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Al Jabbari YS, Fournelle R, Sufyan A, Zinelis S. Is fatigue mechanism implicated in intraoral fracture of narrow dental implants? A thorough retrieval analysis of two failed implant fixtures retrieved from a single patient. Saudi Dent J 2024; 36:770-777. [PMID: 38766294 PMCID: PMC11096602 DOI: 10.1016/j.sdentj.2024.02.006] [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: 09/01/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose This study aimed to perform a thorough failure analysis of two fractured narrow dental implants after medium-term in vivo use. Materials and methods The top parts of two fractured Narrow Dental Implant (NDI) fixtures were retrieved from two different locations at two different times from the same patient. The NDI-specimen-1 was 12-months in service while the NDI-specimen-2 was 17-months in service. In both cases, the top parts of the fractured NDI fixtures that were attached to prosthetic components were retrieved and subjected to thorough, non-destructive and destructive testing. Results Light Microscopy (LM) and Scanning Electron Microscopy (SEM) revealed that both the retrieved fractured NDIs failed because of fatigue, characterized by beach and ratchet marks. Macroscopic examination revealed that fatigue cracks initiated at the internal thread surfaces of the implants and propagated around them until final fracture. Both samples fractured near the end of the retaining screw and followed the root of the internal thread. Optical and SEM analyses revealed a uniform distribution of irregularly shaped grains (diameter = 2 to 5 μm). X -ray Energy Dispersive Spectroscopy (EDS) analysis showed that the NDI-specimen-1 was made using Ti-14%Zr with a Vickers Hardens (HV) of 288 ± 5. Conclusion Since the fracture occurred by a fatigue; thus, an increase in fatigue resistance will be beneficial for the longevity of NDI.
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Affiliation(s)
- Youssef S. Al Jabbari
- Dental Biomaterials Research and Development Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Raymond Fournelle
- Professor Emeritus, Department of Mechanical and Industrial Engineering, Marquette University School of Engineering, Milwaukee, WI, United States
| | - Arif Sufyan
- Dental Biomaterials Research and Development Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Spiros Zinelis
- Dental Biomaterials Research and Development Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Douest Y, Forrest RM, Ter-Ovanessian B, Courtois N, Tancret F, Greer AL, Chevalier J, Fabrègue D. Machine learning-guided exploration and experimental assessment of unreported compositions in the quaternary Ti-Zr-Cu-Pd biocompatible metallic glass system. Acta Biomater 2024; 175:411-421. [PMID: 38135205 DOI: 10.1016/j.actbio.2023.12.028] [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] [Received: 09/22/2023] [Revised: 11/21/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023]
Abstract
Due to their outstanding elastic limit, biocompatible Ti-based bulk metallic glasses (BMGs) are candidate materials to decrease the size of medical implants and therefore reduce their invasiveness. However, the practical use of classical Ti-BMGs in medical applications is in part hindered by their high copper content: more effort is thus required to design low-copper Ti-BMGs. In this work, in line with current rise in AI-driven tools, machine learning (ML) approaches, a neural-network ML model is used to explore the glass-forming ability (GFA) of unreported low-copper compositions within the biocompatible Ti-Zr-Cu-Pd system. Two types of models are trained and compared: one based on the alloy composition only, and a second based on various features derived from the alloying elements. Contrary to expectation, the predictive power of both models in evaluating GFA is similar. The compositional space identified by ML as promising is experimentally assessed, finding unfortunately low GFA. These results indicate that the ML approach may be premature for specific composition tuning of amorphous metallic materials. We emphasise that the development of ML tools in GFA prediction requires an improvement of the dataset, in terms of homogeneity, size and GFA descriptors, which must be supported by increased reporting of high-quality experimental GFA measurements, both positive and negative. STATEMENT OF SIGNIFICANCE: Biocompatible Ti-based bulk metallic glasses (BMGs) are candidate materials for use in the next generation of minimally invasive dental implants where improved mechanical properties, such as high strength are required. Despite promising in vitro/vivo evaluations, implementation of alloys for practical applications is partly hindered by the presence of copper as the main alloying element. Recent studies have presented AI-guided and machine learning strategies as appealing approaches to understand and describe the glass forming ability (GFA) of BMG-forming compositions. In this work, we employ and evaluate the capacity of a machine-learning model to explore low-copper compositional spaces in the biocompatible Ti-Zr-Cu-Pd system. Our results highlight the limits of such a computational approach and suggest improvements for future designing routes.
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Affiliation(s)
- Yohan Douest
- Anthogyr SAS, 2237 Avenue André Lasquin, 74700 Sallanches, France; INSA-Lyon, Université de Lyon, UMR CNRS 5510 MATEIS, 20 Avenue Albert Einstein, 69621 Villeurbanne CEDEX, France.
| | - Robert M Forrest
- Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS, UK
| | - Benoit Ter-Ovanessian
- INSA-Lyon, Université de Lyon, UMR CNRS 5510 MATEIS, 20 Avenue Albert Einstein, 69621 Villeurbanne CEDEX, France
| | - Nicolas Courtois
- Anthogyr SAS, 2237 Avenue André Lasquin, 74700 Sallanches, France
| | - Franck Tancret
- Université de Nantes, Institut des Matériaux Jean Rouxel (IMN), UMR CNRS 6502, Polytech Nantes, Rue Christian Pauc, BP 50609, 44306 Nantes CEDEX 3, France
| | - A Lindsay Greer
- Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS, UK
| | - Jérôme Chevalier
- INSA-Lyon, Université de Lyon, UMR CNRS 5510 MATEIS, 20 Avenue Albert Einstein, 69621 Villeurbanne CEDEX, France
| | - Damien Fabrègue
- INSA-Lyon, Université de Lyon, UMR CNRS 5510 MATEIS, 20 Avenue Albert Einstein, 69621 Villeurbanne CEDEX, France
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Assaf A, Saad M, Hijawi S. Use of narrow-diameter implants in the posterior segments of the jaws: A retrospective observational study of 2 to 11 years. J Prosthet Dent 2023; 130:840-848. [PMID: 35190196 DOI: 10.1016/j.prosdent.2022.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022]
Abstract
STATEMENT OF PROBLEM The placement of narrow-diameter implants (NDIs) in the posterior region is still debated in view of the high biomechanical risks in these areas. PURPOSE The purpose of this retrospective observational study was to evaluate the success and survival rates of NDIs restored with fixed prostheses in the posterior region (primary outcome) and analyze whether splinting multiple units (prosthesis design) affects the biological and mechanical complications (secondary outcome). MATERIAL AND METHODS Dental records from 2 private clinics were reviewed for NDIs in the posterior region installed between 2009 and 2018. Ninety study participants (58 women and 32 men) aged between 21 and 84 years (mean age 49.9 years) were recalled for the assessment of implant survival and success of 160 NDIs previously provided for partial posterior edentulism associated with moderate horizontal bone loss or reduced interradicular space (105 premolars and 55 molars). The implants were restored with metal-ceramic single crowns or splinted multiple-unit prostheses, either screw-retained or cemented on custom (n=100) or stock titanium abutments (n=60). Peri-implant probing depth (PPD), bleeding on probing (BOP), bone quality, type of edentulism, and patient satisfaction were scored. The chi-squared test for independence and 2-sample Welch t test were performed for statistical analysis (α=.05). RESULTS The overall success rate was 89.37%. One implant had been removed 4 years after loading, another after 9 years, yielding a cumulative survival rate of 98.75%. Fourteen implants exhibited PPD > 5 mm. One implant and 1 abutment screw fractured, and 16 restorations demonstrated porcelain chipping. The chi-squared test showed no significant relationship between prosthetic design and complications whether biological (P=.087) or mechanical (P=.805). Eighty-two percent of patients were satisfied with esthetics, 76% with function, 85% with total duration of treatment, and 90% with overall treatment cost. CONCLUSIONS Within the limitations of this retrospective study, NDIs may be considered a reliable option to replace posterior teeth. The prosthetic design had no significant impact on biological or mechanical complications.
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Affiliation(s)
- André Assaf
- Clinical Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon; Former Head, Dental Biomaterials and Technology Unit, Faculty of Dentistry, Lebanese University, Beirut, Lebanon.
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Khaohoen A, Sornsuwan T, Chaijareenont P, Poovarodom P, Rungsiyakull C, Rungsiyakull P. Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review. J Clin Med 2023; 12:6924. [PMID: 37959389 PMCID: PMC10649288 DOI: 10.3390/jcm12216924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand;
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
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Walter C, Sagheb K, Blatt S, Klein MO, Herrmann J, Kleinheinz J, Al-Nawas B. Evaluation of the clinical safety and performance of a narrow diameter (2.9 mm) bone-level implant: a 1-year prospective single-arm multicenter study. Int J Implant Dent 2023; 9:32. [PMID: 37725234 PMCID: PMC10509112 DOI: 10.1186/s40729-023-00495-x] [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] [Received: 04/13/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE Narrow-diameter implants facilitate single-tooth restoration when interdental or inter-implant spaces and bone volume are inadequate for using standard diameter implants. This study reports the short-term data on the clinical safety and performance of a bone-level-tapered two-piece implant with a 2.9 mm diameter in the clinical practice setting. This study was retrospectively registered on March 1st, 2016 (NCT02699866). METHODS Implants were placed in partially healed extraction sockets of the central and lateral incisors in the mandible and lateral incisors in the maxilla for single-tooth replacement. The primary outcome was to assess implant survival at 12 months after placement. Secondary outcomes included implant success, pink esthetic score, marginal bone-level changes, and safety. RESULTS Twenty four males and 17 females with a mean age of 44.5 (± 18.3 standard deviation) received the implant. Three out of 41 implants were lost yielding a survival rate of 92.7% (95%-CI: 79.0%; 97.6%) at 1 year. One patient reported an ongoing foreign body sensation, pain, and/or dysesthesia at month 12. The average pink esthetic score at 6 months was 11.2 (95%-CI: 10.5; 11.9). The bone level was stable with a mean bone-level change of-0.3 mm (± 0.42 mm standard deviation) at 1 year after implantation. No serious adverse events or adverse device events were reported. CONCLUSIONS The use of a 2.9 mm diameter bone-level-tapered implant is a safe and reliable treatment option for narrow tooth gaps at the indicated locations. Overall performance and good survival rates support their use in cases, where wider implants are unsuitable.
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Affiliation(s)
- Christian Walter
- Oral and Maxillofacial Surgery of the Mediplus Clinic, Haifa-Allee 20, 55128, Mainz, Germany.
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - Keyvan Sagheb
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Blatt
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Marcus Oliver Klein
- Oral and Maxillofacial Surgery Private Dental Office, Stresemannstraße 7-9, 40210, Düsseldorf, Germany
| | - Jan Herrmann
- Oral and Maxillofacial Surgery Private Dental Office, Lothar-Streit-Straße 10B, 08056, Zwickau, Germany
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Münster, Albert Schweitzer-Campus 1, 48149, Münster, Germany
| | - Bilal Al-Nawas
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Alevizakos V, Mosch R, von See C. Influence of Multiple Used Implant Drills on Their Cutting Performance and Fracture Resistance. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5271. [PMID: 37569975 PMCID: PMC10420324 DOI: 10.3390/ma16155271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023]
Abstract
This study aimed to analyze the influence of multiple uses of zirconia implant drills on their cutting performance and bending strength. The hypothesis was that drill usage and sterilization cycles would not affect drilling time or flexural strength. Sixty zirconia twist drills from Z-Systems were used to drill in the angulus mandibulae region of fresh porcine jaws. The drills were divided into four groups based on the cycle count, and the drilling time was measured. Bending strength tests were conducted using a universal testing machine, and statistical analysis was performed using ANOVA tests. The results showed that drilling times followed a normal distribution, and significant differences were observed in drilling times between group 1 and the other groups for the pilot drill. However, no significant differences were found for ø3.75 mm and ø4.25 mm drills, and drilling times also varied significantly among different drill diameters, regardless of the cycle count. Flexural strength did not significantly differ among drill diameters or sterilization cycles. Overall, using and sterilizing zirconia implant drills had no significant impact on drilling time or flexural strength. Nevertheless, drilling times did vary depending on the diameter of the drill. These findings provide valuable insights into the performance and durability of zirconia implant drills, contributing to the optimization of dental implant procedures.
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Affiliation(s)
- Vasilios Alevizakos
- Research Center for Digital Technologies in Dentistry and CAD/CAM, Danube Private University, Steiner Landstrasse 124, 3500 Krems an der Donau, Austria; (R.M.); (C.v.S.)
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Pesce P, Del Fabbro M, Modenese L, Sandron S, Francetti L, Isola G, Canullo L, Menini M. Influence of implant diameter on implant survival rate and clinical outcomes in the posterior area: a systematic review and meta-analysis. BMC Oral Health 2023; 23:235. [PMID: 37085829 PMCID: PMC10122303 DOI: 10.1186/s12903-023-02962-8] [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] [Received: 10/01/2022] [Accepted: 04/11/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE The aim of the present systematic review was to test the hypothesis that the diameter of implants inserted in the posterior area affects implant survival rate, prosthetic survival rate and peri-implant parameters (bleeding on probing (BoP), marginal bone loss (MBL), pocket probing depth (PPD)). MATERIALS AND METHODS An electronic search of studies published until December 2021 was done on three databases (Pubmed, Scopus, Cochrane) independently by two authors. Clinical trials comparing implant survival rate, BoP, MBL and PPD among narrow diameter implants (NDI: ≥ 3.0 mm to < 3.75 mm) and regular diameter implants (RDI ≥ 3.75 mm to < 5 mm) were included. Data were independently extracted by two reviewers. Risk of bias was evaluated according to the Cochrane risk-of-bias tool for randomized studies and to the Joanna Briggs Institute Critical Appraisal tools for non-randomized ones. A pair-wise meta-analysis was conducted on the included studies. RESULTS Seven articles were included out of the 4291 identified from the digital research. Overall, a total of 939 implants were inserted (319 NDI, 620 RDI). Only one study was judged at serious risk of bias. No statistically significant difference was found in implant survival rate (risk ratio 1.01 (95% CI [0.98 to 1.04], P = 0.67)) while the difference was significant for BoP (mean difference 2.89 (95% CI [0.30 to 5.48] mm, P = 0.03)) with higher values for NDI. Higher MBL was identified among regular diameter implants (mean difference -0.15 mm (95% CI [-0.32 to 0.01 mm], P = 0.07). No statistically significant differences were identified for prosthetic survival and PPD. CONCLUSIONS No differences were found in implant survival rate between narrow and regular implants. A higher BoP was identified among narrow implants, but there was no higher bone loss. It is not possible to draw definitive conclusions about the use of narrow-diameter implants in the posterior region.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Ospedale S. Martino, L. Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Modenese
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- IRCCS Orthopedic Institute Galeazzi, Dental Clinic, Milan, Italy
| | - Stefano Sandron
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Ospedale S. Martino, L. Rosanna Benzi 10, 16132, Genoa, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- IRCCS Orthopedic Institute Galeazzi, Dental Clinic, Milan, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical SpecialtiesSchool of Dentistry, University of Catania Via S, Sofia 78, Pad. 2 Piano -1 Stanza 53, 95124, Catania, Italy
| | - Luigi Canullo
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Ospedale S. Martino, L. Rosanna Benzi 10, 16132, Genoa, Italy
| | - Maria Menini
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Ospedale S. Martino, L. Rosanna Benzi 10, 16132, Genoa, Italy
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Mechanical stability of angulated zirconia abutments supporting maxillary anterior single crowns on narrow-diameter implants. Clin Oral Investig 2023; 27:221-233. [PMID: 36161530 DOI: 10.1007/s00784-022-04715-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To investigate the fracture strength of angulated hybrid abutments supporting anterior single crowns on narrow-diameter implants (NDIs). MATERIAL AND METHODS Zirconia abutment with angulations of labial inclination 0° (TZ0Z), 15° (TZ15Z), 30° (TZ30Z) and palatal inclination 15° (TZ - 15Z) was designed on 3.3-mm titanium-zirconium (Ti-Zr) NDIs. Titanium abutment connected with Ti-Zr implant (TZ0T) and 0° zirconia abutment connected with pure titanium (Ti) implant (T0Z) were control groups. Thirty-six un-restored abutments and 36 abutments restored with highly translucent zirconia (HTZ) crowns were tested. Failure loads were compared among 6 groups, and bending moments were calculated for comparison between un-restored and restored abutments. RESULTS Failure loads of un-restored abutments were affected by the abutment angle. Sixty-seven percent samples in TZ30Z and 83% samples in TZ - 15Z group fractured at the thinnest part of the zirconia abutment and exhibited lower failure load (p < .05). Failure loads of restored abutments were close to or exceeded the maximum bite force of anterior teeth, and no differences were found among six groups (p > .05). Except TZ15Z and TZ0T group, the bending moment increased with the crown construction, especially for TZ30Z and TZ - 15Z groups (p < .001). CONCLUSIONS The fracture strength of hybrid abutments restored with HTZ crown on Ti-Zr NDIs exceeded the bite forces of anterior teeth for all the groups and were not affected by the abutment angle. CLINICAL RELEVANCE In terms of fracture strength, Ti-Zr NDIs combined with angulated hybrid abutments and HTZ crowns can be used in the anterior region.
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Zhang Y, Yu P, Yu H. Stress distribution and microgap formation in angulated zirconia abutments with a titanium base in narrow diameter implants: A 3D finite element analysis. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3610. [PMID: 35490303 DOI: 10.1002/cnm.3610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE This in vitro study aimed to use failure stress and implant abutment interface (IAI) microgap size to find the compromised axial angle range of angulated zirconia abutments with a titanium base in narrow diameter implants in the esthetic region. MATERIALS AND METHODS A three-dimensional (3D) finite element model of maxillary central incisor implant prosthesis was reconstructed. Angulated zirconia abutments (0°, 15°, 30°, and - 15°) with a titanium base in narrow diameter implants (3.3*12 mm, Bone level, Roxolid SLActive, Straumann AG, Switzerland) were designed to simulate clinical scenarios of buccal inclination 0°, 15°, and 30°, and palatal inclination 15° of the implant long axis. Straight titanium abutment and pure titanium implant were used as two control groups. An oblique force at 30° inclination to the long axis of the crown was applied 3 mm below the incisal edge on the palatal surface of the prosthesis. Under simulated dynamic chewing force, the stress distribution of the implant components and surrounding bone were investigated. The relative micromotion displacement between the implant and abutment models at the IAI area was recorded, and the influence of tightening torque on the IAI microgap was evaluated. RESULTS The angulation of the zirconia abutment could affect the stress value and IAI microgap of implant restorations. When the zirconia abutment angle increased from -15 °to 30°, the stress on the central screw, titanium base, and surrounding bone tissue gradually increased by 9%, 20%, and 23%, respectively. The stress levels of the 30° zirconia abutment group showed the risk of exceeding the threshold. When the long axis of the implant was inclined in the palatal direction, the -15° angle abutment reduced the stress by 3% and reduced the strain level of the implant system by 17% and the surrounding bone tissue by 26%. Under simulated dynamic chewing load, the displacement between the implants and the abutment occurred in each group of the implant system, and the amplitude of the micromotion fluctuated with the change in the load. The horizontal displacement caused a 0.075-1.459 μm palatal microgap and 0.091-0.945 μm distal microgap in the IAI. The microgap between the lip and palate was more evident, and the vertical displacement difference was manifested as the abutment sliding down the implant. CONCLUSIONS In cases of upper implant restoration with difficulties such as small gaps and axial defects in the esthetic zone, the abutment angle is highly recommended to be in a slightly palatal-inclined direction or to not exceed 15° when the implant is inclined to the labial side to avoid mechanical damage and leakage caused by the appearance of excessively large micromotion gaps. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yuqiang Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Ping Yu
- Department of Stomatology, Chengdu Second People's Hospital, Chengdu, People's Republic of China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
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Armentia M, Abasolo M, Coria I, Sainitier N. Effect of the geometry of butt-joint implant-supported restorations on the fatigue life of prosthetic screws. J Prosthet Dent 2022; 127:477.e1-477.e9. [DOI: 10.1016/j.prosdent.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
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Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121388. [PMID: 34946333 PMCID: PMC8705565 DOI: 10.3390/medicina57121388] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/17/2022]
Abstract
Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.
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Sharma A, Waddell JN, Li KC, A Sharma L, Prior DJ, Duncan WJ. Is titanium-zirconium alloy a better alternative to pure titanium for oral implant? Composition, mechanical properties, and microstructure analysis. Saudi Dent J 2021; 33:546-553. [PMID: 34803299 PMCID: PMC8589587 DOI: 10.1016/j.sdentj.2020.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Titanium (Ti) is widely accepted as a biomaterial for orthopaedic and dental implants, primarily due to its capacity to integrate directly into the bone and its superior corrosion resistance. It has been suggested that titanium–zirconium alloy (TiZr), with 13–17% of zirconium, has better mechanical properties than pure Ti, but there are very few published studies assessing the suitability of TiZr for high-load- bearing implants. This study aimed to compare the mechanical properties and microstructures of TiZr and commercially pure titanium (Ti). Methodology Pure Ti and TiZr alloy discs were prepared and subjected to characterisation by nanoindentation, electron dispersive spectroscopy (EDS), X-ray diffraction (XRD), and electron backscatter diffraction (EBSD). Results The TiZr alloy was found to have significantly lower elastic modulus value (p < 0.0001) and greater hardness than Ti (p < 0.05). The EDS results confirmed the presence of Zr (13–17%) in the TiZr alloy, with XRD and EBSD images showing microstructure with the alpha phase similar to commercially available Ti. Conclusion The lower elastic modulus, higher hardness, presence of alpha phase, and the finer grain size of the TiZr alloy make it more suitable for high-load-bearing implants compared to commercially available Ti and is likely to encourage a positive biological response.
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Affiliation(s)
- Ajay Sharma
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - John N Waddell
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Kai C Li
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lavanya A Sharma
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - David J Prior
- Department of Geology, University of Otago, Dunedin, New Zealand
| | - Warwick J Duncan
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Mortazavi H, Khodadoustan A, Kheiri A, Kheiri L. Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials. J Korean Assoc Oral Maxillofac Surg 2021; 47:153-174. [PMID: 34187956 PMCID: PMC8249186 DOI: 10.5125/jkaoms.2021.47.3.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissue-level designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Khodadoustan
- Member of Iranian Association of Periodontology, Private Practice, Tehran, Iran
| | - Aida Kheiri
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lida Kheiri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
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Use of Narrow-Diameter Implants in Completely Edentulous Patients as a Prosthetic Option: A Systematic Review of the Literature. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5571793. [PMID: 34239926 PMCID: PMC8241526 DOI: 10.1155/2021/5571793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/15/2021] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
Objective The objective of the present review is to assess the implant survival, marginal bone loss, and biomechanical features of narrow-diameter implants (2.5-3.5 mm) supporting or retaining full-arch fixed or removable restorations. Materials and Methods Three operators screened the literature (PubMed, Cochrane Library, and Google Scholar) and performed a hand search on the main journals that focus on implantology until 24 March 2019. Only articles that considered full-arch restorations supported or retained by narrow-diameter implants (2.5-3.5 mm) were considered if they have a minimum of 10 patients and a mean follow-up of at least 6 months. The outcome variables were survival of implants and marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure rates were analyzed using random effect Poisson regression models to obtain the summary estimate of 5-year survival rate and marginal bone loss. Results A total of nine papers were finally selected, reporting a high survival rate of the implants. Eight studies focused only on the mandible while one study reported data from both mandible and maxilla. All studies reported on removable restorations; none focused on fixed rehabilitations. The estimated survival rate for 5 years of follow-up was calculated to be 92.25% for the implants. The estimated marginal bone loss after 5 years was calculated to be 1.40 mm. No study reported implant fractures. Conclusions With the limitations of the present study, there is evidence that 2.5-3.5 mm narrow-diameter implants retaining a removable restoration can be a successful treatment in fully edentulous patients. No data on fixed restorations was available.
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Hultin K, Eriksson A, Backe C, Johansson U, Bougas K. A Pilot Study with Randomised Controlled Design Comparing TiZr Alloy Dental Implants to Ti Implants. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2020; 11:e3. [PMID: 33598111 PMCID: PMC7875101 DOI: 10.5037/jomr.2020.11403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
Objectives Evidence on the clinical performance of recently introduced dental implants in titanium-zirconium alloy is sparse. The aim of the present pilot study with randomized controlled design is to compare changes in supporting structures around dental titanium-zirconium alloy implants to commercially pure titanium implants. Material and Methods The present material includes consecutive patients referred to a specialist clinic in Sweden. Two patient groups treated with dental implants in two different materials - titanium (Ti) and titanium-zirconium (TiZr) - were defined after block randomisation for smoking. In total, 40 implants installed in 21 patients were available for one-year follow-up. Marginal bone level, soft tissue height and width of keratinised mucosa were registered at baseline and at one-year follow-up. Results At implant level, the test group (TiZr) yielded significant marginal bone loss (P < 0.001) after one year. Additionally, marginal bone loss after one year was significantly higher for TiZr implants (P < 0.001) as compared to traditional Ti implants. Soft tissue dimensions were stable throughout the evaluation time for both implant materials. Conclusions One-year results indicate more pronounced initial marginal bone loss for dental implants in titanium-zirconium alloy as compared to implants made of commercially pure titanium.
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Affiliation(s)
- Kristina Hultin
- Department of Prosthodontics, Södra Älvsborg Hospital, BoråsSweden
| | - Annelie Eriksson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Christina Backe
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Ulf Johansson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Kostas Bougas
- Department of Periodontology, Södra Älvsborg Hospital, BoråsSweden
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Abstract
In the past, the only way to replace missing teeth was to have a removable appliance. However, these days, dental implants are commonly being used to replace missing teeth. The dental implants are improving as a result of new technological and scientific advances. Different materials have been used in the past for dental implants such as lead, stainless steel, and gold. Currently, the focus is on using Roxolid, surface-modified titanium implants, and zirconia. These materials have superior esthetic and functional characteristics for dental implants.
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Affiliation(s)
- Allen Glied
- Department of Dentistry, St. Barnabas Hospital, 4422 Third Avenue, Bronx, NY 10457, USA.
| | - Junaid Mundiya
- Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
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Abstract
Regenerative therapies aim to develop novel treatments to restore tissue function. Several strategies have been investigated including the use of biomedical implants as three-dimensional artificial matrices to fill the defect side, to replace damaged tissues or for drug delivery. Bioactive implants are used to provide growth environments for tissue formation for a variety of applications including nerve, lung, skin and orthopaedic tissues. Implants can either be biodegradable or non-degradable, should be nontoxic and biocompatible, and should not trigger an immunological response. Implants can be designed to provide suitable surface area-to-volume ratios, ranges of porosities, pore interconnectivities and adequate mechanical strengths. Due to their broad range of properties, numerous biomaterials have been used for implant manufacture. To enhance an implant’s bioactivity, materials can be functionalised in several ways, including surface modification using proteins, incorporation of bioactive drugs, growth factors and/or cells. These strategies have been employed to create local bioactive microenvironments to direct cellular responses and to promote tissue regeneration and controlled drug release. This chapter provides an overview of current bioactive biomedical implants, their fabrication and applications, as well as implant materials used in drug delivery and tissue regeneration. Additionally, cell- and drug-based bioactivity, manufacturing considerations and future trends will be discussed.
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Tharani Kumar S, Prasanna Devi S, Krithika C, Raghavan RN. Review of Metallic Biomaterials in Dental Applications. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:S14-S19. [PMID: 33149425 PMCID: PMC7595562 DOI: 10.4103/jpbs.jpbs_88_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/09/2020] [Indexed: 11/23/2022] Open
Abstract
Titanium and its alloys are mainly used in manufacturing dental implants. The fact that titanium implants are immunologically very effective, new methods are being experimented to achieve utmost success rate as a biomaterial. One fundamental indicator for clinical achievement of implant is the decision of composition decided for the implant with the objective to improve osseointegration. The main objective of this study was to explore literature on dental materials used for implants, contrast them with titanium dental implants, with the aim to improve osseointegration and mechanical quality using Ti–Ga–Si dental implant.
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Affiliation(s)
- S Tharani Kumar
- Dr. MGR Educational and Research Institute University, Chennai, Tamil Nadu, India
| | - S Prasanna Devi
- Department of Computer Science & Engineering, SRM Institute of Science & Technology, Chennai, Tamil Nadu, India
| | - Chandrasekaran Krithika
- Department of Oral Medicine, Thai Moogambigai Dental College, Dr. MGR Educational and Research Institute University, Chennai, Tamil Nadu, India
| | - R N Raghavan
- RNR Dental Clinic and Research Services, Chennai, Tamil Nadu, India
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Barker E, AlQobaly L, Shaikh Z, Franklin K, Moharamzadeh K. Implant Soft-Tissue Attachment Using 3D Oral Mucosal Models-A Pilot Study. Dent J (Basel) 2020; 8:E72. [PMID: 32645887 PMCID: PMC7558259 DOI: 10.3390/dj8030072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The aim of this study was to investigate soft-tissue attachment to different metal, ceramic, and polymer implant surfaces using an inflamed, three-dimensional (3D), tissue-engineered, human oral mucosal model, as well as multiple-endpoint qualitative and quantitative biological approaches. METHODS Normal human oral fibroblasts, OKF6/TERT-2 keratinocytes and THP-1 monocytes were cultured, and full-thickness, 3D oral mucosal models were engineered inside tissue culture inserts. Sand-blasted and acid-etched (SLA) and machined (M) titanium-zirconium alloy (TiZr; commercially known as Roxolid; Institut Straumann AG, Switzerland), ceramic (ZrO2), and polyether ether ketone (PEEK) rods (Ø 4 mm × 8 mm) were inserted into the center of tissue-engineered oral mucosa following a Ø 4mm punch biopsy. Inflammation was simulated with addition of the lipopolysaccharide (LPS) of Escherichia coli (E. coli) and tumor necrosis factor (TNF)-alpha to the culture medium. Implant soft-tissue attachment was assessed using histology, an implant pull-test with PrestoBlue assay, and scanning electron microscopy (SEM). RESULTS Inflamed, full-thickness, 3D human oral mucosal models with inserted implants were successfully engineered and histologically characterized. The implant pull-test with PrestoBlue assay showed higher viability of the tissue that remained attached to the TiZr-SLA surface compared to the other test groups. This difference was statistically significant (p < 0.05). SEM analysis showed evidence of epithelial cell attachment on different implant surfaces. CONCLUSIONS The inflamed, 3D, oral mucosal model has the potential to be used as a suitable in vitro test system for visualization and quantification of implant soft-tissue attachment. The results of our study indicate greater soft tissue attachment to TiZr-SLA compared to TiZr-M, ceramic, and PEEK surfaces.
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Affiliation(s)
| | | | | | | | - Keyvan Moharamzadeh
- School of Clinical Dentistry, University of Sheffield, Western Bank, Sheffield S10 2TN, UK; (E.B.); (L.A.); (Z.S.); (K.F.)
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Pérez R, Gargallo J, Altuna P, Herrero-Climent M, Gil F. Fatigue of Narrow Dental Implants: Influence of the Hardening Method. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E1429. [PMID: 32245138 PMCID: PMC7143173 DOI: 10.3390/ma13061429] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 12/27/2022]
Abstract
The use of narrow titanium dental implants (NDI) for small ridges, reduced interdental space, or missing lateral incisors can be a viable option when compared to the conventional wider dental implants. Furthermore, in many cases, standard diameter implant placement may not be possible without grafting procedures, which increases the healing time, cost, and morbidity. The aim of this study was to analyze the mechanical viability of the current narrow implants and how narrow implants can be improved. Different commercially available implants (n = 150) were tested to determine maximum strength, strain to fracture, microhardness, residual stress, and fatigue obtaining the stress-number of cycles to fracture (SN) curve. Fractography was studied by scanning electron microscopy. The results showed that when the titanium was hardened by the addition of 15% of Zr or 12% cold worked, the fatigue limit was higher than the commercially pure grade 4 Ti without hardening treatment. Grade 4 titanium without hardening treatment in narrow dental implants can present fractures by fatigue. These narrow implants are subjected to high mechanical stresses and the mechanical properties of titanium do not meet the minimal requirements, which lead to frequent fractures. New hardening treatments allow for the mechanical limitations of conventional narrow implants to be overcome in dynamic conditions. These hardening treatments allow for the design of narrow dental implants with enhanced fatigue life and long-term behavior.
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Affiliation(s)
- R.A. Pérez
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya. C/ Josep Trueta s/n. Sant Cugat del Valles, 08195 Barcelona, Spain;
| | - J. Gargallo
- Faculty of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n. Sant Cugat del Valles, 08195 Barcelona, Spain; (J.G.); (P.A.)
| | - P. Altuna
- Faculty of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n. Sant Cugat del Valles, 08195 Barcelona, Spain; (J.G.); (P.A.)
| | - M. Herrero-Climent
- Master Periodoncia, School of Dentistry, University of Seville, 41009 Seville, Spain;
| | - F.J. Gil
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya. C/ Josep Trueta s/n. Sant Cugat del Valles, 08195 Barcelona, Spain;
- Faculty of Dentistry, Universitat Internacional de Catalunya, C/ Josep Trueta s/n. Sant Cugat del Valles, 08195 Barcelona, Spain; (J.G.); (P.A.)
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Materials for Orthopedic Bioimplants: Modulating Degradation and Surface Modification Using Integrated Nanomaterials. COATINGS 2020. [DOI: 10.3390/coatings10030264] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Significant research and development in the field of biomedical implants has evoked the scope to treat a broad range of orthopedic ailments that include fracture fixation, total bone replacement, joint arthrodesis, dental screws, and others. Importantly, the success of a bioimplant depends not only upon its bulk properties, but also on its surface properties that influence its interaction with the host tissue. Various approaches of surface modification such as coating of nanomaterial have been employed to enhance antibacterial activities of a bioimplant. The modified surface facilitates directed modulation of the host cellular behavior and grafting of cell-binding peptides, extracellular matrix (ECM) proteins, and growth factors to further improve host acceptance of a bioimplant. These strategies showed promising results in orthopedics, e.g., improved bone repair and regeneration. However, the choice of materials, especially considering their degradation behavior and surface properties, plays a key role in long-term reliability and performance of bioimplants. Metallic biomaterials have evolved largely in terms of their bulk and surface properties including nano-structuring with nanomaterials to meet the requirements of new generation orthopedic bioimplants. In this review, we have discussed metals and metal alloys commonly used for manufacturing different orthopedic bioimplants and the biotic as well as abiotic factors affecting the failure and degradation of those bioimplants. The review also highlights the currently available nanomaterial-based surface modification technologies to augment the function and performance of these metallic bioimplants in a clinical setting.
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Kilic E, Doganay O. Evaluation of Stress in Tilted Implant Concept With Variable Diameters in the Atrophic Mandible: Three-Dimensional Finite Element Analysis. J ORAL IMPLANTOL 2020; 46:19-26. [PMID: 31647683 DOI: 10.1563/aaid-joi-d-19-00066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The beneficial mechanical properties provided by greater diameter or short implants increases their usage in the tilted implant concept. The aim of the present study is to compare the stress distribution of 4 different treatment models including variable implant numbers and diameters under a static loading protocol in the atrophic mandible using 3-dimensional finite element analysis. Three models included 2 tilted and 2 vertically positioned implants with different diameters, whereas 2 distally placed short implants were added to the fourth model. The von Mises stress as well as the maximum and minimum principal stress values were evaluated after applying 200 N bilateral oblique loads to the first molar teeth with the inclination of 45° to the longitudinal axis. Tilted implants were associated with higher stress values when compared with vertical implants in all models. The lowest stress values were obtained in the fourth model, including short implants. Although all stress values showed slight increases by descending implant diameters, the stress values of the model including implants with 3.3-mm diameter were within physiologic limits. All in all, an increasing number or diameter of implants may have a positive effect on implant survival. In addition, when narrow-diameter implants need to be inserted in the tilted implant concept, combination with short implants may be recommended for long-term success.
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Affiliation(s)
- Erdem Kilic
- Bezmialem Vakıf University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey
| | - Ozge Doganay
- Bezmialem Vakıf University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey
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Fracture and Fatigue of Titanium Narrow Dental Implants: New Trends in Order to Improve the Mechanical Response. MATERIALS 2019; 12:ma12223728. [PMID: 31726659 PMCID: PMC6888446 DOI: 10.3390/ma12223728] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 11/17/2022]
Abstract
Sixty-four fractured commercially pure titanium (cp-Ti) narrow dental implants (NDIs) with similar macrogeometry and connection designs were studied after different implantation times in humans in order to determine their reliability and to evaluate the causes of the fracture. These NDIs were compared with other similar implants, made with alloyed titanium with 15% Zr and with 12% strained titanium. Original implants were tested under static and fatigue conditions, simulating the tri-axial loads in the mouth by means of a Bionix hydraulic test machine. Fractography was studied using field-emission scanning electron microscopy (FSEM). The results showed that cp-Ti NDI exhibits low strength for mechanical cycling, and the alloyed Ti and strained titanium increase the mechanical strength, guaranteeing long term mechanical behavior. NDIs fractured due to fatigue, and, in some cases, the presence of cracks in the original NDIs quickly led to fracture. These cracks were attributed to plastic deformation during machining were found to be exacerbated due to acid etching in the passivation process. All cases of fracture were cp-Ti dental implants due to the low fatigue limit. The results show that, when titanium is alloyed or cold-worked, the fatigue limit is higher than cp-Ti. This in vitro research will help clinicians to select a better NDI system for safer treatment.
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Longevity and marginal bone loss of narrow-diameter implants supporting single crowns: A systematic review. PLoS One 2019; 14:e0225046. [PMID: 31710656 PMCID: PMC6844460 DOI: 10.1371/journal.pone.0225046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/28/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To compare the longevity and marginal bone loss of narrow-diameter (≤3.3-mm) versus standard-diameter implants supporting single crowns. MATERIAL AND METHODS The MEDLINE (via PubMed), Scopus, and SciELO databases were searched for relevant publications. In addition, the scientific references provided by each of the implant companies that appeared in the search were reviewed. Intervention studies comparing longevity and bone loss between narrow-diameter and standard-diameter implants were included. RESULTS The search was limited to in vivo studies in humans. The query returned 1931 results, of which 4 met the inclusion criteria. The implant success rate ranged from 93.8% to 100% over a maximum follow-up of 3 years, with no difference between narrow- and standard-diameter implants. Meta-analysis of all included studies showed greater bone loss in narrow-diameter implants as compared with standard ones; however, when analysis was restricted to randomized trials, no such difference was present. CONCLUSION The meta-analysis showed no difference in longevity between narrow implants and standard implants when supporting single crowns. However, narrow-diameter implants may be associated with greater marginal bone loss. These findings should be regarded cautiously due to the short follow-up duration and methodological heterogeneity of the primary studies.
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Si M, Zhang Y, Li J, He F. Retrospective study on the clinical outcomes of small-diameter implants supporting fixed prostheses without bone augmentation in the posterior region after 2 to 12 years. Clin Implant Dent Relat Res 2019; 21:454-461. [PMID: 31025491 DOI: 10.1111/cid.12782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Small-diameter implants (SDIs: diameter <3.5 mm) are often chosen as an alternative to bone augmentation in clinical practice, but the scientific evidence regarding SDI application in the posterior area remains deficient. PURPOSE To evaluate the clinical and radiographic outcomes of SDIs supporting fixed prostheses without bone augmentation in the posterior region, and to analyze the potential influencing factors related to SDI failures. MATERIALS AND METHODS Clinical and radiographic data of 243 SDIs in 156 patients were retrospectively assembled after 2 to 12 (mean 4.75) years of follow-up. Implant and prosthesis failures, mechanical and biological complications, and radiographic marginal bone loss (MBL) were evaluated. The influence of patient/implant characteristics and prosthetic design on SDI failures was investigated. RESULTS Five implants in five patients failed, contributing to 10-year cumulative survival rates of 97.9% on an implant-based analysis and 96.8% on a patient-based analysis. Biological complications and mechanical complications were detected in 22 (9.1%) and 31 (12.8%) of implants, respectively. No implant fracture was detected. Peri-implant MBL during 10 years was 0.60 ± 0.90 mm on average. The implant type (bone-level or tissue-level) was the only factor that significantly influenced SDI failures. CONCLUSION SDIs supporting fixed prostheses in the posterior region achieved predictable long-term clinical outcomes. However, tissue-level titanium SDIs should be avoided where possible.
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Affiliation(s)
- Misi Si
- Department of Oral Implantology, Stomatology Hospital affiliated to the School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yu Zhang
- Department of Prevention and Health protection, Hangzhou Dental Hospital, Hangzhou, Zhejiang, China
| | - Jiaying Li
- Mingyang Dental Clinic Yuhang, Hangzhou, Zhejiang, China
| | - Fuming He
- Department of Oral Implantology and Prosthodontics, Stomatology Hospital affiliated to the School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Cruz RS, Lemos CAA, Oliveira HFF, de Souza Batista VE, Pellizzer EP, Verri FR. Comparison of the Use of Titanium–Zirconium Alloy and Titanium Alloy in Dental Implants: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2018; 44:305-312. [DOI: 10.1563/aaid-joi-d-17-00233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to compare the values of bone-implant contact (BIC) and removal torque (RTQ) reported in different animal studies for titanium–zirconium (TiZr) and titanium (Ti) dental implants. This review has been registered at PROSPERO under number CRD42016047745. We undertook an electronic search for data published up until November 2017 using the PubMed/Medline, Embase, and The Cochrane Library databases. Eligibility criteria included in vivo studies, comparisons between Ti and TiZr implants in the same study, and studies published in English that evaluated BIC and RTQ. After inclusion criteria, 8 studies were assessed for eligibility. Of the 8 studies, 7 analyzed BIC outcome and 3 analyzed RTQ outcome. Among such studies, 6 studies were considered for meta-analysis of quantitative for BIC and 2 studies for RTQ. There was no significant difference for BIC analysis (P = .89; random ration [RR]: −0.21; 95% confidence interval [CI]: −3.14 to 2.72). The heterogeneity of the primary outcome studies was considered low (7.19; P = .21; I2: 30%). However, the RTQ analysis showed different results favoring the TiZr dental implants (P = .001; RR: 23.62; 95%CI: 9.15 to 38.10). Low heterogeneity was observed for RTQ (χ2: 1.25; P = .26; I2: 20%). Within the limitations of this study, there was no difference between TiZr and Ti alloys implants in terms of BIC. However, TiZr implants had higher RTQ than Ti alloys.
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Affiliation(s)
- Ronaldo Silva Cruz
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP – Univ Estadual Paulista, Aracatuba Dental School, Sao Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP – Univ Estadual Paulista, Aracatuba Dental School, Sao Paulo, Brazil
| | - Hiskell Francine Fernandes Oliveira
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP – Univ Estadual Paulista, Aracatuba Dental School, Sao Paulo, Brazil
| | - Victor Eduardo de Souza Batista
- Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP – Univ Estadual Paulista, Aracatuba Dental School, Sao Paulo, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP – Univ Estadual Paulista, Aracatuba Dental School, Sao Paulo, Brazil
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He Y, Fischer D, Hasan I, Götz W, Keilig L, Ziegler L, Abboud M, Bourauel C, Wahl G. Sika deer antler as a novel model to investigate dental implant healing: A pilot experimental study. PLoS One 2018; 13:e0200957. [PMID: 30063761 PMCID: PMC6067741 DOI: 10.1371/journal.pone.0200957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/04/2018] [Indexed: 11/30/2022] Open
Abstract
Dental implants are important tools for restoring the loss of teeth. The rapid growth and periodic regeneration of antlers make Sika deer a good and less invasive alternative model for studying bone remodelling in mammals. We developed a special loading device for antlers and analysed the bone reaction around unloaded implants and under immediate loading conditions until osseointegration occurred. In micro-computed tomography images, the density of antler tissue around the implants increased as the loading time increased. This finding was histologically confirmed by the good osseointegration observed in unloaded and loaded specimens. Antler tissue displays a similar healing process to human bone. The use of an antler model is a promising alternative for implant studies that does not require animal sacrifice.
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Affiliation(s)
- Yun He
- Endowed Chair of Oral Technology, University of Bonn, Bonn, Germany
- Department of Oral Surgery, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Dominik Fischer
- Raptor Centre and Wildlife Park Hellenthal, Hellenthal, Germany
- Clinic for Birds, Reptiles, Amphibians and Fish, Veterinary Faculty, Justus Liebig University Giessen, Giessen, Germany
| | - Istabrak Hasan
- Endowed Chair of Oral Technology, University of Bonn, Bonn, Germany
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, University of Bonn, Bonn, Germany
- * E-mail:
| | - Werner Götz
- Department of Orthodontics, Oral Biology Laboratory, University of Bonn, Bonn, Germany
| | - Ludger Keilig
- Endowed Chair of Oral Technology, University of Bonn, Bonn, Germany
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, University of Bonn, Bonn, Germany
| | - Luisa Ziegler
- Clinic for Birds, Reptiles, Amphibians and Fish, Veterinary Faculty, Justus Liebig University Giessen, Giessen, Germany
| | - Markus Abboud
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | | | - Gerhard Wahl
- Department of Oral Surgery, University of Bonn, Bonn, Germany
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Cinel S, Celik E, Sagirkaya E, Sahin O. Experimental evaluation of stress distribution with narrow diameter implants: A finite element analysis. J Prosthet Dent 2018. [DOI: 10.1016/j.prosdent.2017.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Badran Z, Struillou X, Strube N, Bourdin D, Dard M, Soueidan A, Hoornaert A. Clinical Performance of Narrow-Diameter Titanium-Zirconium Implants: A Systematic Review. IMPLANT DENT 2018; 26:316-323. [PMID: 28114266 DOI: 10.1097/id.0000000000000557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Implant-supported prosthetic rehabilitations are in constant augmentation in everyday dental practice. This is largely due to increasing demand from patients for fixed or implant-stabilized prosthesis, although they are frequently reticent to complex preimplant bone augmentation surgeries, whenever bone volume is lacking. Narrow-diameter implants (NDI; ≤3.5 mm) have been developed to offer relatively simple implant solutions in challenging bone-deficient sites. However, concerns regarding their mechanical properties have been raised. Special titanium-zirconium material (Ti-Zr), with superior mechanical resistance, compared with pure titanium alloys has been introduced into the market. The purpose of this systematic review was to determine the available data on clinical performance of Ti-Zr NDI. MATERIALS AND METHODS A literature search of all available clinical articles dealing with Ti-Zr NDI has been carried out. After including only prospective clinical trials, 14 papers were retrieved for thorough reviewing. CONCLUSION Short-term results from preliminary clinical reports are quite promising, although the number of published studies and the follow-up periods are still insufficient to determine the real benefit of this hybrid material compared with titanium, especially when using NDI.
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Affiliation(s)
- Zahi Badran
- *Clinical Instructor, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France; Associate Professor, Department of Periodontology, Faculty of Dental surgery, (Inserm U791/UIC 11) CHU de Nantes, France. †Clinical Instructor, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France. ‡Adjunct Assistant Professor, Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, NY, and Institut Straumann, Basel, Switzerland. §Professor and Head, Department of Periodontology, Faculty of Dental surgery, (Inserm U791/UIC 11) CHU de Nantes, Nantes, France. ¶Associate Professor and Head, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France
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Chiapasco M, Casentini P. Horizontal bone-augmentation procedures in implant dentistry: prosthetically guided regeneration. Periodontol 2000 2018; 77:213-240. [DOI: 10.1111/prd.12219] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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31
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SUZUKI K, TAKANO T, TAKEMOTO S, UEDA T, YOSHINARI M, SAKURAI K. Influence of grade and surface topography of commercially pure titanium on fatigue properties. Dent Mater J 2018; 37:308-316. [DOI: 10.4012/dmj.2017-125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kaoru SUZUKI
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
- Oral Health Science Center, Tokyo Dental College
| | - Tomofumi TAKANO
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
- Oral Health Science Center, Tokyo Dental College
| | - Shinji TAKEMOTO
- Oral Health Science Center, Tokyo Dental College
- Department of Dental Materials Science, Tokyo Dental College
| | - Takayuki UEDA
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
| | | | - Kaoru SAKURAI
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College
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Iegami CM, Uehara PN, Sesma N, Pannuti CM, Tortamano Neto P, Mukai MK. Survival rate of titanium-zirconium narrow diameter dental implants versus commercially pure titanium narrow diameter dental implants: A systematic review. Clin Implant Dent Relat Res 2017; 19:1015-1022. [DOI: 10.1111/cid.12527] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/26/2017] [Accepted: 07/31/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Carolina Mayumi Iegami
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | | | - Newton Sesma
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | | | - Pedro Tortamano Neto
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | - Márcio Katsuyoshi Mukai
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
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Siddiqi A, Khan AS, Zafar S. Thirty Years of Translational Research in Zirconia Dental Implants: A Systematic Review of the Literature. J ORAL IMPLANTOL 2017; 43:314-325. [PMID: 28594591 DOI: 10.1563/aaid-joi-d-17-00016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Thirty years of transitional research in zirconia (Zr) ceramics has led to significant improvements in the biomedical field, especially in dental implantology. Oral implants made of yttria-tetragonal zirconia polycrystals (Y-TZP) because of their excellent mechanical properties, good biocompatibility, and esthetically acceptable color have emerged as an attractive metal-free alternative to titanium (Ti) implants. The aim of the review was to highlight the translation research in Zr dental implants that has been conducted over the past 3 decades using preclinical animal models. A computer search of electronic databases, primarily PubMed, was performed with the following key words: "zirconia ceramics AND animal trials," "ceramic implants AND animal trials," "zirconia AND animal trials," "zirconia AND in vivo animal trials," without any language restriction. However, the search was limited to animal trials discussing percentage bone-implant contact (%BIC) around zirconia implants/discs. This search resulted in 132 articles (reviews, in vivo studies, and animal studies) of potential interest. We restricted our search terms to "zirconia/ceramic," "bone-implant-contact," and "animal trials" and found 29 relevant publications, which were then selected for full-text reading. Reasons for exclusion included the article's not being an animal study, being a review article, and not discussing %BIC around Zr implants/discs. Most of the studies investigated BIC around Zr in rabbits (30%), pigs (approximately 20%), dogs, sheep, and rats. This review of the literature shows that preclinical animal models can be successfully used to investigate osseointegration around Zr ceramics. Results of the reviewed studies demonstrated excellent %BIC around Zr implants. It should be noted that most of the studies investigated %BIC/removal torque under nonloading conditions, and results would have been somewhat different in functional loading situations because of inherent limitations of Zr ceramics. Further trials are needed to evaluate the performance of Zr ceramics in clinical conditions using implants designed and manufactured via novel techniques that enhance their biomechanical properties.
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Affiliation(s)
- Allauddin Siddiqi
- 1 School of Dentistry and Health Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - Abdul Samad Khan
- 2 Department of Restorative Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia
| | - Sobia Zafar
- 3 Discipline of Paediatric Dentistry, UWA Dental School, Australia
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Chang YY, Kim SH, Park KO, Yun JH. Effect of microthreads on coronal bone healing of narrow-diameter implants with reverse-tapered design in beagle dogs. Clin Oral Implants Res 2017; 28:1532-1542. [PMID: 28543806 DOI: 10.1111/clr.13022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the effect of microthreads on the coronal bone healing of narrow-diameter implants with reverse-tapered design. MATERIAL AND METHODS A total of 52 implants were classified into two groups according to presence or absence of coronal microthreads, the reverse-tapered narrow-diameter implant (RTN) group, and the reverse-tapered narrow-diameter implant with microthreads (RTNM) group. The implants were installed in split-mouth design in the edentulous mandible of six dogs. Three animals were sacrificed at 4 weeks and three at 8 weeks. Resonance frequency analysis, bone measurement using microcomputed tomography (micro-CT), removal torque test, and histometric analysis were performed. RESULTS No significant differences in implant stability quotient value were observed between the groups at baseline, 4 weeks, or 8 weeks. Bone measurement using micro-CT showed that bone-implant contact volume (BICV) and bone-implant contact volume ratio (BICVR) in the coronal part of RTNM were statistically higher than those in RTN at 4 and 8 weeks. Histometric analysis showed statistically higher bone-implant contact length (BICL) in the coronal part of RTNM than in RTN at 4 weeks; however, bone-implant contact ratio (BICR) was not significantly different between the groups. At 8 weeks, the BICL and BICR did not differ significantly between the groups. Removal torque test showed no significant differences between the groups at 4 and 8 weeks. CONCLUSIONS The microthreads might facilitate more coronal bone-implant contact due to increased surface areas at an early healing phase; however, they did not significantly affect coronal bone healing at 8 weeks.
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Affiliation(s)
- Yun-Young Chang
- Division of Periodontology, Department of Dentistry, Inha International Medical Center, Incheon, Korea
| | - Su-Hwan Kim
- Department of Periodontics, Asan Medical Center & Department of Dentistry, University of Ulsan College of Medicine, Seoul, Korea
| | - Keun-Oh Park
- Department of Bio-fibers and Materials Science, Kyungpook National University, Daegu, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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35
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Is there scientific evidence favoring the substitution of commercially pure titanium with titanium alloys for the manufacture of dental implants? MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 71:1201-1215. [DOI: 10.1016/j.msec.2016.10.025] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/07/2016] [Accepted: 10/16/2016] [Indexed: 11/22/2022]
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Abstract
STATEMENT OF PROBLEM Evidence is limited on the efficacy of narrow-diameter implants (NDIs) in the posterior jaw. PURPOSE The purpose of this systematic review was to assess the survival of NDIs and provide guidelines for their safe use. MATERIALS AND METHODS Electronic search of the English-language literature enriched by hand search to identify suitable publications was made. Only peer-reviewed clinical studies published from January 1990 through March 2014 were included. RESULTS Seventeen studies with a total of 1644 implants met the inclusion criteria, with an observation period from 1 up to 12 years. The mean survival rate of 98.6% was reported. Technical and other complications were observed. CONCLUSION Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.
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37
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Martinof AM, Ionita D, Demetrescu I. Influence of Various Albumin Concentrations on the Corrosion Resistance of Zr-2.5%Nb Alloy. CHEM ENG COMMUN 2016. [DOI: 10.1080/00986445.2016.1225197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Anca Maria Martinof
- Faculty of Applied Chemistry and Materials Science, University “Politehnica” of Bucharest, Bucharest, Romania
| | - Daniela Ionita
- Faculty of Applied Chemistry and Materials Science, University “Politehnica” of Bucharest, Bucharest, Romania
| | - Ioana Demetrescu
- Faculty of Applied Chemistry and Materials Science, University “Politehnica” of Bucharest, Bucharest, Romania
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38
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Marković A, Đinić A, Calvo Guirado JL, Tahmaseb A, Šćepanović M, Janjić B. Randomized clinical study of the peri-implant healing to hydrophilic and hydrophobic implant surfaces in patients receiving anticoagulants. Clin Oral Implants Res 2016; 28:1241-1247. [DOI: 10.1111/clr.12948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Aleksa Marković
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Ana Đinić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - José Luis Calvo Guirado
- Department of Research; International Dentistry Research Cathedra; UCAM Universidad Catolica San Antonio de Murcia; Murcia Spain
| | - Ali Tahmaseb
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
| | - Miodrag Šćepanović
- Department of Prosthodontics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Bojan Janjić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
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39
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Altuna P, Lucas-Taulé E, Gargallo-Albiol J, Figueras-Álvarez O, Hernández-Alfaro F, Nart J. Clinical evidence on titanium–zirconium dental implants: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2016; 45:842-50. [DOI: 10.1016/j.ijom.2016.01.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 10/21/2015] [Accepted: 01/11/2016] [Indexed: 11/15/2022]
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Lotz EM, Olivares-Navarrete R, Hyzy SL, Berner S, Schwartz Z, Boyan BD. Comparable responses of osteoblast lineage cells to microstructured hydrophilic titanium-zirconium and microstructured hydrophilic titanium. Clin Oral Implants Res 2016; 28:e51-e59. [DOI: 10.1111/clr.12855] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Ethan M. Lotz
- Department of Biomedical Engineering; School of Engineering; Virginia Commonwealth University; Richmond VA USA
| | - Rene Olivares-Navarrete
- Department of Biomedical Engineering; School of Engineering; Virginia Commonwealth University; Richmond VA USA
| | - Sharon L. Hyzy
- Department of Biomedical Engineering; School of Engineering; Virginia Commonwealth University; Richmond VA USA
| | | | - Zvi Schwartz
- Department of Biomedical Engineering; School of Engineering; Virginia Commonwealth University; Richmond VA USA
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Barbara D. Boyan
- Department of Biomedical Engineering; School of Engineering; Virginia Commonwealth University; Richmond VA USA
- Wallace H. Coulter Department of Biomedical Engineering; Georgia Institute of Technology; Atlanta GA USA
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41
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Zembic A, Tahmaseb A, Jung RE, Wismeijer D. One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes. Clin Oral Implants Res 2016; 28:e60-e67. [DOI: 10.1111/clr.12863] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Anja Zembic
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ali Tahmaseb
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
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Kamo M, Kyomoto M, Miyaji F. Time course of surface characteristics of alkali- and heat-treated titanium dental implants during vacuum storage. J Biomed Mater Res B Appl Biomater 2016; 105:1453-1460. [DOI: 10.1002/jbm.b.33686] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/16/2016] [Accepted: 03/29/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Michimasa Kamo
- Research Department; KYOCERA Medical Corporation; Yodogawa-ku Osaka 532-0003 Japan
| | - Masayuki Kyomoto
- Research Department; KYOCERA Medical Corporation; Yodogawa-ku Osaka 532-0003 Japan
- Department of Materials Engineering; School of Engineering; The University of Tokyo; Bunkyo-ku Tokyo 113-8656 Japan
- Division of Science for Joint Reconstruction; Graduate School of Medicine; The University of Tokyo; Bunkyo-ku Tokyo 113-8655 Japan
| | - Fumiaki Miyaji
- Research Department; KYOCERA Medical Corporation; Yodogawa-ku Osaka 532-0003 Japan
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43
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Altinci P, Can G, Gunes O, Ozturk C, Eren H. Stability and Marginal Bone Level Changes of SLActive Titanium-Zirconium Implants Placed with Flapless Surgery: A Prospective Pilot Study. Clin Implant Dent Relat Res 2016; 18:1193-1199. [DOI: 10.1111/cid.12392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Pinar Altinci
- Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Ankara University; Ankara Turkey
| | - Gulsen Can
- Professor, Department of Prosthodontics, Faculty of Dentistry, Ankara University; Ankara Turkey
| | - Onur Gunes
- Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University; Ankara Turkey
| | - Caner Ozturk
- Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Ankara University; Ankara Turkey
| | - Hakan Eren
- Research Assistant, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University; Ankara Turkey
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44
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Wen B, Chen J, Dard M, Cai Z. The Performance of Titanium-Zirconium Implants in the Elderly: A Biomechanical Comparative Study in the Minipig. Clin Implant Dent Relat Res 2016; 18:1200-1209. [PMID: 26834004 DOI: 10.1111/cid.12389] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/03/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Bo Wen
- Professor, Division of Implant Dentistry, Department of Oral & Maxillofacial Surgery, Nanjing Stomatology Hospital; Medical School of Nanjing University; Nanjing China
| | - Jiang Chen
- professor, Department of Implant Dentistry, School and Hospital of Stomatology; Fujian Medical University; Fuzhou China
| | - Michel Dard
- head and director, Preclinical Research; Institut Straumann AG; Basel Switzerland
- professor, Department of Periodontology and Implant Dentistry; College of Dentistry, New York University; New York NY USA
| | - Zhiyu Cai
- professor, Department of Implant Dentistry, School and Hospital of Stomatology; Fujian Medical University; Fuzhou China
- associate professor, Department of Stomatology; Fujian Medical University Union Hospital; Fuzhou China
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45
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Colasante C, Sanford Z, Garfein E, Tepper O. Current Trends in 3D Printing, Bioprosthetics, and Tissue Engineering in Plastic and Reconstructive Surgery. CURRENT SURGERY REPORTS 2016. [DOI: 10.1007/s40137-016-0127-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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46
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Ioannidis A, Gallucci GO, Jung RE, Borzangy S, Hämmerle CHF, Benic GI. Titanium-zirconium narrow-diameter versus
titanium regular-diameter implants for anterior and premolar single crowns: 3-year results of a randomized controlled clinical study. J Clin Periodontol 2015; 42:1060-70. [DOI: 10.1111/jcpe.12468] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Alexis Ioannidis
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - German O. Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences; Harvard School of Dental Medicine; Boston MA USA
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Sary Borzangy
- Department of Restorative Dentistry and Biomaterials Sciences; Harvard School of Dental Medicine; Boston MA USA
- Department of Substitutive Dental Sciences; College of Dentistry; Taibah University; Al Madinah Al Munawwarah Kingdom of Saudi Arabia
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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The effects of pulsed electromagnetic field (PEMF) on osteoblast-like cells cultured on titanium and titanium-zirconium surfaces. J Craniofac Surg 2015; 24:2127-34. [PMID: 24220422 DOI: 10.1097/scs.0b013e31829a7ebc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Commercially pure Ti, together with Ti Ni, Ti-6Al-4V, and Ti-6Al-7Nb alloys, are among the materials currently being used for this purpose. Titanium-zirconium (TiZr) has been developed that allows SLActive surface modification and that has comparable or better mechanical strength and improved biocompatibility compared with existing Ti alloys. Furthermore, approaches have targeted making the implant surface more hydrophilic, as with the Straumann SLActive surface, a modification of the SLA surface. PURPOSE The aim of this study is to evaluate the effects of pulsed electromagnetic field (PEMF) to the behavior of neonatal rat calvarial osteoblast-like cells cultured on commercially pure titanium (cpTi) and titanium-zirconium alloy (TiZr) discs with hydrophilic surface properties. MATERIALS AND METHODS Osteoblast cells were cultured on titanium and TiZr discs, and PEMF was applied. Cell proliferation rates, cell numbers, cell viability rates, alkaline phosphatase, and midkine (MK) levels were measured at 24 and 72 hours. RESULTS At 24 hours, the number of cells was significantly higher in the TiZr group. At 72 hours, TiZr had a significantly higher number of cells when compared to SLActive, SLActive + PEMF, and machine surface + PEMF groups. At 24 hours, cell proliferation was significantly higher in the TiZr group than SLActive and TiZr + PEMF group. At 72 hours, TiZr group had higher proliferation rate than machine surface and TiZr + PEMF. Cell proliferation in the machine surface group was lower than both SLActive + PEMF and machine surface + PEMF. MK levels of PEMF-treated groups were lower than untreated groups for 72 hours. CONCLUSIONS Our findings conclude that TiZr surfaces are similar to cpTi surfaces in terms of biocompatibility. However, PEMF application has a higher stimulative effect on cells cultured on cpTi surfaces when compared to TiZr.
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Anitua E, Saracho J, Begoña L, Alkhraisat MH. Long-Term Follow-Up of 2.5-mm Narrow-Diameter Implants Supporting a Fixed Prostheses. Clin Implant Dent Relat Res 2015; 18:769-77. [DOI: 10.1111/cid.12350] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Eduardo Anitua
- Oral implantology; Eduardo Anitua Foundation; Vitoria Spain
- Eduardo Anitua Foundation; Vitoria Spain
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Jimbo R, Naito Y, Galli S, Berner S, Dard M, Wennerberg A. Biomechanical and Histomorphometrical Evaluation of TiZr Alloy Implants: An in vivo Study in the Rabbit. Clin Implant Dent Relat Res 2015; 17 Suppl 2:e670-8. [DOI: 10.1111/cid.12305] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ryo Jimbo
- Department of Prosthodontics, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Yoshihito Naito
- Department of Oral and Maxillofacial Prosthodontics and Oral Implantology, Institute of Health Biosciences; The University of Tokushima Graduate School; Tokushima Japan
| | - Silvia Galli
- Department of Prosthodontics, Faculty of Odontology; Malmö University; Malmö Sweden
| | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- Department of Periodontics; New York University College of Dentistry; New York NY USA
| | - Ann Wennerberg
- Department of Prosthodontics, Faculty of Odontology; Malmö University; Malmö Sweden
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Numerical assessment of bone remodeling around conventionally and early loaded titanium and titanium–zirconium alloy dental implants. Med Biol Eng Comput 2015; 53:453-62. [DOI: 10.1007/s11517-015-1256-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
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