, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Kahori Nakagawa
- Visiting scholar, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Makoto Hirota
- Visiting scholar, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Wonhee Park
- Visiting scholar, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Ken Miyazawa
- Professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shigemi Goto
- Professor and chairman, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Takahiro Ogawa
- Professor, Laboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
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Teixeira ABV, Beja GBSP, Shimano AC, Macedo AP, Oliscovicz NF, Reis ACD. Influence of the ultimate torsion on the geometry of dental implants. Braz Dent J 2015; 24:213-7. [PMID: 23969908 DOI: 10.1590/0103-6440201302165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/05/2013] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the profile of implants subjected to torsion test. Four types of implants (Conexão®) were analyzed: Master Porous (MP - external hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm), Master Screw (MS - external hexagon, cylindrical, machined implants; 11.5 X 3.75 mm), Conect Conic (CC - external hexagon, cylindrical, machined implants; 11.5 X 3.5 mm) and Master Conect AR (CA - internal hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm). The Nikon® model C profile projector was used for the analysis before and after torsion test with a Mackena® model MK-20XX digital torque meter. The measures analyzed in the profile of implants were: diameter and height of the platform, diameter of the screw/platform connection, angle of the screw/platform connection, external diameter, internal diameter, thread pitch, height and length of the thread. Statistical analysis was performed using ANOVA and Tukey test at 5% significance level. The torsion test caused a visible deformity on the external implant profile. There was a statistical difference among the implants before and after torsion (p<0.05) for the variables: platform diameter, platform height, diameter of the screw/platform connection and length. Changes were observed in platform height of CC and CA, fracture of CA implants, fracture of the MP and MS assembler/connectors, and internal thread stripping of CC. Thus, it was concluded that excessive or some unadvised torque by the manufacturer can lead to changes in different geometric measurements of implants.
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Al-Juboori MJ, AbdulRahaman SB. The Effect of Flapless and Full-thickness Flap Techniques on Implant Stability During the Healing Period. Open Dent J 2015; 9:243-9. [PMID: 26312095 PMCID: PMC4541338 DOI: 10.2174/1874210601509010243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/26/2015] [Accepted: 05/31/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose :
When soft tissue flaps are reflected for implant placement, the blood supply from the periosteum to the bone is disrupted. The aim of this study was to compare the effects of the flapless (FL) and full-thickness flap (FT) techniques on implant stability. Methods : Nine patients received 22 implants. The implants were placed using the FL technique on the contralateral side of the jaw; the FT technique was used as the control technique. Resonance frequency analysis (RFA) was performed at the time of implant placement and at 6 and 12 weeks after implant placement. RFA values were compared between the FL and FT groups and between time intervals in the same group. Results : The median (interquartile range [IQR]) RFA values at the time of implant placement were 75.00 (15.00) for the FL technique and 75.00 (9.00) for the FT technique. At 6 weeks, the median (IQR) values were 79 (3.30) for the FL technique and 80 (12.70) for the FT technique. At 12 weeks, the median (IQR) values were 82.3 (3.30) for the FL technique and 82.6 (8.00) for the FT technique. There were no significant differences between the 2 techniques at the time of implant placement, after 6 weeks or after 12 weeks, with p values of 0.994, 0.789, and 0.959, respectively. There were significant differences between the RFA values at the time of implant placement and after 6 weeks for the FL technique (p=0.028) but not for the FT technique (p=0.091). There were also significant differences between the RFA values at 6 weeks and the RFA values at 12 weeks for the FL technique (p=0.007) and for the FT technique (p=0.003). Conclusion : Periosteum preservation during the FL procedure will speed up bone remodeling and result in early secondary implant stability as well as early loading.
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A Revolving Temporary Anchorage Cap Connecting to an Orthodontic Miniscrew Using In Vitro Experimental Testing: Safety and Biomechanical Evaluations. IMPLANT DENT 2015. [PMID: 26204168 DOI: 10.1097/id.0000000000000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study is to develop a plastic revolving (translation and rotation) temporary anchorage cap (TAC) as the orthodontic anchor and evaluate its biomechanical safety and clinical used feasibility. MATERIALS AND METHODS The TAC was designed to connect onto a mini-implant head with 45-degree switching unit and extended arm for tying an orthodontic elastic chain/coil spring. The removal force between the TAC and mini-implant head and torque resistance on the mini-implant/bone interface were performed to evaluate the biomechanical safety. Clinical molar uprighting and mesial drive application were performed to reveal the TAC feasibility/capacity. RESULTS The removal force was 43.95 N (>>finger-pulling force 9.3 N) to prevent the TAC from detaching, and the torque resistance was 159.25 N·mm to maintain micromotion smaller than 30.4 μm between the screw and bone. The strain value in using TAC treatment was found to be about 2 times that of traditional tracing (without using TAC) in molar uprighting/mesial drive application. CONCLUSIONS The plastic revolving TAC can provide optional use with translation/rotation features to change the angles and directions in orthodontic tractions and increase treatment efficiency under biomechanical safety considerations.
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Noda K, Arakawa H, Kimura-Ono A, Yamazaki S, Hara ES, Sonoyama W, Maekawa K, Okura K, Shintani A, Matsuka Y, Kuboki T. A longitudinal retrospective study of the analysis of the risk factors of implant failure by the application of generalized estimating equations. J Prosthodont Res 2015; 59:178-84. [DOI: 10.1016/j.jpor.2015.04.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 04/08/2015] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
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Affiliation(s)
- J Dudley
- School of Dentistry; The University of Adelaide; South Australia Australia
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Al-Juboori MJ. Progressive immediate loading of a perforated maxillary sinus dental implant: a case report. Clin Cosmet Investig Dent 2015; 7:25-31. [PMID: 25678816 PMCID: PMC4317063 DOI: 10.2147/ccide.s76637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement.
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Elias CN, Fernandes DJ, Resende CR, Roestel J. Mechanical properties, surface morphology and stability of a modified commercially pure high strength titanium alloy for dental implants. Dent Mater 2015; 31:e1-e13. [DOI: 10.1016/j.dental.2014.10.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/02/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
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Migliorati M, Drago S, Schiavetti I, Olivero F, Barberis F, Lagazzo A, Capurro M, Silvestrini-Biavati A, Benedicenti S. Orthodontic miniscrews: an experimental campaign on primary stability and bone properties. Eur J Orthod 2014; 37:531-8. [DOI: 10.1093/ejo/cju081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kundu R, Rathee M. Effect of Platelet-Rich-Plasma (PRP) and Implant Surface Topography on Implant Stability and Bone. J Clin Diagn Res 2014; 8:ZC26-30. [PMID: 25121060 DOI: 10.7860/jcdr/2014/9177.4478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 05/04/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the effect of Platelet-Rich-Plasma (PRP) and different implant surface topography on implant stability and bone levels around immediately loaded dental implants. MATERIALS AND METHODS Dental implants were placed in subjects divided into two groups and four subgroups on basis of implant treatment with PRP and implant surface topography used. A total of 30 implants were placed, 15 in each group. For PRP group, implants were placed after surface treatment with PRP. Temporization was done within two weeks and final prosthesis was given after three months. Implant stability was measured with Periotest at baseline, one month and three months. Bone height was measured on mesial & distal side on standardized IOPA x-rays. RESULTS A statistically significant difference was noticed in implant stability with PRP at baseline. The effect of PRP on bone height changes was not statistically significant. A synergistic effect of PRP and square thread-form was observed on improved implant stability and bone levels; however, no such effect is seen with PRP and reverse buttress thread-form. CONCLUSION Within the limitation of this study, enhancement on implant stability and bone healing was observed with PRP treated implant surfaces, and with use of implant with square thread-form.
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Affiliation(s)
- Renu Kundu
- Post Graduate Student, Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B.D. Sharma University of Health Sciences , Rohtak, Haryana, India
| | - Manu Rathee
- Senior Professor and Head, Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Pt. B.D. Sharma University of Health Sciences , Rohtak, Haryana, India
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Mahesh L, Narayan T, Kostakis G, Shukla S. Periotest values of implants placed in sockets augmented with calcium phosphosilicate putty graft: a comparative analysis against implants placed in naturally healed sockets. J Contemp Dent Pract 2014; 15:181-5. [PMID: 25095840 DOI: 10.5005/jp-journals-10024-1511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To measure implant stability using periotest values of implants placed in sockets augmented with calcium phospho-silicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. MATERIALS AND METHODS Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. RESULT Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. CONCLUSION Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation.
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Affiliation(s)
- Lanka Mahesh
- Private Practice, The Dental Center, Panshila Park, New Delhi, India
| | - Tv Narayan
- Private Practice, Bengaluru, Karnataka, India
| | - Georgios Kostakis
- Resident, Department of Periodontology, University of Minnesota, Minneapolis, MN, USA
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Bertl K, Subotic M, Heimel P, Schwarze UY, Tangl S, Ulm C. Morphometric characteristics of cortical and trabecular bone in atrophic edentulous mandibles. Clin Oral Implants Res 2014; 26:780-7. [PMID: 24502624 DOI: 10.1111/clr.12340] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Adaptations of the alveolar ridge after tooth loss have been well described. However, studies on the morphometric characteristics of cortical bone are rare; hence, this study of human atrophic edentulous mandibles was undertaken. MATERIAL AND METHODS Total cortical area, porosity, and thickness, and the percentage of cortical area in the complete mandibular area as well as in an area (height, 10 mm) starting at the most caudal point of the trabecular compartment and extending in the coronal direction were determined in 185 thin ground sections of edentulous mandibles (incisor region, 49; premolar region, 76; molar region, 60; 95 from females and 90 from males; mean age, 78.2 years, SD ± 7.8 years; Caucasian donors; cause of death: cardiovascular disease). Further, mandibular height and width and degree of residual ridge resorption (RRR) were recorded. RESULTS The percentage of cortical area in the complete mandibular area increased with increasing RRR. Yet, evaluation of the 10-mm caudal portion corresponding to the basal part of the mandibular body did not confirm these changes in cortical bone. Cortical porosity and thickness decreased from the mesial to the distal region. Cortical porosity was unaffected by RRR, while cortical thickness increased, mainly at lingual aspects. CONCLUSIONS In conclusion, cortical bone remained stable in different degrees of RRR except for some modulations in the lingual aspects. Changes in the relative composition between cortical and trabecular bone are due to loss of height and total area, mainly at expense of trabecular bone area, but not to adaptations of the cortical bone.
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Affiliation(s)
- Kristina Bertl
- Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Miroslav Subotic
- Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Patrick Heimel
- Division of Oral Surgery, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - Uwe Y Schwarze
- Division of Oral Surgery, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Stefan Tangl
- Division of Oral Surgery, Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Vienna, Austria
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Kopp S, Behrend D, Kundt G, Ottl P, Frerich B, Warkentin M. Dental implants and immediate loading: Multivariate analysis of success factors. ACTA ACUST UNITED AC 2013; 114:146-54. [DOI: 10.1016/j.revsto.2013.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 02/18/2013] [Indexed: 11/24/2022]
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Quesada-García MP, Prados-Sánchez E, Olmedo-Gaya MV, Muñoz-Soto E, Vallecillo-Capilla M, Bravo M. Dental Implant Stability Is Influenced by Implant Diameter and Localization and by the Use of Plasma Rich in Growth Factors. J Oral Maxillofac Surg 2012; 70:2761-7. [DOI: 10.1016/j.joms.2012.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 08/01/2012] [Accepted: 08/04/2012] [Indexed: 11/25/2022]
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Migliorati M, Benedicenti S, Signori A, Drago S, Barberis F, Tournier H, Silvestrini-Biavati A. Miniscrew design and bone characteristics: an experimental study of primary stability. Am J Orthod Dentofacial Orthop 2012; 142:228-34. [PMID: 22858333 DOI: 10.1016/j.ajodo.2012.03.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 03/01/2012] [Accepted: 03/01/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the correlations between bone characteristics, orthodontic miniscrew designs, and primary stability. METHODS Four different miniscrews were placed in pig ribs. The miniscrews were first scanned with a scanning electron microscope to obtain measurable images of their threads. Subsequently, the maximum insertion torque of the screws and the maximum load value in the pullout force tests were measured; furthermore, bone specimen characteristics were analyzed by using cone-beam computed tomography. For each bone sample, the insertion site cortical thickness as well as both cortical and marrow bone density were evaluated. The nonparametric Kendall rank correlation (tau) was used to evaluate the strength of the associations among the characteristics measured. The nonparametric Kruskall-Wallis test was used to evaluate the differences among the groups, and post-hoc comparisons were assessed by using the Nemenyi-Damico-Wolfe-Dunn test. RESULTS A significant dependence was found between pitch and maximum insertion torque (tau, -0.49). Positive correlations were also found between pullout force and maximum insertion torque (tau, 0.64), cortical thickness (tau, 0.36), and marrow bone density (tau, 0.35). CONCLUSIONS In this in-vitro experimental study, strong correlations were observed among miniscrew geometry, bone characteristics, and primary stability.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, Genoa University, Genoa, Italy.
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STRUB JR, JURDZIK BA, TUNA T. Prognosis of immediately loaded implants and their restorations: a systematic literature review. J Oral Rehabil 2012; 39:704-17. [DOI: 10.1111/j.1365-2842.2012.02315.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sano M, Ikebe K, Yang TC, Maeda Y. Biomechanical rationale for six splinted implants in bilateral canine, premolar, and molar regions in an edentulous maxilla. IMPLANT DENT 2012; 21:220-4. [PMID: 22513501 DOI: 10.1097/id.0b013e31825023f5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the influence of number and location of implants loaded on the stress to the bone in an edentulous maxilla using a three-dimensional finite element model (3D FEM). MATERIAL AND METHODS Computed tomographic data with the bone density of a dry skull were used to construct a 3D FEM. Titanium implants were simulated in the configuration as 14 unsplinted implants (US14), 14 splinted implants (S14), 6 splinted implants (canine, premolar, and molar regions, S6), 4 splinted implants (S4), and 6 anterior implants (incisors and canines, A6). Distributed loads of 200 N were applied on the occlusal table of the superstructures. RESULTS The S6 model was subjected to a similar amount of stress and deformation to the US14 and the S14. The S4 and A6 models were subjected to approximately three times of stress under the vertical load, and approximately five times of stress under the inclined load, respectively, compared with the S6 model. CONCLUSIONS The 3D FEM analyses suggest that the six splinted implants configuration has a similar stress and deformation pattern as compared with naturally positioned splinted 14 implants in the edentulous maxilla.
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Affiliation(s)
- Masashi Sano
- Department of Prosthodontics and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Alghamdi H, Anand PS, Anil S. Undersized Implant Site Preparation to Enhance Primary Implant Stability in Poor Bone Density: A Prospective Clinical Study. J Oral Maxillofac Surg 2011; 69:e506-12. [DOI: 10.1016/j.joms.2011.08.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 08/03/2011] [Accepted: 08/05/2011] [Indexed: 10/15/2022]
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Ho DSW, Yeung SCH, Zee KY, Curtis B, Hell P, Tumuluri V. Clinical and radiographic evaluation of NobelActiveTMdental implants. Clin Oral Implants Res 2011; 24:297-304. [DOI: 10.1111/j.1600-0501.2011.02313.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2011] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | - Bradley Curtis
- Discipline of Epidemiology and Biostatistics; Faculty of Dentistry; University of Sydney; Sydney; NSW; Australia
| | - Peter Hell
- Oral Restorative Sciences Department; Westmead Centre for Oral Health; Westmead Hospital; Westmead; NSW; Australia
| | - Vijay Tumuluri
- Periodontics Unit; Westmead Centre for Oral Health; Westmead Hospital; Westmead; NSW; Australia
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Hsu JT, Fuh LJ, Tu MG, Li YF, Chen KT, Huang HL. The effects of cortical bone thickness and trabecular bone strength on noninvasive measures of the implant primary stability using synthetic bone models. Clin Implant Dent Relat Res 2011; 15:251-61. [PMID: 21599830 DOI: 10.1111/j.1708-8208.2011.00349.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE This study investigated how the primary stability of a dental implant as measured by the insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ) is affected by varying thicknesses of cortical bone and strengths of trabecular bone using synthetic bone models. MATERIALS AND METHODS Four synthetic cortical shells (with thicknesses of 0, 1, 2, and 3 mm) were attached to four cellular rigid polyurethane foams (with elastic moduli of 137, 47.5, 23, and 12.4 MPa) and one open-cell rigid polyurethane foam which mimic the osteoporotic bone (with an elastic modulus 6.5 MPa), to represent the jawbones with various cortical bone thicknesses and strengths of trabecular bone. A total of 60 bone specimens accompanied with implants was examined by a torque meter, Osstell resonance frequency analyzer, and Periotest electronic device. All data were statistically analyzed by two-way analysis of variance. In addition, second-order nonlinear regression was utilized to assess the correlations of the primary implant stability with the four cortex thicknesses and five strengths of trabecular bone. RESULTS ITV, ISQ, and PTV differed significantly (p < .05) and were strongly correlated with the thickness of cortical bone (R(2) > 0.9) and the elastic modulus of trabecular bone (R(2) = 0.74-0.99). CONCLUSIONS The initial stability at the time of implant placement is influenced by both the cortical bone thickness and the strength of trabecular bone; however, these factors are mostly nonlinearly correlated with ITV, PTV, and ISQ. Using ITV and PTV seems more suitable for identifying the primary implant stability in osteoporotic bone with a thin cortex.
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Affiliation(s)
- Jui-Ting Hsu
- School of Dentistry, China Medical University, Taiwan
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Wei X, Zhao L, Xu Z, Tang T, Zhao Z. Effects of cortical bone thickness at different healing times on microscrew stability. Angle Orthod 2011; 81:760-6. [PMID: 21534723 DOI: 10.2319/111610-667.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective:
To compare the effects of different cortical bone thicknesses on the stability of microscrews at different healing times.
Materials:
Sixty-four microscrews were inserted into the femurs of eight beagles, with four microscrews for one femur of one beagle dog. The dogs were sacrificed at 0, 3, 6, and 9 weeks after microscrew placement, respectively. All specimens were prepared for pullout testing. Cortical bone thickness was measured. Statistical analyses were conducted with analysis of variance (ANOVA) and Student-Neuman-Keuls (SNK) tests.
Results:
Pullout forces in thick cortical bone sites are significantly higher than those in thin sites at 0 week and 3 weeks. For both thick and thin cortical bone thickness sites, the highest pullout forces were seen in the 0 week group and the lowest in the 3 week group. In the thin cortical bone thickness sites, the pullout force of the 3 week group was statistically different from those of the 6 week group and the 9 week group; however, no such differences were noted in thick cortical bone thickness sites.
Conclusion:
Microscrews inserted into thick cortical bone thickness sites had better stability than those inserted into thin cortical bone thickness sites at early healing time. The difference diminished and became insignificant as healing time got longer. Longer healing time may be necessary if microscrews are inserted into thin cortical bone thickness sites.
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Affiliation(s)
- Xing Wei
- PhD student-graduate, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Lixing Zhao
- Instructor, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Zhenrui Xu
- PhD student-graduate, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Tian Tang
- Instructor, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Zhihe Zhao
- Professor and Chair, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
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Bedi A, Michalakis KX, Mariani Jr. EJ, Zourdos DM. Immediately Loaded Maxillary and Mandibular Dental Implants with Fixed CAD/CAM Prostheses Using a Flapless Surgical Approach: A Clinical Report. J Prosthodont 2011; 20:319-25. [DOI: 10.1111/j.1532-849x.2011.00689.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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den Hartog L, Raghoebar GM, Stellingsma K, Vissink A, Meijer HJ. Immediate non-occlusal loading of single implants in the aesthetic zone: a randomized clinical trial. J Clin Periodontol 2010; 38:186-94. [DOI: 10.1111/j.1600-051x.2010.01650.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Boever AL, Quirynen M, Coucke W, Theuniers G, De Boever JA. Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non-susceptible patients: a prospective long-term study. Clin Oral Implants Res 2009; 20:1341-50. [DOI: 10.1111/j.1600-0501.2009.01750.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Seong WJ, Conrad HJ, Hinrichs JE. Potential Damage to Bone–Implant Interface When Measuring Initial Implant Stability. J Periodontol 2009; 80:1868-74. [DOI: 10.1902/jop.2009.090169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ikebe K, Wada M, Kagawa R, Maeda Y. Is old age a risk factor for dental implants? JAPANESE DENTAL SCIENCE REVIEW 2009. [DOI: 10.1016/j.jdsr.2009.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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