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Suh H, Lee D, Lee J, Seol YJ, Lee YM, Koo KT. Comparative evaluation of 3D-printed and conventional implants in vivo: a quantitative microcomputed tomographic and histomorphometric analysis. Sci Rep 2023; 13:21041. [PMID: 38030796 PMCID: PMC10687100 DOI: 10.1038/s41598-023-48315-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023] Open
Abstract
In recent years, 3D-printing technology to fabricate dental implants has garnered widespread attention due to its patient-specific customizability and cost-effectiveness. This preclinical animal study analyzed the radiographic and histomorphometric outcomes of 3D-printed implants (3DIs) placed immediately after extraction and compared them to conventional implants (CIs). 3DIs and CIs of the same dimensions placed immediately were analyzed at 2, 6, and 12 weeks. The micro-computed tomography (micro-CT) analysis revealed statistically significant differences at 2 weeks in favor of 3DIs over the CIs in terms of bone volume/tissue volume (BV/TV), bone surface/bone volume (BS/BV), trabecular bone pattern factor (Tb.Pf), and structure model index (SMI). At 2 weeks, the mean bone-to-implant contact (BIC) of the 3DIs was greater than that of the CIs; the mean bone area fraction occupancy (BAFO) and the number of Haversian canals of the 3DIs showed no statistically significant differences compared to CIs at 2 weeks. At 6 and 12 weeks, there were no statistically significant differences between the 3DIs and CIs in any parameters. Within limitations, in the early stage of extraction socket healing, the 3DIs demonstrated a higher BIC than the CIs, presenting that 3DIs may be a potential option for immediate placement to enhance osseointegration.
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Affiliation(s)
- Hyemee Suh
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea.
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea.
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Lee D, Lee J, Seol YJ, Lee YM, Koo KT. Effect of polydeoxyribonucleotide on early bone formation in lateral bone augmentation with immediate implant placement: an experimental in vivo study. Sci Rep 2023; 13:16853. [PMID: 37803058 PMCID: PMC10558504 DOI: 10.1038/s41598-023-43213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/21/2023] [Indexed: 10/08/2023] Open
Abstract
This study investigated early bone formation using collagenated biphasic calcium phosphate (CBCP) with or without polynucleotide (PDRN). Third (P3) or fourth (P4) premolars of six male beagle dogs were extracted and 5-mm-high dehiscence defects were created, followed by 3D-printed implant placement. The buccal bone defects were grafted with (i) CBCP and collagen membrane or (ii) CBCP soaked in polydeoxyribonucleotide (CBCP/PDRN) and collagen membrane. Samples of the experimental sites were harvested at 2- and 6-weeks post-surgery. The specimens were evaluated with radiologic and histomorphometric analysis. No significant differences were found between the CBCP and CBCP/PDRN groups in the micro-CT analysis at 2 or 6 weeks. No significant differences were observed in bone-to-implant contact (BIC) or bone area fraction occupancy (BAFO) in buccal augmented and lingual non-augmented areas. In the qualitative analysis, the new bone (NB) area and NB proportion in buccal augmented areas showed significantly higher values in the CBCP/PDRN group than in the CBCP group at 2 and 6 weeks. Peri-implant buccal dehiscence defects with immediate 3D-printed implant placement were corrected using a collagen membrane and CBCP or CBCP/PDRN. PDRN might have the potential to facilitate early bone formation with sufficient stability over time in dehiscence defects.
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Affiliation(s)
- Dongseob Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea.
| | - Yang-Jo Seol
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Periodontology, Seoul National University Dental Hospital, Seoul, 03080, Republic of Korea.
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Ferraz MP. Bone Grafts in Dental Medicine: An Overview of Autografts, Allografts and Synthetic Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114117. [PMID: 37297251 DOI: 10.3390/ma16114117] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
This review provides an overview of various materials used in dentistry and oral and maxillofacial surgeries to replace or repair bone defects. The choice of material depends on factors such as tissue viability, size, shape, and defect volume. While small bone defects can regenerate naturally, extensive defects or loss or pathological fractures require surgical intervention and the use of substitute bones. Autologous bone, taken from the patient's own body, is the gold standard for bone grafting but has drawbacks such as uncertain prognosis, surgery at the donor site, and limited availability. Other alternatives for medium and small-sized defects include allografts (from human donors), xenografts (from animals), and synthetic materials with osteoconductive properties. Allografts are carefully selected and processed human bone materials, while xenografts are derived from animals and possess similar chemical composition to human bone. Synthetic materials such as ceramics and bioactive glasses are used for small defects but may lack osteoinductivity and moldability. Calcium-phosphate-based ceramics, particularly hydroxyapatite, are extensively studied and commonly used due to their compositional similarity to natural bone. Additional components, such as growth factors, autogenous bone, and therapeutic elements, can be incorporated into synthetic or xenogeneic scaffolds to enhance their osteogenic properties. This review aims to provide a comprehensive analysis of grafting materials in dentistry, discussing their properties, advantages, and disadvantages. It also highlights the challenges of analyzing in vivo and clinical studies to select the most suitable option for specific situations.
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Affiliation(s)
- Maria Pia Ferraz
- Departamento de Engenharia Metalúrgica e de Materiais, Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4099-002 Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, 4099-002 Porto, Portugal
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Lima JR, Soares PBF, Pinotti FE, Marcantonio RAC, Marcantonio-Junior E, de Oliveira GJPL. Comparison of the osseointegration of implants placed in areas grafted with HA/TCP and native bone. Microsc Res Tech 2022; 85:2776-2783. [PMID: 35397154 DOI: 10.1002/jemt.24126] [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: 06/05/2021] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 11/10/2022]
Abstract
This study evaluated the osseointegration of implants in areas grafted with biphasic ceramic based on hydroxyapatite/β-tricalcium phosphate (HA/TCP) and in native bone (NB). Twenty-eight rats were randomly assigned into two groups of 14 animals each: HA/TCP group: implants installed in areas grafted with HA/TCP and NB group: implants installed in areas of native bone. Bone defects were made in both tibiae of the rats belonging to the HA/TCP group and then filled with this bone substitute. After 60 days, the rats were submitted to surgical procedures for implant placement in grafted areas in both tibiae in the HA/TCP group while the implants were installed directly in native bone in the NB group. The animals were euthanized 15 and 45 days, respectively, after the implant placement. Biomechanical (removal torque), microtomographic (volume of mineralized tissues around the implants), and histomorphometric (Bone-Implant contact-%BIC and bone area between the implant threads-%BBT) analyzes were conducted to assess the osseointegration process. The HA/TCP group showed lower values of removal torque, volume of mineralized tissue around the implants, lower %BIC, and %BBT compared to the NB group in both experimental periods. Osseointegration of implants placed in grafted areas with HA/TCP was lower compared to the osseointegration observed in native bone areas.
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Affiliation(s)
- Julia Raulino Lima
- Department of Periodontology/Implantology, Universidade Federal de Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil
| | | | - Felipe Eduardo Pinotti
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
| | | | - Elcio Marcantonio-Junior
- Department of Diagnosis and Surgery, Universidade Estadual Paulista - UNESP, School of Dentistry, Araraquara, SP, Brazil
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Seyssens L, Eeckhout C, Cosyn J. Immediate implant placement with or without socket grafting: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:339-351. [PMID: 35313067 DOI: 10.1111/cid.13079] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/19/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible. RESULTS Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made. CONCLUSION SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Célien Eeckhout
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Oliveira VXRD, Pinotti FE, Marcantonio RAC, Marcantonio Jr E, Oliveira GJPLD. Comparison of osseointegration in areas grafted with different osteoconductive biomaterials. Preclinical study. Braz Dent J 2022; 33:105-111. [DOI: 10.1590/0103-6440202204378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract This study evaluated osseointegration in areas grafted with deproteinized bovine bone (DBB) and biphasic ceramic based on hydroxyapatite and beta-tricalcium phosphate (HA/TCP) in rat tibias. Noncritical bone defects were made in the tibias of 28 rats that were randomly assigned to 2 groups: DBB: DBB-filled defects and HA/TCP: HA/TCP-filled defects. Bone defects were made in the tibias bilaterally and filled with biomaterials. After 60 days, the implants were inserted, and the animals were euthanized 15 and 45 days after the implants were installed. Osseointegration was evaluated by biomechanical, microtomographic and histometric analysis. Implants installed in the defects filled with DBB presented higher removal torque forces (2.33 ± 0.51 Ncm vs. 1.50 ± 0.54 Ncm) and mineralized tissue volume around implants at 15 days (34.96 ± 3.68 % vs. 25.61 ± 2.95 %) and greater bone-implant contact (20.87 ± 8.28 % vs. 11.52 ± 7.42 %) and bone area within implant threads (26.83 ± 12.35 % vs. 11.98 ± 7.56 %) at 45 days compared to the measurements of implants in areas grafted with HA/TCP. Implants installed in defects in areas grafted with DBB had a better osseointegration pattern than implants placed in defects in areas grafted with HA/TCP.
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Barros-Filho LA, de Oliveira GJ, Barros LA, Marcantonio E. Retrospective evaluation about morse taper versus external hexagon implants placed after maxillary sinus lift. Minerva Dent Oral Sci 2021; 71:10-15. [PMID: 34132507 DOI: 10.23736/s2724-6329.21.04533-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The objective of this study was to retrospectively evaluate the success and survival rate of implants with different types of prosthetic connections inserted in the posterior maxilla in native bone or in sinuses previously grafted with different biomaterials. METHODS A total of 310 implants inserted in 113 patients were evaluated, 87 of which were inserted in association with grafted maxillary sinuses (56 morse taper (MT) implants and 31 external hexagon (EH) implants) in 37 patients, and 223 implants were inserted in native bone areas (112 MT and 111 EH implants) in 76 patients. Peri-implant clinical analyses were performed (bleeding on probing, probing depth, clinical insertion level, peri-implant marginal level, and the presence of mobility or suppuration), and the radiographic bone level was evaluated. RESULTS Two implants were lost, yielding a survival rate of 99.35 %. The MT implants had lower probing depths and peri-implant bone levels than the EH implants in both grafted areas and native bone areas (p <0.05). No statistically significant differences in any parameter evaluated were found between implants inserted in native bone and those inserted in grafting areas. EH implants inserted in native bone areas showed higher periimplantitis rates. CONCLUSIONS It can be concluded that the MT implants connection reduce periimplant bone loss, but implants inserted in maxillary sinuses previously grafted with osteoconductive biomaterials do not predispose patients to peri-implant bone loss.
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Affiliation(s)
- Luiz A Barros-Filho
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil
| | - Guilherme J de Oliveira
- Department of Periodontology/Implantology, Dental School, Federal University of Uberlândia - UFU, Uberlândia, Brazil
| | - Luiz A Barros
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara, Brazil -
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Oliveira GJPLD, Pinotti FE, Aroni MAT, Marcantonio E, Marcantonio RAC. Effect of different low-level intensity laser therapy (LLLT) irradiation protocols on the osseointegration of implants placed in grafted areas. J Appl Oral Sci 2021; 29:e20200647. [PMID: 33886940 PMCID: PMC8054649 DOI: 10.1590/1678-7757-2020-0647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/14/2020] [Accepted: 01/15/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate the effect of different protocols of low-level intensity laser therapy (LLLT) irradiation on the osseointegration of implants placed in grafted areas. METHODOLOGY 84 rats were randomly allocated into six groups: DBB: defect filled with deproteinized bovine bone; HA/TCP: defect filled with biphasic ceramic of hydroxyapatite/β-tricalcium phosphate ; DBB-LI: defect filled with DBB and treated with LLLT after implant placement; HA/TCP-LI: defect filled with HA/TCP and treated with LLLT after implant placement; DBB-LIB: defect filled with DBB and treated with LLLT after graft procedure and implant placement; and HA/TCP-LIB: defect filled HA/TCP and treated with LLLT after graft procedure and implant placement. The bone defects were made in the tibia and they were grafted. After 60 days, the implants were placed. The rats were subsequently subjected to euthanasia 15 and 45 days after implant placement. The pattern of osseointegration and bone repair in the grafted area was evaluated by biomechanical, microtomographic, and histometric analyses. Furthermore, the expression of bone biomarker proteins was assessed. RESULTS The LLLT groups presented higher removal torque, mineralized tissue volume, and a greater degree of osseointegration, especially when LLLT was performed only after implant placement, and these findings were associated with higher expression of BMP2 and alkaline phosphatase. CONCLUSION LLLT performed on implants placed in grafted areas enhances the osseointegration process.
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Affiliation(s)
| | - Felipe Eduardo Pinotti
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departmento de Diagnóstico e Cirurgia, Araraquara, SP, Brasil
| | | | - Elcio Marcantonio
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araraquara, Departmento de Diagnóstico e Cirurgia, Araraquara, SP, Brasil
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Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:1655-1675. [PMID: 33515121 DOI: 10.1007/s00784-021-03794-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Preserving peri-implant tissues after immediate implant placement (IIP), especially in aesthetic zones, is a topic of interest. OBJECTIVES This systematic review investigated the effects of currently available surgical procedures for preserving peri-implant tissue or ensuring dimensional stability following immediate implant placement. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement's guidelines were followed, and articles were sought on the PubMed and Cochrane databases with no date restrictions. Only randomised clinical trials that evaluated changes in soft and hard tissues around immediately placed implants were included. Statistical analyses were performed, and the studies´ quality was assessed using the Cochrane Collaboration tool. The agreement between reviewers was assessed based on Cohen's kappa statistics. RESULTS Of the 14 studies that met the inclusion criteria, 11 were analysed in the meta-analysis (kappa = 0.814; almost perfect agreement). The use of connective tissue grafts resulted in a significantly greater improvement of the facial gingival level (MD = -0.51; 95% CI: -0.76 to -0.31; p = < .001), and the placement of bone grafts significantly reduced the horizontal resorption of the buccal bone (MD = -0.59; 95% CI: -0.78 to -0.39; p < .001). CONCLUSION Connective tissue grafts and bone grafts positively influence tissue preservation around immediately placed implants. Neither the flapless technique nor palatal implant positioning resulted in significant improvements to any of the investigated parameters. Additional longitudinal studies are required. CLINICAL RELEVANCE This meta-analysis is useful for discerning the effects of soft tissue augmentation, bone grafting, the flapless technique, and palatal implant positioning on preserving peri-implant tissues after immediate implant placement.
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Pires LCDA, da Silva RC, Poli PP, Ruas Esgalha F, Hadad H, Palin LP, Piquera Santos AF, Teixiera Colombo L, Kawamata de Jesus L, Bassi APF, Maiorana C, Okamoto R, de Carvalho PSP, Souza FÁ. Evaluation of Osteoconduction of a Synthetic Hydroxyapatite/β-Tricalcium Phosphate Block Fixed in Rabbit Mandibles. MATERIALS 2020; 13:ma13214902. [PMID: 33142881 PMCID: PMC7662777 DOI: 10.3390/ma13214902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/21/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022]
Abstract
(1) Background: This study aimed to evaluate the incorporation of hydroxyapatite/β-tricalcium phosphate blocks grafted in rabbit mandibles. (2) Methods: Topographic characterization of biomaterial was performed through scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDX). Ten rabbits randomly received autogenous bone graft harvested from the tibia (Autogenous Group—AG) or synthetic biomaterial manufactured in β-tricalcium phosphate (Biomaterial Group—BG) at their right and left mandibular angles. Euthanasia was performed at 30 and 60 postoperative days; (3) Results: SEM-EDX showed a surface with the formation of crystals clusters. Histological analyses in BG at 30 days showed a slower process of incorporation than AG. At 60 days, BG showed remnants of biomaterial enveloped by bone tissue in the anabolic modeling phase. Histometric analysis showed that mean values of newly formed bone-like tissue in the AG (6.56%/9.70%) were statistically higher compared to BG (3.14%/6.43%) in both periods, respectively. Immunohistochemical analysis demonstrated early bone formation and maturation in the AG with more intense osteopontin and osteocalcin staining. (4) Conclusions: The biomaterial proved to be a possible bone substitute, being incorporated into the receiving bed; however, it showed delayed bone incorporation compared to autogenous bone.
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Affiliation(s)
- Luis Carlos de Almeida Pires
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Rodrigo Capalbo da Silva
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
- Correspondence: ; Tel.: +39-02-55032621
| | - Fernando Ruas Esgalha
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Henrique Hadad
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Letícia Pitol Palin
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Ana Flávia Piquera Santos
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Luara Teixiera Colombo
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Ana Paula Farnezi Bassi
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy;
| | - Roberta Okamoto
- Department of Basic Science, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil;
| | - Paulo Sérgio Perri de Carvalho
- Implant Dentistry Post-Graduation Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, SP 13 045 755, São Paulo, Brazil; (L.C.d.A.P.); (F.R.E.); (P.S.P.d.C.)
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho—UNESP, Araçatuba, SP 16 015 050, São Paulo, Brazil; (R.C.d.S.); (H.H.); (L.P.P.); (A.F.P.S.); (L.T.C.); (L.K.d.J.); (A.P.F.B.); (F.Á.S.)
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11
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Sousa DND, Roriz VM, Oliveira GJPLD, Duarte WR, Pinto LNDMP, Vianna LMDS, Carneiro FP, Ferreira VMM. Local effect of simvastatin combined with different osteoconductive biomaterials and collagen sponge on new bone formation in critical defects in rat calvaria. Acta Cir Bras 2020; 35:e202000102. [PMID: 32215463 PMCID: PMC7092666 DOI: 10.1590/s0102-865020200010000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/14/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the local effect of simvastatin (SVT) combined with deproteinized bovine bone (DBB) with hydroxyapatite/β-tricalcium phosphate biphasic ceramics (HA/TCP) and with collagen sponge (CS) on bone repair in critical size defects (CSDs) in rat calvaria. Methods Forty-two 5-mm diameter CSDs were made bilaterally in the calvaria of 18 rats. The animals were allocated according to the type of biomaterial and associations used to fill the CSD. After 8 weeks, the animals were euthanized, and their calvaria were evaluated for repaired tissue composition using histologic and histometric analyses. Results In the histometric analysis, the use of SVT showed to increase bone formation in the CSDs when combined with all the bone substitutes tested in this study (p<0.05). Greater bone formation was observed in the groups with SVT compared to the groups without SVT. Conclusions The use of SVT without the need for a vehicle and combined with a commercially available biomaterial may be a cheaper way to potentiate the formation of bone tissue without the need to produce new biomaterials. Therefore, SVT combined with DBB induced significantly greater new bone formation than did the other treatments.
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12
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Sheftel Y, Ruddiman F, Schmidlin P, Duncan W. Biphasic calcium phosphate and polymer-coated bovine bone matrix for sinus grafting in an animal model. J Biomed Mater Res B Appl Biomater 2019; 108:750-759. [PMID: 31199055 DOI: 10.1002/jbm.b.34429] [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] [Received: 10/16/2018] [Revised: 04/25/2019] [Accepted: 05/17/2019] [Indexed: 11/09/2022]
Abstract
Autogenous bone grafting requires a donor site and may lose substantial volume during remodeling. Several bone replacement materials (BRMs) are under development to overcome these limitations, especially for indications for minimally intervention surgeries. The objective of our study was to assess the potential of an equine collagen cone reinforced with biphasic calcium phosphate (CC-BCP) particles and deproteinized bovine bone matrix (BBM) coated with polylactic acid, and poly-ε-caprolactone copolymer (BBM-PCC) and then to compare the outcomes with a deproteinized BBM and an equine CC without a filler in a sheep sinus grafting model in the Elleven female sheep were selected. Two experimental sites on each side of the animals were prepared using an extraoral approach for maxillary sinus wall. The four treatments were performed in each animal through a standardized 10-mm access window. While the BBM access was covered with a collagen membrane, all other sites were closed with an equine collagen membrane. All animals were euthanized after 16 weeks. New bone (NB), residual graft particles, and connective tissue were measured in undemineralized resin-embedded sections. As a result, one sheep did not survive the surgery. All sites in the remaining 10 sheep healed uneventfully. All CC and BBM-PCC grafts resorbed and failed to augment the sinuses. BBM and CC-BCP, in contrast, showed some histologic evidence of NB and surgical site augmentation. The NB fraction in the latter two groups accounted for 10 ± 9 and 4 ± 5%, respectively (p > 0.05). In conclusion, BBM-PCC and collagen cone performed poorly for sinus floor augmentation, while deproteinised BBM and reinforced collagen cone demonstrated comparable outcomes.
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Affiliation(s)
- Yevgeny Sheftel
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Frances Ruddiman
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Patrick Schmidlin
- Division of Periodontology and Peri-implant Diseases, Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Warwick Duncan
- Division of Periodontology, Department of Oral Sciences, University of Otago, Dunedin, New Zealand
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13
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Naujokat H, Açil Y, Harder S, Lipp M, Böhrnsen F, Wiltfang J. Osseointegration of dental implants in ectopic engineered bone in three different scaffold materials. Int J Oral Maxillofac Surg 2019; 49:135-142. [PMID: 31053519 DOI: 10.1016/j.ijom.2019.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/15/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022]
Abstract
The in vivo regeneration of bone flaps might be an alternative to autogenous bone grafting. The first human case of mandibular reconstruction using the greater omentum as a bioreactor was reported in 2016. However, whether engineered bone will support the osseointegration of dental implants has not yet been investigated. In this study, bone tissue engineering was performed in the greater omentum of nine miniature pigs using bone morphogenetic protein 2, bone marrow aspirate, and three different scaffolds: hydroxyapatite, biphasic calcium phosphate (BCP), and titanium. After 8 weeks, two implants were placed in each scaffold; after another 8 weeks, the bone blocks were harvested for radiographic, histological, and histomorphometric analysis. All implants exhibited sufficient primary stability, and the success rate was 100%. The bone-to-implant contact ratios (BICs) were 38.2%, 68.5%, and 42.9%; the inter-thread bone densities were 29.4%, 64.9%, and 33.5%; and the peri-implant bone-scaffold densities were 56.4%, 87.6%, and 68.6% in the hydroxyapatite, BCP, and titanium groups, respectively. The BIC showed a strong correlation (r = 0.76) with the peri-implant bone-scaffold density. This study shows that de novo engineered bone leads to successful osseointegration and therefore may allow implant-based prosthodontic rehabilitation.
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Affiliation(s)
- H Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany.
| | - Y Açil
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - S Harder
- Department of Prosthodontics, Propaedeutics and Dental Materials, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - M Lipp
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - F Böhrnsen
- Department of Oral and Maxillofacial Surgery, University Hospital of Göttingen, Göttingen, Germany
| | - J Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany
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Is Impregnation of Xenograft with Caffeine Effective on Bone Healing Rate in Mandibular Defects? A Pilot Histological Animal Study. J Maxillofac Oral Surg 2019; 19:85-92. [PMID: 31988569 DOI: 10.1007/s12663-019-01221-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/23/2019] [Indexed: 10/27/2022] Open
Abstract
Introduction and Aim The aim of this study was to evaluate the effect of two concentrations of caffeine (1.5% and 3%) powder added to Bio-Oss xenograft on bone healing rate of iatrogenic mandibular defects in dogs. Materials and Method The researchers implemented a pilot study on ten male adult mongrel dogs. Two 4-mm circular critical-sized defects were trephined on each side of the mandibular body (a total of 4 defects for each dog). One of the defects remained empty as a control group. The other three defects in each case were randomly filled with 1.5% or 3% caffeinated Bio-Oss or pure Bio-Oss. The mandible specimens were sent for histological and histomorphometric assessments, 4 months postoperatively. Our predictor variable was the type of bone substitute. The study outcomes were new bone formation, angiogenesis, and fibrosis. The p value was set at 0.05 using SPSS 16. Results The histological assessment showed that the administration of 1.5% caffeinated Bio-Oss to mandibular defects caused more angiogenesis and more new bone formation as well as less fibrosis compared to the other groups (p < 0.05). Conclusion This study suggested that the application of 1.5% caffeinated Bio-Oss in bone defects of dogs resulted in the higher new bone formation. However, further clinical trials are needed to support its relevancy.
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15
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Santos IGBP, de Santana CMM, Alves ATNN, de Uzeda MJPG, Calasans-Maia MD, de Santana RB. Effects of methods of hydration of a biphasic ceramic graft on bone regeneration of extraction socket defects. J Periodontol 2018; 90:425-432. [PMID: 30367739 DOI: 10.1002/jper.18-0209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/29/2018] [Accepted: 09/13/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Alveolar volumetric changes are inherent to the healing process after tooth extraction and filling of the extraction site with biomaterials can reduce these volumetric changes and provide a more favorable environment for the future prosthetic restoration with implants. Among the biomaterials available, biphasic ceramic compounds have shown promissing clinical results, however, histologic evaluation of bone tissue response to different hydration and incorporation methods are limited. The objective of this study was to comparatively evaluate in vivo the osteoconductive potential of the biphasic ceramic bone substitute (SBC) composed of beta-tricalcium phosphate and hydroxyapatite after different hydration methodologies in rat extraction sockets. METHODS Wistar rats (n = 20) were randomly distributed in two subgroups (G1, G2) according to the hydration methods used. After extraction of the right upper central incisor the alveoli were filled with SBC hydrated by two different methods. Group 1: biomaterial hydrated in blood; Group 2: biomaterial hydrated in physiologic saline. The animals were euthanized after 1 and 6 weeks for removal of the bone blocks containing the biomaterial and were submitted to histologic processing. Five-μm-thick demineralized sections of the samples were stained with hematoxylin and eosin (HE) and subjected to histomorphometric analysis. RESULTS Bone formation was limited 7 days after the extraction procedure and increased in both groups between 7 and 42 days from surgery, demonstrating a time dependent increase of bone volume throughtout the experimental period (p < 0.05). CONCLUSIONS The hydration of SBC with saline significantly increased new bone formation and reduced connective tissue volume after 42 days demonstrating that hydration method may significantly influence bone healing in such defects, and, thus should be carefully performed.
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Affiliation(s)
| | - Carolina Miler Mattos de Santana
- Department of Periodontology, School of Dentistry, Federal Fluminense University, Rua São Paulo 28, Niterói, Rio de Janeiro, 24000-000, Brazil
| | | | | | - Mônica Diuana Calasans-Maia
- Department of Oral Surgery, School of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil
| | - Ronaldo Barcellos de Santana
- Department of Periodontology, School of Dentistry, Federal Fluminense University, Rua São Paulo 28, Niterói, Rio de Janeiro, 24000-000, Brazil
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Pinotti FE, de Oliveira GJPL, Aroni MAT, Marcantonio RAC, Marcantonio E. Analysis of osseointegration of implants with hydrophilic surfaces in grafted areas: A Preclinical study. Clin Oral Implants Res 2018; 29:963-972. [DOI: 10.1111/clr.13361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 06/07/2018] [Accepted: 06/13/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Felipe E. Pinotti
- School of Dentistry; São Paulo State University (Unesp); Araraquara Brazil
| | | | | | | | - Elcio Marcantonio
- School of Dentistry; São Paulo State University (Unesp); Araraquara Brazil
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Impact of particulate deproteinized bovine bone mineral and porous titanium granules on early stability and osseointegration of dental implants in narrow marginal circumferential bone defects. Int J Oral Maxillofac Surg 2018; 47:1086-1094. [PMID: 29571671 DOI: 10.1016/j.ijom.2018.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/24/2017] [Accepted: 02/19/2018] [Indexed: 11/22/2022]
Abstract
The use of two particulate bone graft substitute materials in experimental narrow marginal peri-implant bone defects was investigated with respect to early bone healing and implant stability. Porous titanium granules, oxidized white porous titanium granules (WPTG), and demineralized bovine bone mineral (DBBM) were characterized in vitro, after which the two latter materials were tested in experimental peri-implant bone defects in six minipigs, with empty defects as control. After mandibular premolar extraction, the top 5mm of the alveoli were widened to 6mm in diameter, followed by the placement of six implants, three on each side, in each pig. Six weeks of healing was allowed. The WPTG showed better mechanical properties. No significant differences in resonance frequency analysis were found directly after compacting or healing, and similar quantities of defect bone formation were observed on micro-computed tomography for all groups. Histomorphometric analysis demonstrated a more coronal bone-to-implant contact in the DBBM group, which also displayed more defect bone fill as compared to the WPTG group. The better mechanical properties observed for WPTG appear of negligible relevance for the early stability and osseointegration of implants.
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18
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Efficacy of Octacalcium Phosphate Collagen Composite for Titanium Dental Implants in Dogs. MATERIALS 2018; 11:ma11020229. [PMID: 29393874 PMCID: PMC5848926 DOI: 10.3390/ma11020229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 12/02/2022]
Abstract
Background: Previous studies showed that octacalcium (OCP) collagen composite (OCP/Col) can be used to repair human jaw bone defects without any associated abnormalities. The present study investigated whether OCP/Col could be applied to dental implant treatment using a dog tooth extraction socket model. Methods: The premolars of dogs were extracted; each extraction socket was extended, and titanium dental implants were placed in each socket. OCP/Col was inserted in the space around a titanium dental implant. Autologous bone was used to fill the other sockets, while the untreated socket (i.e., no bone substitute material) served as a control. Three months after the operation, these specimens were analyzed for the osseointegration of each bone substitute material with the surface of the titanium dental implant. Results: In histomorphometric analyses, the peri-implant bone areas (BA%) and bone-implant contact (BIC%) were measured. There was no difference in BA% or BIC% between OCP/Col and autologous bone. Conclusion: These results suggested that OCP/Col could be used for implant treatment as a bone substitute.
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Silva KC, Zenóbio EG, Souza PEA, Soares RV, Cosso MG, Horta MCR. Assessment of Dental Implant Stability in Areas Previously Submitted to Maxillary Sinus Elevation. J ORAL IMPLANTOL 2018; 44:109-113. [PMID: 29303412 DOI: 10.1563/aaid-joi-d-17-00094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to compare the primary and secondary stability, measured by resonance frequency analysis (RFA), in implants of different lengths installed in areas submitted to maxillary sinus lift. Correlation between RFA and implant insertion torque was also assessed. Twenty implants of 9 and 11 mm were inserted in areas submitted to maxillary sinus lift. The insertion torque was measured by the Bien Air motor. Osstell, through RFA, determined the implant stability quotient (ISQ) 2 times: the day of implant installation (T1) and 90 days after implant installation (T2). No differences were observed in the ISQ between T1 and T2 when the 20 implants were grouped, nor when the 9 mm implants were evaluated separately. In contrast, when the 11 mm values were evaluated separately, the ISQ was significantly higher in T2 than in T1 ( P < .05). In T1, 9 mm implants had a higher ISQ than 11 mm ones ( P < .05), whereas in T2, the implants of 11 mm showed a higher ISQ than did the 9 mm implants ( P < .05). There was no difference in insertion torque between 9 and 11 mm implants ( P > .05), nor was there a correlation between ISQ and insertion torque ( P > .05). In conclusion, longer implants (11 mm) presented a significant increase in ISQ values during the healing period when installed in areas previously submitted to maxillary sinus lift. This phenomenon was not observed for shorter implants (9 mm). Finally, no correlation was observed between ISQ and insertion torque.
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Affiliation(s)
- Karine Câmara Silva
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Elton Gonçalves Zenóbio
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Eduardo Alencar Souza
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Villamarim Soares
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maurício Greco Cosso
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Uzeda MJ, de Brito Resende RF, Sartoretto SC, Alves ATNN, Granjeiro JM, Calasans-Maia MD. Randomized clinical trial for the biological evaluation of two nanostructured biphasic calcium phosphate biomaterials as a bone substitute. Clin Implant Dent Relat Res 2017; 19:802-811. [DOI: 10.1111/cid.12516] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 06/19/2017] [Accepted: 06/26/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Marcelo José Uzeda
- Dentistry School, Postgraduate Program in Dentistry; Fluminense Federal University; Niteroi Rio de Janeiro Brazil
| | | | - Suelen Cristina Sartoretto
- Dentistry School, Postgraduate Program in Dentistry; Fluminense Federal University; Niteroi Rio de Janeiro Brazil
| | | | - José Mauro Granjeiro
- Bioengineering Program, National Institute of Metrology; Quality and Technology; Duque de Caxias Rio de Janeiro Brazil
- Dentistry School; Fluminense Federal University; Niteroi Rio de Janeiro Brazil
| | - Mônica Diuana Calasans-Maia
- Dental Clinical Research Center, Oral Surgery Department, Dentistry School; Fluminense Federal University; Niteroi Rio de Janeiro Brazil
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Abstract
This study aims to evaluate the possible effect of more cortical bone decortication (CBD) on guided bone augmentation. A total of 16 New Zealand rabbits and 32 titanium domes were used. No cortical bone decortication was applied to the control group and in the study groups, the cortical bones were decorticated with a round burr (Group A: 1 hole with bleeding, Group B: 5 holes with bleeding, Group C: a thin layer of compact bone was completely removed with no bleeding). Then 2 titanium domes were placed on the calvarium of each rabbit with hydroxyapatite/beta-tricalcium phosphate. After 3 months, the animals were sacrificed and specimens were sent for histological and histomorphometric analysis. Histological and histomorphometric analysis showed that bone decortication with burr significantly increased new bone regeneration in all the experimental groups compared with the control group (P <0.05). No statistically significant difference was determined between the study groups. In conclusion, CBD, which has no negative impact on surgery, has a positive effect on guided bone augmentation. However, a greater amount of CBD does not have a greater effect.
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Yokota K, Matsuno T, Tabata Y, Mataga I. Evaluation of a Porous Hydroxyapatite Granule and Gelatin Hydrogel Microsphere Composite in Bone Regeneration. J HARD TISSUE BIOL 2017. [DOI: 10.2485/jhtb.26.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kensho Yokota
- Department of Oral Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo
- Department of Regeneration Science and Engineering, Labatory of Biomaterials, Institute for Frontier Life and Medical Sciences, Kyoto University
| | - Tomonori Matsuno
- Department of Oral Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo
| | - Yasuhiko Tabata
- Department of Regeneration Science and Engineering, Labatory of Biomaterials, Institute for Frontier Life and Medical Sciences, Kyoto University
| | - Izumi Mataga
- Department of Oral Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Tokyo
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Dos Santos PL, de Molon RS, Queiroz TP, Okamoto R, de Souza Faloni AP, Gulinelli JL, Luvizuto ER, Garcia IR. Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia. J Periodontal Implant Sci 2016; 46:176-96. [PMID: 27382506 PMCID: PMC4928206 DOI: 10.5051/jpis.2016.46.3.176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/28/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia. Methods Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss® (BI), and Bio-Oss® Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
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Affiliation(s)
- Pâmela Letícia Dos Santos
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, Sao Paulo State University - UNESP School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Thallita Pereira Queiroz
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Jéssica Lemos Gulinelli
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Eloá Rodrigues Luvizuto
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Idelmo Rangel Garcia
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
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Pereira FP, Hochuli-Vieira E, Maté Sánchez de Val JE, De Santis E, Salata LA, Botticelli D. Bone Ceramic® at Implants Installed Immediately into Extraction Sockets in the Molar Region: An Experimental Study in Dogs. Clin Implant Dent Relat Res 2015; 18:360-8. [PMID: 26250898 DOI: 10.1111/cid.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this paper was to study the healing of 1-1.4 mm wide buccal defects at implants placed immediately into extraction sockets (IPIES) filled with a mixture of synthetic hydroxyapatite (HA) 60% and beta-tricalciumphosphate (TCP) 40% or left with the clot alone and both covered with collagen membranes. MATERIAL AND METHODS Eight Labrador dogs were used and implants were placed immediately into the extraction sockets of the first molar bilaterally. A mixture of synthetic HA 60% and beta-TCP 40% at the test or the clot alone at the control sites were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membrane and a non-submerged healing was allowed. After 4 months, the animals were euthanized, biopsies harvested and processed for histomorphometric analysis. RESULTS At the time of installation, residual buccal defects occurred that were 1.1 mm and 1.4 mm wide and 3 mm and 4 mm deep at the control and test sites, respectively. After 4 months of healing, the top of the bony crest and the coronal level of osseointegration were located respectively at 0.1 ± 1.8 mm and 1.5 ± 1.8 mm at the test, and 0.6 ± 1.6 mm and 1.2 ± 0.7 mm at the control sites apically to the implant shoulder. Bone-to-implant contact at the buccal aspect was 34.9 ± 25.9% and 36.4 ± 17.3% at the test and control sites, respectively. No statistically significant differences were found between test and control sites for any of the variables analyzed at the buccal aspects. CONCLUSIONS The use of a mixture of synthetic HA 60% and beta-TCP 40% to fill residual buccal defects 1-1.4 mm wide at IPIES did not improve significantly the results of healing.
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Affiliation(s)
| | | | | | | | - Luiz Antonio Salata
- Department of Oral & Maxillofacial Surgery, The University of São Paulo, Faculty of Dentistry of Ribeirão Preto, Ribeirão Preto, Brazil
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Acar AH, Yolcu Ü, Gül M, Keleş A, Erdem NF, Altundag Kahraman S. Micro-computed tomography and histomorphometric analysis of the effects of platelet-rich fibrin on bone regeneration in the rabbit calvarium. Arch Oral Biol 2015; 60:606-14. [DOI: 10.1016/j.archoralbio.2014.09.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 06/05/2014] [Accepted: 09/28/2014] [Indexed: 12/20/2022]
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Qian SJ, Gu YX, Mo JJ, Qiao SC, Zhuang LF, Lai HC. Resonance frequency analysis of implants placed with osteotome sinus floor elevation in posterior maxillae. Clin Oral Implants Res 2014; 27:113-9. [PMID: 25521163 DOI: 10.1111/clr.12541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Jia-Ji Mo
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Long-Fei Zhuang
- Faculty of Dentistry, the University of Hong Kong, Hong Kong, SAR, China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Benic GI, Hämmerle CHF. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000 2014; 66:13-40. [DOI: 10.1111/prd.12039] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/18/2022]
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Bone formation with deproteinized bovine bone mineral or biphasic calcium phosphate in the presence of autologous platelet lysate: comparative investigation in rabbit. Int J Biomater 2014; 2014:367265. [PMID: 24982676 PMCID: PMC4058493 DOI: 10.1155/2014/367265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 05/08/2014] [Accepted: 05/09/2014] [Indexed: 12/20/2022] Open
Abstract
Bone substitutes alone or supplemented with platelet-derived concentrates are widely used to promote bone regeneration but their potency remains controversial. The aim of this study was, therefore, to compare the regenerative potential of preparations containing autologous platelet lysate (APL) and particles of either deproteinized bovine bone mineral (DBBM) or biphasic calcium phosphate (BCP), two bone substitutes with different resorption patterns. Rabbit APL was prepared by freeze-thawing a platelet suspension. Critical-size defects in rabbit femoral condyle were filled with DBBM or DBBM+APL and BCP or BCP+APL. Rabbits were sacrificed after six weeks and newly formed bone and residual implanted material were evaluated using nondemineralized histology and histomorphometry. New bone was observed around particles of all fillers tested. In the defects filled with BCP, the newly formed bone area was greater (70%; P < 0.001) while the residual material area was lower (60%; P < 0.001) than that observed in those filled with DBBM. New bone and residual material area of defects filled with either APL+DBBM or APL+BCP were similar to those observed in those filled with the material alone. In summary, osteoconductivity and resorption of BCP were greater than those of DBBM, while APL associated with either DBBM or BCP did not have an additional benefit.
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Si MS, Mo JJ, Zhuang LF, Gu YX, Qiao SC, Lai HC. Osteotome sinus floor elevation with and without grafting: an animal study in Labrador dogs. Clin Oral Implants Res 2013; 26:197-203. [PMID: 24372993 DOI: 10.1111/clr.12313] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 11/29/2022]
Abstract
AIM To evaluate implant stability and histological outcomes after osteotome sinus floor elevation (OSFE) procedure, and to compare new bone formation and implant osseointegration with and without grafting. MATERIAL AND METHODS OSFE with simultaneous implant placement was conducted bilaterally on 6 Labrador dogs. Twenty-four implants were placed. The right side sinus (Group 1) was grafted with biphasic calcium phosphate (BCP), whereas the left side (Group 2) was left without any grafting materials. The animals were euthanized 8 and 24 weeks after surgery for histological and histomorphometric assessment. Bone-to-implant contact (BIC%), alveolar bone height (ABH), bone density (BD) and grafting material density (GMD) were measured. The implant stability (ISQ) was assessed using resonance frequency analysis (RFA) at implant placement and 1, 2, 4, 8, 12, 24 weeks after surgery. RESULTS Endo-sinus new bone with direct contact to implant surface were observed in two groups at both time points. ABH showed no difference between groups at both time points. BIC% and BD in Group 2 (40.05%, 35.90%) was higher than those in Group 1 (23.30%,25.59%) at 24 weeks. Significant shrinkage of grafting material was seen in Group 1. The GMD in Group 1 at 8 weeks was 24.35%, while it dropped to 19.90% at 24 weeks. The changing pattern of ISQ for both groups were similar. CONCLUSIONS Spontaneous new bone formation and better bone-to-implant contact were found for OSFE without grafting. The grafting material application during OSFE procedure showed no advantages in histological results.
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Affiliation(s)
- Mi-Si Si
- Department of Oral and Maxilliofacial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Institute of Stomatology, Shanghai Jiaotong University, Shanghai, China
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Bone substitutes for peri-implant defects of postextraction implants. Int J Biomater 2013; 2013:307136. [PMID: 24454377 PMCID: PMC3876702 DOI: 10.1155/2013/307136] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/08/2013] [Accepted: 11/11/2013] [Indexed: 11/25/2022] Open
Abstract
Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration.
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Antunes AA, Grossi-Oliveira GA, Martins-Neto EC, De Almeida ALG, Salata LA. Treatment of Circumferential Defects with Osseoconductive Xenografts of Different Porosities: A Histological, Histometric, Resonance Frequency Analysis, and Micro-CT Study in Dogs. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e202-20. [DOI: 10.1111/cid.12181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Manresa C, Bosch M, Echeverría JJ. The comparison between implant stability quotient and bone-implant contact revisited: an experiment in Beagle dog. Clin Oral Implants Res 2013; 25:1213-1221. [PMID: 24102812 DOI: 10.1111/clr.12256] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Resonance frequency analysis (RFA) is applied clinically for the assessment of implant stability, and the relevance of this application is widely accepted. However, the relationship between resonance frequency (RF) and other parameters of implant stability, such as the histomorphometrical bone-to-implant contact (BIC) parameter, has become controversial in the last decade. OBJECTIVE To analyse and clarify the controversial relationship between RF and histomorphometrical BIC measurements. MATERIAL AND METHODS A total of 36 dental implants (9 mm length, Ø 4.0 mm; Biohorizons(®) Implant Systems Inc., Birmingham, AL, USA) with a soluble blasting media (sandblasting with soluble particles) surface were implanted in six beagle dog mandibles. RFA assessments were performed with a magnetic Osstel Mentor(®) device at the time of implant installation, and during the monitoring period at weeks 1, 2, 4, 6 and 8, before implant retrieval. The dogs were sacrificed and the implants were removed in block after 8, 6, 4, 2, 1 and 0 weeks, respectively. One group was obtained at time 0, immediately after the implantation. The samples were embedded in methyl methacrylate polymers (Technovit(®) ) and cut along their long axis. BIC values were assessed by a non-subjective and systematic method based on backscattered scanning electron microscopy (BS-SEM) images. BIC% at the different time points was compared with the corresponding implant stability quotient (ISQ) values of the RFA assessment. RESULTS No statistically significant correlation between BIC and ISQ values (Osstell Mentor(®) ) was identified. The absence of a relationship between these two parameters is in agreement with several previous studies in humans and experimental animals. CONCLUSIONS The lack of correlation between BIC and ISQ values suggests that ISQ as determined by RFA is not able to identify the relationship between RF and histomorphometrical data.
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Affiliation(s)
- Carolina Manresa
- Departament d'Odontoestomatologia, Odontologia Integrada d'Adults, Facultat d'Odontologia, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Manel Bosch
- Unitat de Microscòpia Òptica Avançada, Centres Científics i Tecnològics de la Universitat de Barcelona (CCiTUB), Barcelona, Spain
| | - José J Echeverría
- Departament d'Odontoestomatologia, Odontologia Integrada d'Adults, Facultat d'Odontologia, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
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Thoma DS, Schneider D, Mir-Mari J, Hämmerle CHF, Gemperli AC, Molenberg A, Dard M, Jung RE. Biodegradation and bone formation of various polyethylene glycol hydrogels in acute and chronic sites in mini-pigs. Clin Oral Implants Res 2013; 25:511-21. [DOI: 10.1111/clr.12203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Javier Mir-Mari
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | | | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- Department of Periodontology and Implant Dentistry; College of Dentistry; New York University; New York NY USA
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
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