1
|
Yang F, Liu D, Yin W, Yuan C, Hu Y, Xu J, Yang Y, Tang J, Chen J. Three-dimensional finite element analysis of the biomechanical behaviour of different dental implants under immediate loading during three masticatory cycles. Heliyon 2024; 10:e32616. [PMID: 38961961 PMCID: PMC11219977 DOI: 10.1016/j.heliyon.2024.e32616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
The study aimed to evaluate the impact of varying modulus of elasticity (MOE) values of dental implants on the deformation and von Mises stress distribution in implant systems and peri-implant bone tissues under dynamic cyclic loading. The implant-bone interface was characterised as frictional contact, and the initial stress was induced using the interference fit method to effectively develop a finite element model for an immediately loaded implant-supported denture. Using the Ansys Workbench 2021 R2 software, an analysis was conducted to examine the deformation and von Mises stress experienced by the implant-supported dentures, peri-implant bone tissue, and implants under dynamic loading across three simulated masticatory cycles. These findings were subsequently evaluated through a comparative analysis. The suprastructures showed varying degrees of maximum deformation across zirconia (Zr), titanium (Ti), low-MOE-Ti, and polyetheretherketone (PEEK) implant systems, registering values of 103.1 μm, 125.68 μm, 169.52 μm, and 844.06 μm, respectively. The Zr implant system demonstrated the lowest values for both maximum deformation and von Mises stress (14.96 μm, 86.71 MPa) in cortical bone. As the MOE increased, the maximum deformation in cancellous bone decreased. The PEEK implant system exhibited the highest maximum von Mises stress (59.12 MPa), whereas the Ti implant system exhibited the lowest stress (22.48 MPa). Elevating the MOE resulted in reductions in both maximum deformation and maximum von Mises stress experienced by the implant. Based on this research, adjusting the MOE of the implant emerged as a viable approach to effectively modify the biomechanical characteristics of the implant system. The Zr implant system demonstrated the least maximum von Mises stress and deformation, presenting a more favourable quality for preserving the stability of the implant-bone interface under immediate loading.
Collapse
Affiliation(s)
- Feng Yang
- School and Hospital of Stomatology, Fujian Medical University, Fujian, China
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
- Department of Stomatology, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Dianbin Liu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Wenjie Yin
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Changyong Yuan
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Yiming Hu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jiaqi Xu
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Yunfan Yang
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jianteng Tang
- School of Stomatology, Xuzhou Medical University, Jiangsu, China
| | - Jiang Chen
- School and Hospital of Stomatology, Fujian Medical University, Fujian, China
| |
Collapse
|
2
|
Báskay J, Pénzes D, Kontsek E, Pesti A, Kiss A, Guimarães Carvalho BK, Szócska M, Szabó BT, Dobó-Nagy C, Csete D, Mócsai A, Németh O, Pollner P, Mijiritsky E, Kivovics M. Are Artificial Intelligence-Assisted Three-Dimensional Histological Reconstructions Reliable for the Assessment of Trabecular Microarchitecture? J Clin Med 2024; 13:1106. [PMID: 38398417 PMCID: PMC10889719 DOI: 10.3390/jcm13041106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Objectives: This study aimed to create a three-dimensional histological reconstruction through the AI-assisted classification of tissues and the alignment of serial sections. The secondary aim was to evaluate if the novel technique for histological reconstruction accurately replicated the trabecular microarchitecture of bone. This was performed by conducting micromorphometric measurements on the reconstruction and comparing the results obtained with those of microCT reconstructions. Methods: A bone biopsy sample was harvested upon re-entry following sinus floor augmentation. Following microCT scanning and histological processing, a modified version of the U-Net architecture was trained to categorize tissues on the sections. Detector-free local feature matching with transformers was used to create the histological reconstruction. The micromorphometric parameters were calculated using Bruker's CTAn software (version 1.18.8.0, Bruker, Kontich, Belgium) for both histological and microCT datasets. Results: Correlation coefficients calculated between the micromorphometric parameters measured on the microCT and histological reconstruction suggest a strong linear relationship between the two with p-values of 0.777, 0.717, 0.705, 0.666, and 0.687 for BV/TV, BS/TV, Tb.Pf Tb.Th, and Tb.Sp, respectively. Bland-Altman and mountain plots suggest good agreement between BV/TV measurements on the two reconstruction methods. Conclusions: This novel method for three-dimensional histological reconstruction provides researchers with a tool that enables the assessment of accurate trabecular microarchitecture and histological information simultaneously.
Collapse
Affiliation(s)
- János Báskay
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Dorottya Pénzes
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Endre Kontsek
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - Adrián Pesti
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - András Kiss
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | | | - Miklós Szócska
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Dániel Csete
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Attila Mócsai
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Péter Pollner
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;
- Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| |
Collapse
|
3
|
Wu C, Yang M, Ma K, Zhang Q, Bai N, Liu Y. Improvement implant osseointegration through nonthermal Ar/O 2 plasma. Dent Mater J 2023. [PMID: 37032105 DOI: 10.4012/dmj.2022-158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
This study investigated the effects of nonthermal Ar/O2 plasma on the osseointegration of titanium implants. Through 8 weeks' in vivo evaluation of implants inserted into femoral bones of male Sprague-Dawley rats, the new bone mineralization apposition rate (MAR) is increased by 1.87 and 2.14 times for implants of smooth machined (SM) and sand-blasted and acid-etched (SLA) after plasma treatment. The bone volume fraction (bone volume/total volume, BV/TV) and bone-implant contact (BIC) ratios are improved by 1.31, 1.26 times and 1.35, 1.15 times after 90 s plasma treatment. The improved hydrophilicity rather than implant surface morphology is believed to play a critical role for the osseointegration improvement.
Collapse
Affiliation(s)
- Chengzan Wu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University
| | - Min Yang
- Department of Oral and Maxillofacial Surgery, Shanxi Provincial People's Hospital
| | - Kai Ma
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University
| | - Qian Zhang
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University
| | - Na Bai
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University
| | - Yanshan Liu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University
| |
Collapse
|
4
|
|
5
|
Tayman MA, Kamburoğlu K, Ocak M, Özen D. Effect of different voxel sizes on the accuracy of CBCT measurements of trabecular bone microstructure: A comparative micro-CT study. Imaging Sci Dent 2022; 52:171-179. [PMID: 35799972 PMCID: PMC9226237 DOI: 10.5624/isd.20220025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/24/2022] [Accepted: 04/02/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mahmure Ayşe Tayman
- Department of Periodontology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mert Ocak
- Department of Basic Medical Sciences-Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Doğukan Özen
- Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Mirzaie T, Rouhi G, Mehdi Dehghan M, Farzad-Mohajeri S, Barikani H. Dental implants' stability dependence on rotational speed and feed-rate of drilling: In-vivo and ex-vivo investigations. J Biomech 2021; 127:110696. [PMID: 34419826 DOI: 10.1016/j.jbiomech.2021.110696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to explore the effects of drilling rotational speed and feed-rate on the stability of dental implants through in-vivo and ex-vivo experiments. To this end, a total of 16 identical dental implants were inserted in the mandible of four dogs. The osteotomies were made with two drilling rotational speeds, i.e., 800 and 1500 rpm, and two different feed-rates, i.e., 1 and 2 mm/s. Implant stability quotients (ISQs) were recorded immediately after inserting implants and then each week for four subsequent weeks. Then, all animals were euthanized, and a bone sample containing the implants was extracted from each hemi-mandible for the pull-out test. A two-way ANOVA was performed for ISQs, and pull-out strengths (PoS), and the significance level was set to <0.05. The effect of rotational speed and feed-rate, used in this study, on the primary stability quotients was not significant (P > 0.05). Increasing the rotational speed from 800 to 1500 rpm significantly increased both ISQ and PoS values at the end of the 4th week after the implantation (P = 0.022 and P = 0.001, respectively). Moreover, by decreasing the feed-rate from 2 to 1 mm/s, a significant increase in PoSs of the dental implants was observed four weeks after the implantation (P = 0.019). Results of this study showed that either by increasing drilling rotational speed, here from 800 to 1500 rpm, or by reducing feed-rate, here from 2 to 1 mm/s, the secondary stability would be reinforced. Further investigations are needed to see if and how the conclusions made in this study can be generalized.
Collapse
Affiliation(s)
- Tahereh Mirzaie
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Gholamreza Rouhi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.
| | - Mohammad Mehdi Dehghan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran; Institute of Biomedical Research, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Saeed Farzad-Mohajeri
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran; Institute of Biomedical Research, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Hamidreza Barikani
- Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Oliveira MR, Gonçalves A, Gabrielli MAC, de Andrade CR, Scardueli CR, Pereira Filho VA. The correlation of different methods for the assessment of bone quality in vivo: an observational study. Int J Oral Maxillofac Surg 2021; 51:388-397. [PMID: 34127353 DOI: 10.1016/j.ijom.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
Different methods for the assessment of bone quality were evaluated in this study. Sixty alveolar bone areas were investigated. Peri-apical and panoramic radiographs were obtained with an aluminium scale to assess optical density. The Lekholm and Zarb (L&Z) classification was determined through radiographic analysis and the surgeon's tactile perception. A trephine was used to obtain a bone biopsy for assessment by micro-computed tomography (micro-CT) and histomorphometry. Primary stability of the implants was assessed using insertion torque (IT) and the implant stability quotient (ISQ). The optical density on peri-apical radiographs was correlated with IT, ISQ, and micro-CT (BV, BV/BT, Tb.Th, Tb.N, BS/BV, Tb.Pf, and SMI) (rho ≤ 0.471, P ≤ 0.028). Panoramic radiography showed a correlation only with bone surface (BS) and bone surface/volume ratio (BS/TV) (rho ≤ 0.290, P ≤ 0.031). IT showed a correlation with ISQ, histometry, and micro-CT (BV, BS/TV, Tb.Th, Tb.N, BS/BV, Tb.Pf, Tb.Sp, BV/BT) (rho ≤ 0.550, P ≤ 0.022). ISQ did not show any correlation with micro-CT. The L&Z classification showed correlations with the optical density obtained in the peri-apical radiographs, histometry, osteocyte count, IT, and micro-CT (BS/BV, Tb.Sp, Tb.Pf, BV, BS/TV, Tb.Th, Tb.N) (rho ≤ 0.344, P ≤ 0.042). The L&Z bone classification and IT are reliable methods, peri-apical radiographs and ISQ are acceptable, and panoramic radiography is not a reliable method for the assessment of bone quality.
Collapse
Affiliation(s)
- M R Oliveira
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - A Gonçalves
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - M A C Gabrielli
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - C R de Andrade
- Department of Pathology and Physiology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - C R Scardueli
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - V A Pereira Filho
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| |
Collapse
|
9
|
Ibrahim N, Parsa A, Hassan B, van der Stelt P, Rahmat RA, Ismail SM, Aartman IHA. Comparison of anterior and posterior trabecular bone microstructure of human mandible using cone-beam CT and micro CT. BMC Oral Health 2021; 21:249. [PMID: 33964918 PMCID: PMC8106860 DOI: 10.1186/s12903-021-01595-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this study was to compare the trabecular bone microstructures of anterior and posterior edentulous regions of human mandible using cone-beam computed tomography (CBCT) and micro computed tomography (µCT). Methods Twenty volumes of interests consisting of six anterior and fourteen posterior edentulous regions were obtained from human mandibular cadavers. A CBCT system with a resolution of 80 µm (3D Accuitomo 170, J. Morita, Kyoto, Japan) and a µCT system with a resolution of 35 µm (SkyScan 1173, Kontich, Belgium) were used to scan the mandibles. Three structural parameters namely, trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were analysed using CTAn software (v 1.11, SkyScan, Kontich, Belgium). For each system, the measurements obtained from anterior and posterior regions were tested using independent sample t-test. Subsequently, all measurements between systems were tested using paired t-test. Results In CBCT, all parameters of the anterior and posterior mandible showed no significant differences (p > 0.05). However, µCT showed a significant different of Tb.Th (p = 0.023) between anterior and posterior region. Regardless of regions, the measurements obtained using both imaging systems were significantly different (p ≤ 0.021) for Tb.Th and Tb.N. Conclusions The current study demonstrated that only the variation of Tb.Th between anterior and posterior edentulous region of mandible can be detected using µCT. In addition, CBCT is less feasible than µCT in assessing trabecular bone microstructures at both regions.
Collapse
Affiliation(s)
- Norliza Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Azin Parsa
- Department of Diagnostic Sciences, School of Dentistry, The University of North Carolina, Chapel Hill, USA
| | - Bassam Hassan
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
| | - Paul van der Stelt
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
| | - Rabiah A Rahmat
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti M Ismail
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Irene H A Aartman
- Department of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA, Amsterdam, The Netherlands
| |
Collapse
|
10
|
Wang L, Gao Z, Su Y, Liu Q, Ge Y, Shan Z. Osseointegration of a novel dental implant in canine. Sci Rep 2021; 11:4317. [PMID: 33619303 PMCID: PMC7900171 DOI: 10.1038/s41598-021-83700-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/05/2021] [Indexed: 01/20/2023] Open
Abstract
This study aimed to compare and verify the osseointegration performance of a novel implant (NI) in vivo, which could provide a useful scientific basis for the further development of NIs. Thirty-two NIs treated with hydrofluoric acid and anodization and sixteen control implants (CIs) were placed in the mandibles of 8 beagles. Micro-CT showed that the trabecular number (Tb.N) significantly increased and trabecular separation (Tb.Sp) significantly decreased in the NIs at 2 weeks. Significant differences were found in the trabecular thickness, Tb.N, Tb.Sp, bone surface/bone volume ratio, and bone volume/total volume ratio between the two groups from the 2nd–4th weeks. However, there were no significant differences between the two groups in the bone volume density at 2, 4, 8, or 12 weeks or bone-implant contact at 2 or 4 weeks, but the BIC in the CIs was higher than that in the NIs at the 8th and 12th weeks. Meanwhile, the histological staining showed a similar osseointegration process between the two groups over time. Overall, the NIs could be used as new potential implants after further improvement.
Collapse
Affiliation(s)
- Lingxiao Wang
- Outpatient Department of Oral and Maxillofacial Surgery, School of Stomatology, Capital Medical University, Tian Tan Xi Li No. 4, Beijing, 100050, People's Republic of China
| | - Zhenhua Gao
- Outpatient Department of Oral and Maxillofacial Surgery, School of Stomatology, Capital Medical University, Tian Tan Xi Li No. 4, Beijing, 100050, People's Republic of China
| | - Yucheng Su
- Department of Stomatology, Chinese Academy of Medical Science & Peking Union Medical College Hospital, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, People's Republic of China.,Beijing Citident Stomatology Hospital, Beijing, 100032, People's Republic of China
| | - Qian Liu
- Beijing Citident Stomatology Hospital, Beijing, 100032, People's Republic of China
| | - Yi Ge
- Department of Stomatology, Chinese Academy of Medical Science & Peking Union Medical College Hospital, No. 41 Damucang Hutong, Xicheng District, Beijing, 100032, People's Republic of China.
| | - Zhaochen Shan
- Outpatient Department of Oral and Maxillofacial Surgery, School of Stomatology, Capital Medical University, Tian Tan Xi Li No. 4, Beijing, 100050, People's Republic of China.
| |
Collapse
|
11
|
Bohner L, Tortamano P, Gremse F, Chilvarquer I, Kleinheinz J, Hanisch M. Assessment of Trabecular Bone During Dental Implant Planning using Cone-beam Computed Tomography with High-resolution Parameters. Open Dent J 2021. [DOI: 10.2174/1874210602115010057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Cone-Beam Computed Tomography (CBCT) with high-resolution parameters may provide an acceptable resolution for bone assessment.
Objectives:
The purpose of this study is to assess trabecular bone using two cone-beam computed tomography (CBCT) devices with high-resolution parameters in comparison to micro-computed tomography (µCT).
Methods:
Bone samples (n=8) were acquired from dry mandibles and scanned by two CBCT devices: 1) VV (Veraview R100, Morita; FOV 4x4, 75kV, 9mA, voxel size 0.125µm); and PR (Prexion 3D, Prexion; FOV 5x5, 90kV, 4mA, 37s, voxel size 108µm). Gold-standard images were acquired using µCT (SkyScan 1272; Bruker; 80kV, 125mA, voxel size 16µm). Morphometric parameters (BvTv- Bone Volume Fraction, BsBv- Trabecular specific surface, TbTh- Trabecular thickness and TbSp- Trabecular separation) were measured. Statistical analysis was performed within ANOVA, Spearman Correlation test and Bland-Altmann plots with a statistical significance level at p=0.05.
Results:
CBCT devices showed similar BvTv values in comparison to µCT. No statistical difference was found for BvTv parameters assessed by CBCT devices and µCT. BsBv values were underestimated by CBCT devices (p<0.01), whereas TbTh and TbSp values were overestimated by them (p<0.01). Positive correlations were found between VV and µCT measurements for BvTv (r2= 0.65, p=0.00), such as between PR and µCT measurements for TbSp (r2= 0.50, p=0.04). For BsBv measurements, PR was negatively correlated with µCT (r2= -0.643, p=0.01).
Conclusion:
The evaluated CBCT device was able to assess trabecular bone. However, bone parameters were under or overestimated in comparison to µCT.
Collapse
|
12
|
Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification. J Craniofac Surg 2021; 32:2114-2118. [PMID: 33405451 DOI: 10.1097/scs.0000000000007405] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry. METHODS Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation. RESULTS Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P ≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398; P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = -0.650, P = 0.016). CONCLUSIONS Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the "gold standard" method for the evaluation of bone quality and greater bone density was observed in older men.
Collapse
|
13
|
Arsan B, Yalcin-Ülker GM, Meral DG, Erdem TL. Is there any predictive bone parameter for implant stability in 2-dimensional and 3-dimensional radiologic images? Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:371-379. [PMID: 32891573 DOI: 10.1016/j.oooo.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/26/2020] [Accepted: 08/07/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This ex vivo study aimed to compare radiomorphometric parameters between 2-dimensional (2-D) and 3-dimensional (3-D) radiographs and evaluate the influence of preoperative radiologic bone parameters on the clinical outcomes of implant stability. STUDY DESIGN Implant recipient sites in fresh bovine blocks were evaluated on panoramic radiographs for gray value (GV), fractal dimension (FD), number of connected trabeculae (Co), and density of connected trabeculae (CoD). Cone beam computed tomography (CBCT) scans were evaluated for trabecular thickness (TbTh), cortical thickness (CTh), degree of anisotropy (DA), FD, and Co. Insertion torque (IT) and implant stability quotient (ISQ) were measured. RESULTS GV was significantly correlated with all parameters in 2-D and 3-D images except FD in 2-D and Co in 3-D, and with all surgical parameters (P ≤ .029). Co and CoD values on panoramic radiographs had significant correlation with TbTh, CTh, and DA values on CBCT images (P < .001). All 2-D parameters and TbTh and CTh in the CBCT data were significantly correlated with IT only (P ≤ .047). Only GV was correlated with ISQ measurements (P ≤ .029). CONCLUSIONS GV, Co, and CoD values on panoramic radiographs reflect the architecture of trabecular bone and the thickness of cortical bone, and might help predict implant stability in clinical situations.
Collapse
Affiliation(s)
- Belde Arsan
- Assistant Professor, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey.
| | - Gül Merve Yalcin-Ülker
- Assistant Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Istanbul Okan University, Istanbul
| | - Deniz Gökce Meral
- Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Istanbul Okan University, Istanbul
| | - Tamer Lütfi Erdem
- Professor, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Beykent University, Istanbul
| |
Collapse
|
14
|
Radiographic Evaluation in the Diagnosis of Alveolar Bone Quality in Implant Rehabilitation. J Craniofac Surg 2020; 31:1805-1808. [PMID: 32657993 DOI: 10.1097/scs.0000000000006755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study evaluated the optical bone density of the maxilla and mandible and correlate with the classification of bone quality of the Lekholm and Zarb (L & Z). Sixty edentulous areas were evaluated. Panoramic and periapical radiographs were performed with an aluminum scale to evaluate the optical bone density. L & Z classification was also applied. By using periapical radiographs, a statistically significant difference was observed in the optical bone density of the posterior maxilla (2.38 ± 1.06) and the posterior mandible (3.84 ± 0.68), when compared to the other regions (P ≤ 0.015). However, with panoramic radiographs, no differences were observed in the optical bone density (P = 0.6322). A negative correlation was observed between the L & Z classification and the optical bone density obtained by the periapical radiographs (rho = -0.463; P < 0.001), that is, the worse the bone quality, the lower the bone density. However, there was no significant correlation with the bone density obtained by panoramic radiographs (rho = -0.009; P = 0.948). As for gender, a correlation between aging and the presence of medullary bone was observed in females, assessed by the L & Z classification (rho = 0.398; P = 0.006). However, there was a correlation between aging and a denser and less medullary presence in males, both assessed by the L & Z classification (rho = -650; P = 0.016), as well as the optical density assessed by periapical (rho = 0.621; P = 0.023) and panoramic (rho = 0.588; P = 0.035) radiographs. These results suggest that gender and age interfere with the bone quality and periapical radiographs are an acceptable method for evaluating bone density. However, a panoramic radiograph was not found to be a reliable method.
Collapse
|
15
|
Nicolielo LFP, Van Dessel J, Jacobs R, Quirino Silveira Soares M, Collaert B. Relationship between trabecular bone architecture and early dental implant failure in the posterior region of the mandible. Clin Oral Implants Res 2019; 31:153-161. [DOI: 10.1111/clr.13551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/17/2019] [Accepted: 10/19/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Laura Ferreira Pinheiro Nicolielo
- OMFS‐IMPATH research group Dept. Imaging & Pathology Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery University Hospitals Leuven Leuven Belgium
| | - Jeroen Van Dessel
- OMFS‐IMPATH research group Dept. Imaging & Pathology Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery University Hospitals Leuven Leuven Belgium
| | - Reinhilde Jacobs
- OMFS‐IMPATH research group Dept. Imaging & Pathology Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery University Hospitals Leuven Leuven Belgium
- Dept. of Dental Medicine Karolinska Institutet Huddinge Sweden
| | | | - Bruno Collaert
- Center for Periodontology and Implantology Leuven Heverlee Belgium
| |
Collapse
|
16
|
Abstract
Clinical assessment and conventional 2-D radiographs often provide inadequate diagnostic data for proper implant placement. Cone beam CT (CBCT) enables 3-D visualization of the alveolar ridge, aiding clinicians with identification of anatomic structures and pathologies. CBCT provides accurate linear measurements at low radiation dose compared with conventional CT scan, which helps in diagnosis and treatment planning, particularly in complex implant cases. Even though straightforward implant surgery can be performed with careful clinical and 2-D radiographic assessment, CBCT should be considered. It provides the unparalleled benefit of computer-aided implant planning, leading to improved clinical outcomes and reduced complications.
Collapse
|
17
|
Del Giudice R, Piattelli A, Grande NM, Cataneo E, Crispino A, Petrini M. Implant insertion torque value in immediate loading: A retrospective study. Med Oral Patol Oral Cir Bucal 2019; 24:e398-e403. [PMID: 31011142 PMCID: PMC6530943 DOI: 10.4317/medoral.22845] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/01/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of this study is to verify if the Insertion Torque Value (ITV) of 32 Ncm for immediate loading protocol (ILP), as indicated by literature, is still, with the advance in implant research, a real significant cut-off for long-term implant survival. MATERIAL AND METHODS In this retrospective study, data from 224 patients that during three years of clinical practice, were submitted to the insertion of 322 implants with immediate loading protocol, have been recorded, pooled and analyzed. Data were organized based on Insertion Torque Value (ITV): > 32 Ncm (CG) and < 32 Ncm (LTG) and two different groups of equal sample size, 161 implants each, were distinguished. Crestal bone reabsorption, and the implant failure rate were evaluated after 2-years of follow-up. RESULTS The bone reabsorption in LTG (0.49 ± 0.11 mm ) was significantly greater than CG (0.22 ± 0.04 mm), p<0.001. However, the survival rate after 2-years of follow-up was quite high and similar for both groups: 96.89% for LTG and 97.52% for CG and no statistically significant differences have been found among the two groups for the implant failure rate (p=0.455).The Odds Ratio (OR) of implant failure was of 1.258 (95% CI 0.332, 4.772), but results were not statistical significant, p=0.740. CONCLUSIONS The present study showed that although implants with ITV> 32 Ncm are still characterized by a lower crestal bone resorption, there are no statistically significant differences among the two groups for what concerning the failure rate during the 2 years of follow-up and OR. These results permit us to suppose that the cut-off of ITV >32 Ncm for immediate loading implants, could be reduced to inferior values. However further studies are necessary to indicate precise clinical guidelines.
Collapse
Affiliation(s)
- R Del Giudice
- Department of Medical Oral and Biotechnological Sciences, University of Chieti - Italy, Address: Via Vestini 31, 66013 Chieti, Italy,
| | | | | | | | | | | |
Collapse
|
18
|
Puttini IDO, Poli PP, Maiorana C, Vasconcelos IRD, Schmidt LE, Colombo LT, Hadad H, Santos GMD, Carvalho PSPD, Souza FÁ. Evaluation of Osteoconduction of Biphasic Calcium Phosphate Ceramic in the Calvaria of Rats: Microscopic and Histometric Analysis. J Funct Biomater 2019; 10:jfb10010007. [PMID: 30658427 PMCID: PMC6462940 DOI: 10.3390/jfb10010007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 12/13/2022] Open
Abstract
(1) Background: Evaluate the osteoconduction capability of a biphasic calcium phosphate (BCP) ceramic composed of hydroxyapatite and β-tricalcium phosphate 60%/40% in a rat model. (2) Methods: In the calvarial bone of 54 adult male rats, 7-mm diameter critical size defects were performed. The animals were randomly allocated to three experimental groups according to the type of material: blood clot (BCG), blood clot covered with a bovine-derived collagen membrane (MBCG), and BCP ceramic covered with a bovine-derived collagen membrane (BCPG). In each group, 6 animals were euthanatized at post-operative days 7, 30, and 60 for histological and histometric analysis. (3) Results: The qualitative analysis revealed the persistence of the collagen membrane at seven days, with no relevant newly bone formation in all groups. At 30 days, centripetal bone formation was observed residual particles of the biomaterial surrounded by fibroblasts noted in the BCPG. At 60 days, while BCG and MBCG showed a partial maturation with the central part of the defect populated by a fibrous connective tissue, in the BCPG the critical area was entirely occupied by newly formed bone. In the intra groups analysis was noted a significant increase in new bone formation during the experimental period (p < 0.05). At 60 days, BCPG showed a higher percentage area of new bone formation (p < 0.05). (4) Conclusion: BCP promoted a new bone formation by osteoconduction and might be considered a valid alternative in bone regeneration procedures.
Collapse
Affiliation(s)
- Igor de Oliveira Puttini
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Maggiore Policlinico Hospital, University of Milan, 20122 Milan, Italy.
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Maggiore Policlinico Hospital, University of Milan, 20122 Milan, Italy.
| | - Igor Rodrigues de Vasconcelos
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, Brazil.
| | - Luis Eduardo Schmidt
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, Brazil.
| | - Luara Teixeira Colombo
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| | - Henrique Hadad
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| | - Gabriel Mulinari Dos Santos
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| | - Paulo Sergio Perri de Carvalho
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| | - Francisley Ávila Souza
- Department of Surgery and Integrated Clinic, Araçatuba Dental of School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, SP 16 015 050, Brazil.
| |
Collapse
|
19
|
Theye CEG, Hattingh A, Cracknell TJ, Oettlé AC, Steyn M, Vandeweghe S. Dento-alveolar measurements and histomorphometric parameters of maxillary and mandibular first molars, using micro-CT. Clin Implant Dent Relat Res 2018; 20:550-561. [PMID: 29732712 DOI: 10.1111/cid.12616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/21/2018] [Accepted: 03/19/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Micro-CT is a high-resolution, non-invasive, and non-destructive imaging technique, currently acknowledged as a gold standard modality for assessing quantitatively and objectively dental morphology and bone microarchitecture parameters. PURPOSE The aim of this study was to analyze critical dental and periodontal measurements characterizing the mandibular (MandFM) and maxillary (MaxFM) first molar architecture, as well as the corresponding bony socket, using micro-CT. MATERIALS AND METHODS Thirty-eight human dried skulls (22-76 years) were scanned to enable the virtual analysis of 61 first molars. Depending on the type of measurement, the parameters were recorded on two-dimensional sections or directly on three-dimensional models. Tooth morphology was described by four aspects (e.g., tooth width, trunk length, root length, and root span), while the socket architecture was assessed by buccal plate thicknesses and bone density measurements. RESULTS Minimum, maximum, and mean distances as well as cortical and trabecular bone densities were recorded in MandFM and MaxFM. It is noteworthy that the buccal plate thickness was found to be less than 1 mm in more than 55% of cases in MaxFM, whereas only in 20.8% of cases in MandFM (and even 0% at two sites). A wide range of bone densities was observed and the comparison between MandFM and MaxFM did not show a significant difference. Furthermore, cortical densities were negatively correlated with aging, while trabecular densities were not influenced. CONCLUSIONS Using micro-CT, three-dimensional aspects of the human first molar morphology and microstructural parameters of the surrounding bone were evaluated in the mandible and in the maxilla. These comprehensive measurements and their correlation with aging may be of great importance for the use of immediate implant placement in molar extraction sockets and thus the potential long-term success of this treatment modality.
Collapse
Affiliation(s)
- Charlotte E G Theye
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng, South Africa
| | - André Hattingh
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Anna C Oettlé
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng, South Africa.,Department of Anatomy and Histology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Maryna Steyn
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Stefan Vandeweghe
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
20
|
Asaumi R, Kawai T, Miwa Y, Sunohara M, Sato I. CBCT imaging of the alveolar bone structure in maxilla of elderly donor cadavers and PCA analysis. Okajimas Folia Anat Jpn 2018; 95:1-7. [PMID: 30101947 DOI: 10.2535/ofaj.95.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is an important bone matrix with remodelling between dentate and edentulous samples of the human maxilla for bone metabolism. Cone beam computed tomography (CBCT) is useful for structural analysis of bone. The objective of this study was to investigate morphological data of donor cadavers in detail using CBCT imaging and principal component analysis (PCA). We analysed 38 donor cadavers using a CBCT apparatus. The analytical results defined differences in skull measurement parameters and dentate and edentulous levels using PCA. We observed cortical bone, trabecular bone, and the distance from the bottom of the maxillary sinus to the oral mucosa at a right angle to the palatal plane of the first molar region between dentate and edentulous samples of the human maxilla using CBCT imaging. In the dentate sample of the maxilla, component 1 was defined by negative contributions from gender (-0.84) and age (-0.54) to positive contributions such as cortical bone structure (CBS, 0.68) and trabecular bone structure (TBS, 0.50). There was a difference in CBS between dentate and edentulous human maxilla samples. This study of CBCT data provides useful basal information for planning dental implant surgery using PCA.
Collapse
Affiliation(s)
- Rieko Asaumi
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University
| | - Yoko Miwa
- Department of Anatomy, School of Life Dentistry at Tokyo, The Nippon Dental University
| | - Masataka Sunohara
- Department of Anatomy, School of Life Dentistry at Tokyo, The Nippon Dental University
| | - Iwao Sato
- Department of Anatomy, School of Life Dentistry at Tokyo, The Nippon Dental University
| |
Collapse
|
21
|
Fu MW, Shen EC, Fu E, Lin FG, Wang TY, Chiu HC. Assessing Bone Type of Implant Recipient Sites by Stereomicroscopic Observation of Bone Core Specimens: A Comparison With the Assessment Using Dental Radiography. J Periodontol 2017; 88:593-601. [PMID: 28398151 DOI: 10.1902/jop.2017.160446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the study is to determine if bone quality evaluation of surgically obtained bone core specimens using a stereomicroscope is reliable for determining bone quality at implant recipient sites. METHODS Bone quality was presurgically assessed in 122 edentulous ridges obtained from 62 patients using periapical radiographs and categorized according to the Lekholm and Zarb classification. During surgery, bone specimens were trephined, and bone types were immediately classified using a stereomicroscope. Microarchitectural characteristics of bone cores were evaluated after being scanned using microcomputed tomography (micro-CT). RESULTS Bone types of implant sites categorized from radiography and stereomicroscope had statistically similar distribution but poor interrater agreement. Using micro-CT, maxillae and mandibles showed significant differences in microarchitectural characteristics of bone cores. Bone volume (BV), total volume (TV), and trabecular thickness (Tb.Th) increased, whereas bone surface density (BS/BV) and open porosity (Po.[Op]) decreased in mandibular bone cores compared with those in maxillary bone cores. Moreover, micro-CT values of BV/TV and Po.(Op) statistically correlated with bone types assessed by stereomicroscopy, particularly in mandibles (adjusted means of BV/TV of Type 2 to 4 versus Type 1 decreasing from -9.88%, -15.09%, -29.31%; those of Po.(Op) ranged from 9.77%, 15.06%, 29.52% in an upward trend). However, such correlations were not found in maxillae or when bone types were classified using periapical radiographs. CONCLUSIONS Caution is needed when using presurgical periapical radiographs to predict bone quality at implant recipient sites. Surgically preserved bone core specimens, whenever obtainable, might offer additional information to accurately assess bone quality, particularly at mandibular implant sites.
Collapse
Affiliation(s)
- Min-Wen Fu
- Department of Dentistry, Tzu Chi General Hospital - Xindian Branch, New Taipei City, Taiwan, Republic of China.,School of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China.,Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - E-Chin Shen
- Department of Dentistry, Tzu Chi General Hospital - Xindian Branch, New Taipei City, Taiwan, Republic of China.,School of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China.,Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - Earl Fu
- Department of Dentistry, Tzu Chi General Hospital - Xindian Branch, New Taipei City, Taiwan, Republic of China.,School of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China.,Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - Fu-Gong Lin
- School of Public Health, National Defense Medical Center
| | - Tian-You Wang
- School of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China.,Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| | - Hsien-Chung Chiu
- School of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China.,Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, Republic of China
| |
Collapse
|
22
|
Haghnegahdar A, Zarif Najafi H, Sabet M, Saki M. Assessment of the changes in alveolar bone quality after fixed orthodontic therapy: A trabecular structure analysis. J Dent Res Dent Clin Dent Prospects 2017; 10:201-206. [PMID: 28096944 PMCID: PMC5237665 DOI: 10.15171/joddd.2016.032] [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] [Received: 10/09/2015] [Accepted: 10/15/2016] [Indexed: 11/21/2022] Open
Abstract
Background. Tooth displacement changes the periodontium. The aim of orthodontic treatment is desired tooth movement with minimum side effects on the alveolar bone quality. The aim of the present study was to assess changes of alveolar trabeculation in children, young adults and adults and the two genders. Methods. In this cross-sectional study, 63 patients who had been treated in Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran, were chosen with convenient sampling method. They were divided into three groups based on their age. Their digitized panoramic radiographs (PRs) were evaluated at six interdental sites from the mesial aspect of the mandibular second molars to the distal aspect of the mandibular first premolars using a visual index. The trabeculation pattern was assigned as either dense (score 3), dense-sparse (score 2) or sparse (score 1). Data were imported to SPSS. Mean of the scores before treatment (score B) and mean of them after treatment (score A) were compared for each group with paired t-test. Changes between score B and sore A of the groups were compared using one-way ANOVA and post hoc tests. Results. Mean score A was significantly higher than mean score B in children (P = 0.001). In contrast, mean score A was significantly lower than mean score B in young adults (P = 0.003). Conclusion. Orthodontists should be cautious when treating young adults and adults regarding the probable, yet possibly temporary, negative effects of orthodontic therapy on the alveolar bone quality.
Collapse
Affiliation(s)
- Abdolaziz Haghnegahdar
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hooman Zarif Najafi
- Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Sabet
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Saki
- Student Research Committee, Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
23
|
Iviglia G, Cassinelli C, Bollati D, Baino F, Torre E, Morra M, Vitale-Brovarone C. Engineered porous scaffolds for periprosthetic infection prevention. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 68:701-715. [DOI: 10.1016/j.msec.2016.06.050] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/26/2016] [Accepted: 06/13/2016] [Indexed: 01/13/2023]
|
24
|
Kang SR, Bok SC, Choi SC, Lee SS, Heo MS, Huh KH, Kim TI, Yi WJ. The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography. J Periodontal Implant Sci 2016; 46:116-27. [PMID: 27127692 PMCID: PMC4848379 DOI: 10.5051/jpis.2016.46.2.116] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/20/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. Methods We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. Results SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (P<0.01) while SPF demonstrated significant negative correlations with other microstructural parameters (Tb.Sp, Tb.Pf, and SMI) using micro-CT and CBCT (P<0.01). Conclusions There was an increase in implant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses.
Collapse
Affiliation(s)
- Se-Ryong Kang
- Department of Biomedical Radiation Sciences, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea
| | - Sung-Chul Bok
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| |
Collapse
|
25
|
Kamigaki Y, Sato I, Yosue T. Histological and radiographic study of human edentulous and dentulous maxilla. Anat Sci Int 2016; 92:470-482. [PMID: 27067228 DOI: 10.1007/s12565-016-0344-z] [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: 12/13/2015] [Accepted: 03/28/2016] [Indexed: 11/26/2022]
Abstract
Data on the bone trabecular structure and density of the edentulous regions of the first upper molars are important for designing successful dental treatments, especially dental implants. However, no detailed defined morphometric properties on the human maxilla are available at the immunohistochemical and radiographic levels. Cone-beam computed tomography analysis and immunohistochemical observation were applied to the maxillary first molar region of 91 cadavers (46 males and 45 females). The edentulous maxilla can be classified into the following three forms: fully edentulous (FE), partially edentulous (PE), and immediately edentulous (IE). Compared with the first molar dentulous (FMD) specimens, significant differences in cortical bone structure and bone density exist among IE, PE, and FE in maxilla (P < 0.001). According to histochemical observations, the positive CD31 reaction clearly described a large vessel of the PE and small vessels of FMD and IE in maxillary sinus connective tissue. These structural issues were clearly related to tooth extraction. These morphological and radiographic data describing the edentulous region of the maxillary first molar might be useful for improving dental treatments.
Collapse
Affiliation(s)
- Yukino Kamigaki
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Iwao Sato
- Department of Anatomy, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Takashi Yosue
- Department of Oral and Maxillofacial Radiology, School of Life Dentistry at Tokyo, The Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.
| |
Collapse
|
26
|
de Faria Vasconcelos K, dos Santos Corpas L, da Silveira BM, Laperre K, Padovan LE, Jacobs R, de Freitas PHL, Lambrichts I, Bóscolo FN. MicroCT assessment of bone microarchitecture in implant sites reconstructed with autogenous and xenogenous grafts: a pilot study. Clin Oral Implants Res 2016; 28:308-313. [DOI: 10.1111/clr.12799] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Karla de Faria Vasconcelos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - Lívia dos Santos Corpas
- Department of Prosthetic Dentistry, Oral Health Sciences, Faculty of Medicine; Katholieke Universiteit Leuven; Leuven Belgium
| | | | | | - Luis Eduardo Padovan
- Department of Implant Dentistry; Latin American Institute for Dental Research and Training (ILAPEO); Curitiba Brazil
| | - Reinhilde Jacobs
- OMFS Impath Research Group, Department of Imaging & Pathology, Faculty of Medicine; University of Leuven; Leuven Belgium
- Department of Maxillofacial Surgery; Leuven University Hospital; Leuven Belgium
| | | | - Ivo Lambrichts
- Biomedical Research Institute, Laboratory of Morphology; Hasselt University; Diepenbeek Belgium
| | - Frab Norberto Bóscolo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| |
Collapse
|
27
|
Support Immersion Endoscopy in Post-Extraction Alveolar Bone Chambers: A New Window for Microscopic Bone Imaging In Vivo. PLoS One 2015; 10:e0145767. [PMID: 26713617 PMCID: PMC4695096 DOI: 10.1371/journal.pone.0145767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/08/2015] [Indexed: 12/15/2022] Open
Abstract
Using an endoscopic approach, small intraoral bone chambers, which are routinely obtained during tooth extraction and implantation, provide visual in vivo access to internal bone structures. The aim of the present paper is to present a new method to quantify bone microstructure and vascularisation in vivo. Ten extraction sockets and 6 implant sites in 14 patients (6 men / 8 women) were examined by support immersion endoscopy (SIE). After tooth extraction or implant site preparation, microscopic bone analysis (MBA) was performed using short distance SIE video sequences of representative bone areas for off-line analysis with ImageJ. Quantitative assessment of the microstructure and vascularisation of the bone in dental extraction and implant sites in vivo was performed using ImageJ. MBA revealed bone morphology details such as unmineralised and mineralised areas, vascular canals and the presence of bleeding through vascular canals. Morphometric examination revealed that there was more unmineralised bone and less vascular canal area in the implant sites than in the extraction sockets.
Collapse
|
28
|
Dias DR, Leles CR, Lindh C, Ribeiro-Rotta RF. Marginal bone level changes and implant stability after loading are not influenced by baseline microstructural bone characteristics: 1-year follow-up. Clin Oral Implants Res 2015; 27:1212-1220. [PMID: 26648053 DOI: 10.1111/clr.12728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of different bone tissue characteristics of implant sites on changes in marginal bone level and implant stability over time. MATERIAL AND METHODS One hundred and one implants were inserted in 41 patients. Cortical bone thickness of the alveolar ridge was measured on computed tomography (CT) images. Histomorphometric and microtomographic analyses (microCT) were performed in bone specimens obtained by using a trephine bur, at first drilling. Implant stability quotient (ISQ) measured by resonance frequency analysis (RFA) was registered at implant insertion. Implant stability quotient was measured also at the stages of uncovering, loading and at the 1-year follow-up, when standardized periapical radiographs were taken to measure the marginal bone level (MBL). Descriptive statistics, Spearman's rho correlation and multiple linear regression were used for data analysis (P < 0.05). RESULTS Comparison between groups of higher and lower values of ISQ changes and between groups of higher and lower values of MBL changes revealed no differences in histomorphometric and microtomographic parameters, according to non-parametric comparison tests, (P > 0.05). Bivariate correlation also showed no association among these microstructural parameters and the outcomes evaluated. There was no correlation between cortical thickness and MBL changes (r = -0.029; P = 0.832) and between cortical thickness and ISQ changes (r = 0.145; P = 0.292). CONCLUSION Microstructural bone characteristics of implant sites have no effect on changes in marginal bone level and implant stability as measured by RFA. Bone morphology cannot predict implant treatment success over time.
Collapse
Affiliation(s)
- Danilo Rocha Dias
- Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Christina Lindh
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | |
Collapse
|
29
|
Monje A, Chan HL, Galindo-Moreno P, Elnayef B, Suarez-Lopez del Amo F, Wang F, Wang HL. Alveolar Bone Architecture: A Systematic Review and Meta-Analysis. J Periodontol 2015; 86:1231-48. [DOI: 10.1902/jop.2015.150263] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
30
|
Pauwels R, Jacobs R, Singer SR, Mupparapu M. CBCT-based bone quality assessment: are Hounsfield units applicable? Dentomaxillofac Radiol 2015; 44:20140238. [PMID: 25315442 DOI: 10.1259/dmfr.20140238] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology.
Collapse
Affiliation(s)
- R Pauwels
- 1 Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | | | | |
Collapse
|
31
|
Assessment of the Correlation between the Implant Distance and Primary Stability by Resonance Frequency Analysis. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/568715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. The aim of this study was to assess the influence of the interimplant distance on the implant primary stability (ISQ) by Resonance Frequency Analysis (RFA). Method. Forty-five implants were placed in the mandible of human cadavers and 108 in artificial bone substrates in the form of polyurethane foam blocks. Primary implant stability was successively measured first by RFA immediately after the placement of the first implant (A) and then after two other implants (B and C) proximal and distal to the first implant. The interimplant distances were defined from 1 to 6 mm and the three primary stability values measured were compared. Results. On the mandibles, no correlation was observed between the interimplant distances and primary stability. On the polyurethane foam block, the primary stability of implant A increased significantly (p<0.001) after the placement of implant B but remained constant after placement of implant C. Conclusion. Reducing the interimplant distance does not affect the primary stability on dry bone or artificial substrate.
Collapse
|
32
|
Linck GKSB, Ferreira GM, De Oliveira RCG, Lindh C, Leles CR, Ribeiro-Rotta RF. The Influence of Tactile Perception on Classification of Bone Tissue at Dental Implant Insertion. Clin Implant Dent Relat Res 2015; 18:601-8. [PMID: 25850635 DOI: 10.1111/cid.12341] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Various ways of using the Lekholm and Zarb (L&Z) classification have added to the lack of scientific evidence of the effectiveness of this clinical method in the evaluation of implant treatment. PURPOSE The study aims to assess subjective jawbone classifications in patients referred for implant treatment, using L&Z classification with and without surgeon's hand perception at implant insertion. The association between bone type classifications and quantitative parameters of primary implant stability was also assessed. MATERIALS AND METHODS One hundred thirty-five implants were inserted using conventional loading protocol. Three surgeons classified bone quality at implant sites using two methods: one based on periapical and panoramic images (modified L&Z) and one based on the same images associated with the surgeon's tactile perception during drilling (original L&Z). Peak insertion torque and implant stability quotient (ISQ) were recorded. RESULTS The modified and original L&Z were strongly correlated (rho = 0.79; p < .001); Wilcoxon signed-rank test showed no significant difference in the distribution of bone type classification between pairs using the two methods (p = .538). Spearman correlation tested the association between primary stability parameters and bone type classifications (-0.34 to -0.57 [p < .001]). CONCLUSIONS Tactile surgical perception has a minor influence on rating of subjective bone type for dental implant treatment using the L&Z classification.
Collapse
|
33
|
Fang L, Ding X, Wang HM, Zhu XH. Chronological changes in the microstructure of bone during peri-implant healing: a microcomputed tomographic evaluation. Br J Oral Maxillofac Surg 2014; 52:816-21. [DOI: 10.1016/j.bjoms.2014.07.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 07/11/2014] [Indexed: 11/28/2022]
|
34
|
Dias DR, Leles CR, Lindh C, Ribeiro-Rotta RF. The effect of marginal bone level changes on the stability of dental implants in a short-term evaluation. Clin Oral Implants Res 2014; 26:1185-90. [DOI: 10.1111/clr.12426] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Danilo R. Dias
- Department of Oral Medicine; School of Dentistry; Federal University of Goias; Goiania Brazil
| | - Cláudio R. Leles
- Department of Prevention and Oral Rehabilitation; School of Dentistry; Federal University of Goias; Goiania Brazil
| | - Christina Lindh
- Department of Oral and Maxillofacial Radiology; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Rejane F. Ribeiro-Rotta
- Department of Oral Medicine; School of Dentistry; Federal University of Goias; Goiania Brazil
| |
Collapse
|
35
|
Dias DR, Leles CR, Batista AC, Lindh C, Ribeiro-Rotta RF. Agreement between Histomorphometry and Microcomputed Tomography to Assess Bone Microarchitecture of Dental Implant Sites. Clin Implant Dent Relat Res 2013; 17:732-41. [PMID: 24238279 DOI: 10.1111/cid.12176] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Histomorphometry and microcomputed tomography (microCT) have been used in implant studies but need better understanding before being used as equivalent methods. PURPOSE The purpose of this study was to investigate the agreement between 2D (histomorphometry) and 3D (microCT) reference methods for assessing jawbone microarchitecture in vivo. MATERIAL AND METHODS Forty-four bone specimens from 32 patients were obtained during implant placement and examined by microCT, followed by hematoxylin-eosin staining and histomorphometric analysis. The morphometric parameters included bone volume density (BV/TV), bone surface fraction (BS/TV), bone surface density, trabecular thickness, trabecular number, and trabecular separation (Tb.Sp). Bland-Altman plots were used for pairwise agreement analysis between the equivalent 3D and 2D parameters, and complemented with Mountain plots. The association between the two methods was tested using Pearson's correlation followed by Passing-Bablok regression. RESULTS Systematic bias was observed in all Bland-Altman and Mountain plots, including constant bias for BV/TV and Tb.Sp, and proportional bias for all other parameters. Significant correlation was found for BV/TV (r = 0.80; p < .001) and BS/TV (r = 0.44; p = .003), and the Passing-Bablok regression showed constant bias for BV/TV and proportional bias for BS/TV. CONCLUSION Because of the poor agreement between measures obtained by histomorphometry and microCT, these methods should not be used interchangeably for jawbones.
Collapse
Affiliation(s)
- Danilo Rocha Dias
- Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Aline Carvalho Batista
- Department of Oral Medicine, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil
| | - Christina Lindh
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | |
Collapse
|
36
|
Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IHA, Wismeijer D. The effect of scan parameters on cone beam CT trabecular bone microstructural measurements of the human mandible. Dentomaxillofac Radiol 2013; 42:20130206. [PMID: 24132024 DOI: 10.1259/dmfr.20130206] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The objective of this study was to investigate the effect of different cone beam CT scan parameters on trabecular bone microstructure measurements. A human mandibular cadaver was scanned using a cone beam CT (3D Accuitomo 170; J.Morita, Kyota, Japan). 20 cone beam CT images were obtained using 5 different fields of view (4×4 cm, 6×6 cm, 8×8 cm, 10×10 cm and 10×5 cm), 2 types of rotation steps (180° and 360°) and 2 scanning resolutions (standard and high). Image analysis software was used to assess the trabecular bone microstructural parameters (number, thickness and spacing). All parameters were measured twice by one trained observer. Intraclass correlation coefficients showed high intraobserver repeatability (intraclass correlation coefficient, 0.95-0.97) in all parameters across all tested scan parameters. Trabecular bone microstructural measurements varied significantly, especially in smaller fields of view (p = 0.001). There was no significant difference in the trabecular parameters when using different resolutions (number, p = 0.988; thickness, p = 0.960; spacing, p = 0.831) and rotation steps (number, p = 1.000; thickness, p = 0.954; spacing, p = 0.759). The scan field of view significantly influences the trabecular bone microstructure measurements. Rotation steps (180° or 360°) and resolution (standard or high) selections are not relevant.
Collapse
Affiliation(s)
- N Ibrahim
- Department of General and Specialized Dentistry, Section of Oral and Maxillofacial Radiology, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | | | | | | | | | | |
Collapse
|
37
|
Van Dessel J, Huang Y, Depypere M, Rubira-Bullen I, Maes F, Jacobs R. A comparative evaluation of cone beam CT and micro-CT on trabecular bone structures in the human mandible. Dentomaxillofac Radiol 2013; 42:20130145. [PMID: 23833320 DOI: 10.1259/dmfr.20130145] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The main purpose of this study was to determine the accuracy of cone beam CT (CBCT) in measuring the trabecular bone microstructure, in comparison with micro-CT. The subobjective was to examine to what extent bone quality assessment is influenced by X-ray tube current and voltage settings as well as soft tissue surrounding the bone. METHODS Eight human mandibular bone samples were scanned using three different clinical exposure protocol within water (W1-3) and without water (NW1-3) by a high-resolution (80 µm) CBCT machine (3D Accuitomo 170(®); Morita, Kyoto, Japan). Subsequently, the samples underwent micro-CT scanning (SkyScan 1174®; SkyScan, Antwerp, Belgium). After image acquisition, similar volumes of interest of the trabecular structures captured with CBCT and micro-CT were aligned with each other. Segmentation was then performed, and the morphometric parameters were quantified within the volumes of interest by CTAn software (CTAnalyser(®); SkyScan, Antwerp, Belgium). Descriptive statistical analyses and multiple comparisons between all protocols were applied in R software. RESULTS High positive Pearson's correlation coefficients were observed between CBCT and micro-CT protocols for all tested morphometric indices except for trabecular thickness. No significant differences were observed between all exposure protocols except for trabecular separation. When examining the soft-tissue effect on trabecular bone structures, no significant differences between NW (1-3) and W (1-3) protocols were observed for all variables. CONCLUSIONS The present study demonstrated the potential of high-resolution CBCT imaging for in vivo applications of quantitative bone morphometry and bone quality assessment. However, the overestimation of morphometric parameters and acquisition settings in CBCT must be taken into account.
Collapse
Affiliation(s)
- J Van Dessel
- Department of Oral Health Science, Oral Imaging Center, KU Leuven, Leuven, Belgium
| | | | | | | | | | | |
Collapse
|
38
|
Ibrahim N, Parsa A, Hassan B, van der Stelt P, Wismeijer D. Diagnostic imaging of trabecular bone microstructure for oral implants: a literature review. Dentomaxillofac Radiol 2013; 42:20120075. [PMID: 23420864 DOI: 10.1259/dmfr.20120075] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Several dental implant studies have reported that radiographic evaluation of bone quality can aid in reducing implant failure. Bone quality is assessed in terms of its quantity, density, trabecular characteristics and cells. Current imaging modalities vary widely in their efficiency in assessing trabecular structures, especially in a clinical setting. Most are very costly, require an extensive scanning procedure coupled with a high radiation dose and are only partially suitable for patient use. This review examines the current literature regarding diagnostic imaging assessment of trabecular microstructure prior to oral implant placement and suggests cone beam CT as a method of choice for evaluating trabecular bone microstructure.
Collapse
Affiliation(s)
- N Ibrahim
- Department of General and Specialized Dentistry, Section of Oral Radiology, Academic Center for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA Amsterdam, Netherlands.
| | | | | | | | | |
Collapse
|
39
|
Ibrahim N, Parsa A, Hassan B, van der Stelt P, Aartman IH, Wismeijer D. Accuracy of trabecular bone microstructural measurement at planned dental implant sites using cone-beam CT datasets. Clin Oral Implants Res 2013; 25:941-5. [DOI: 10.1111/clr.12163] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Norliza Ibrahim
- Department of General and Specialized Dentistry; Section of Oral and Maxillofacial Radiology; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
- Department of General Dental Practice and Oral & Maxillofacial Imaging; Faculty of Dentistry; University of Malaya; Kuala Lumpur Malaysia
| | - Azin Parsa
- Department of General and Specialized Dentistry; Section of Oral and Maxillofacial Radiology; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Bassam Hassan
- Department of General and Specialized Dentistry; Section of Oral and Maxillofacial Radiology; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Paul van der Stelt
- Department of General and Specialized Dentistry; Section of Oral and Maxillofacial Radiology; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Irene H.A. Aartman
- Department of Social Dentistry and Behavioral Sciences; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Daniel Wismeijer
- Department of Oral Function and Restorative Dentistry; Section of Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| |
Collapse
|
40
|
Huang Y, Van Dessel J, Liang X, Depypere M, Zhong W, Ma G, Lambrichts I, Maes F, Jacobs R. Effects of immediate and delayed loading on peri-implant trabecular structures: a cone beam CT evaluation. Clin Implant Dent Relat Res 2013; 16:873-83. [PMID: 23551564 DOI: 10.1111/cid.12063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To develop a method for characterizing trabecular bone microarchitecture using cone beam computed tomography (CBCT) and to evaluate trabecular bone changes after rehabilitation using immediate versus delayed implant protocols. MATERIALS AND METHODS Six mongrel dogs randomly received 27 titanium implants in the maxillary incisor or mandibular premolar areas, following one of four protocols: (1) normal extraction socket healing; (2) immediate implant placement and immediate loading; (3) delayed implant placement and delayed loading; (4) delayed implant placement and immediate loading. The animals were euthanized at 8 weeks, and block biopsies were scanned using high resolution CBCT. Standard bone structural variables were assessed in coronal, middle, and apical levels. RESULTS Coronal and middle regions had more compact, more platelike, and thicker trabeculae. Protocols (2), (3), and (4) had significantly higher values (p < 0.001) than protocol (1) for bone surface density, bone surface volume ratio, and connectivity density, while significantly lower values (p < 0.001) were found for trabecular separation and fractal dimension. However, protocols (2), (3), and (4) did not show significantly different bone remodeling. CONCLUSIONS Compared with normal extraction healing, the implant protocols have an improved bone structural integration. Results do not suggest a different bone remodeling pattern when a delayed versus an immediate implant protocol is used.
Collapse
Affiliation(s)
- Yan Huang
- Oral Imaging Center, Department of Oral Health Science, KU Leuven, Leuven, Belgium; Oral Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Monje A, Monje F, González-García R, Galindo-Moreno P, Rodriguez-Salvanes F, Wang HL. Comparison between microcomputed tomography and cone-beam computed tomography radiologic bone to assess atrophic posterior maxilla density and microarchitecture. Clin Oral Implants Res 2013; 25:723-8. [DOI: 10.1111/clr.12133] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| | - Florencio Monje
- CICOM; Center of Implantology; Oral and Maxillofacial Surgery; Badajoz Spain
| | | | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry; University of Granada; Granada Spain
| | | | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor MI USA
| |
Collapse
|
42
|
Chan HL, Oh TJ, Fu JH, Benavides E, Avila-Ortiz G, Wang HL. Sinus augmentation via transcrestal approach: a comparison between the balloon and osteotome technique in a cadaver study. Clin Oral Implants Res 2012; 24:985-90. [PMID: 22725990 DOI: 10.1111/j.1600-0501.2012.02506.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The transcrestal approach with osteotomes is a commonly applied and predictable technique for maxillary sinus floor elevation. However, Schneiderian membrane perforation is a common and often inevitable intraoperative complication. Recently, the use of balloons has been proposed to reduce the risk of sinus membrane perforation and to facilitate the surgical technique. The aim of this study was to determine membrane elevation height and perforation rate using the transcrestal balloon technique (B) and a conventional osteotome approach, as control (C). METHODS Ten fresh, completely edentulous cadaver heads (seven male and three female) were selected. In a split-mouth design, each sinus was randomly assigned to either the experimental or the control technique. Pre-surgical planning was aided by cone-beam computed tomography. During the procedure, an endoscope was used to monitor the elevation procedure and the occurrence of sinus perforation. The elevation continued until either 15 mm (measured from the alveolar crest) was reached or a perforation occurred. The residual ridge and the elevated membrane height were measured and compared with the paired Student's t-test. Presence of sinus perforation was recorded at three cutoff points: 10, 12, and 15 mm. RESULTS The mean age of the specimens was 77.7 ± 14.2 years (range 49-92). The mean initial, final, and elevated sinus membrane height for the B group was 5.3 ± 1.9, 13.7 ± 1.9, and 8.3 ± 3.1 mm, whereas the correspondent values for the C group were 5.1 ± 2.1, 13.2 ± 2.8, and 8.1 ± 3.1 mm. The incidence of sinus perforation, using 10, 12, and 15 mm as end points was 0%, 22.2%, and 44.4% in the B group, whereas in the C group the respective values were 10.0%, 20.0%, and 50.0%. No statistically significant differences were found between the two groups for all the above-mentioned variables. In addition, mean residual ridge height was not significantly different between the non-perforation and perforation sites in the B group (5.2 ± 2.2 and 5.5 ± 1.7 mm) and in the C group (5.2 ± 2.5 and 5.0 ± 2.0 mm). Three cadavers had perforations in both sinuses, accounting for 66.6% of total number of perforations. CONCLUSIONS Based on the findings of this study, the balloon and the conventional osteotome approach are comparable in terms of perforation rate as it relates to the elevation height. Also, the amount of residual alveolar bone was not related to the incidence of perforation and the height of sinus elevation.
Collapse
Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | | | | | | | | | | |
Collapse
|