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Oki Y, Doi K, Kobatake R, Makihara Y, Morita K, Kubo T, Tsuga K. Histological and histomorphometric aspects of continual intermittent parathyroid hormone administration on osseointegration in osteoporosis rabbit model. PLoS One 2022; 17:e0269040. [PMID: 35675357 PMCID: PMC9176794 DOI: 10.1371/journal.pone.0269040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022] Open
Abstract
In implant treatment, primary stability and osseointegration are improved by continual intermittent administration of parathyroid hormone (PTH) in patients with osteoporosis. However, the histological and histomorphometric aspects are not clear. The aim of this study was to investigate the histological and histomorphometric effects of intermittent PTH administration on osseointegration in a glucocorticoid-induced osteoporotic rabbit model. Fifteen female New Zealand rabbits were prepared for the osteoporosis model with ovariectomy and glucocorticoid administration. After 1 week, five rabbits were intermittently administered PTH for 8 weeks until the end point (PTHa group) and five for 4 weeks until implant placement (PTHb group). The remaining rabbits were intermittently administered saline for 8 weeks until the end point (Control group). Dental implants were inserted into the femoral epiphyses 11 weeks after ovariectomy. After 4 weeks, the maximum removal torque (RT) of the placed implant and bone implant contact (BIC) ratio were evaluated. In addition micro-computed tomography and histomorphometric analyses were performed. The RT and BIC values were significantly higher in the PTHa group compared with those of the PTHb and Control groups (p< 0.05). Furthermore, the bone mineral densities and Hounsfield units were significantly higher in the PTHa group than those in the PTHb and Control groups. Histologic and histomorphometric measurements revealed that continuous administration of PTH improved bone density and bone formation around the implant placement site, as well as systemic bone formation. Therefore, favorable implant stability was achieved under osteoporosis.
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Affiliation(s)
- Yoshifumi Oki
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuya Doi
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- * E-mail:
| | - Reiko Kobatake
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yusuke Makihara
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Koji Morita
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Takayasu Kubo
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Di Stefano DA, Arosio P, Capparè P, Barbon S, Gherlone EF. Stability of Dental Implants and Thickness of Cortical Bone: Clinical Research and Future Perspectives. A Systematic Review. MATERIALS 2021; 14:ma14237183. [PMID: 34885335 PMCID: PMC8658728 DOI: 10.3390/ma14237183] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 12/30/2022]
Abstract
Dental surgery implantation has become increasingly important among procedures that aim to rehabilitate edentulous patients to restore esthetics and the mastication ability. The optimal stability of dental implants is correlated primarily to the quality and quantity of bone. This systematic literature review describes clinical research focusing on the correlation between cortical bone thickness and primary/secondary stability of dental fixtures. To predict successful outcome of prosthetic treatment, quantification of bone density at the osteotomy site is, in general, taken into account, with little attention being paid to assessment of the thickness of cortical bone. Nevertheless, local variations in bone structure (including cortical thickness) could explain differences in clinical practice with regard to implantation success, marginal bone resorption or anchorage loss. Current knowledge is preliminarily detailed, while tentatively identifying which inconclusive or unexplored aspects merit further investigation.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
- Private Practitioner, 20132 Milan, Italy
| | | | - Paolo Capparè
- Department of Dentistry, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-0226433619
| | - Silvia Barbon
- Section of Human Anatomy, Department of Neurosciences, Padua University, 35121 Padua, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute University IRCCS San Raffaele, 20132 Milan, Italy; (D.A.D.S.); (E.F.G.)
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Is It Possible to Monitor Implant Stability on a Prosthetic Abutment? An In Vitro Resonance Frequency Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114073. [PMID: 32521612 PMCID: PMC7313046 DOI: 10.3390/ijerph17114073] [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: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022]
Abstract
In order to apply the “one-abutment–one-time” concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the PenguinRFA when screwing the transducer onto the implant or onto abutments with different heights and angulations. Eighty implants (VEGA®, Klockner Implant System, SOADCO, Les Escaldes, Andorra) were inserted into fresh bovine ribs. The groups were composed of 20 implants, 12 mm in length, with two diameters (3.5 and 4 mm). Five different abutments for screwed retained restorations (Permanent®) were placed as follows: straight with 1, 2, and 3 mm heights, and angulated at 18° with 2 and 3 mm heights. The mean value of the ISQ measured directly on the implant was 75.72 ± 4.37. The mean value of the ISQ registered over straight abutments was 79.5 ± 8.50, 76.12 ± 6.63, and 71.42 ± 6.86 for 1, 2, and 3 mm height abutments. The mean ISQ over angled abutments of 2 and 3 mm heights were 68.74 ± 4.68 and 64.51 ± 4.53 respectively. The present study demonstrates that, when the ISQ is registered over the straight abutments of 2 and 3 mm heights, the values decrease, and values are lower for angled, 3 mm height abutments.
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Nakagawa T, Kudoh K, Fukuda N, Kasugai S, Tachikawa N, Koyano K, Matsushita Y, Sasaki M, Ishikawa K, Miyamoto Y. Application of low-crystalline carbonate apatite granules in 2-stage sinus floor augmentation: a prospective clinical trial and histomorphometric evaluation. J Periodontal Implant Sci 2019; 49:382-396. [PMID: 31886030 PMCID: PMC6920036 DOI: 10.5051/jpis.2019.49.6.382] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO3Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens. Methods Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared. Results Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO3Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO3Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO3Ap were 33.8%±15.1% and 15.3%±11.9%, respectively. Conclusions In this first demonstration, low-crystalline CO3Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO3Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.
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Affiliation(s)
- Takayuki Nakagawa
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Keiko Kudoh
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naoyuki Fukuda
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shohei Kasugai
- Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tachikawa
- Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyoshi Koyano
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Yasuyuki Matsushita
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Masanori Sasaki
- Regenerative Dentistry and Implant Center, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | - Kunio Ishikawa
- Department of Biomaterials, Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Youji Miyamoto
- Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Abstract
INTRODUCTION Implant osseointegration is strongly influenced by the bone quality at the implant insertion site. The present work aims to create distribution diagrams showing the average bone density at each position within the jaws. MATERIALS AND METHODS Data were retrospectively collected from 4 oral surgeons who sought bone-density measurements during implant placement using a torque-measuring implant micromotor. Statistical analyses were performed to investigate whether bone density correlated with the patients' sex and age and whether the bone-density values at different positions within each arch correlated to each other. RESULTS Records of 2408 patients and 6060 bone-density readings were retrieved, and density distribution diagrams were created. Density values showed a significant variation within subjects. Within the same jaw, density between adjacent positions showed significant differences. Density at a given position correlated significantly with that at the other positions in most cases. Bone density was significantly lower in women than in men; no significant correlation was found between bone density and the patient age. CONCLUSIONS Bone density of patients displays significant interindividual variation, thus meaningful assessment must be conducted on a patient-by-patient basis.
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Di Stefano DA, Arosio P, Perrotti V, Iezzi G, Scarano A, Piattelli A. Correlation between Implant Geometry, Bone Density, and the Insertion Torque/Depth Integral: A Study on Bovine Ribs. Dent J (Basel) 2019; 7:dj7010025. [PMID: 30841588 PMCID: PMC6473399 DOI: 10.3390/dj7010025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
During insertion of dental implants, measurement of dynamic parameters such as the torque-depth curve integral or insertion energy might convey more information about primary stability than traditional static parameters such as the insertion or removal torque. However, the relationship between these dynamic parameters, bone density, and implant geometry is not well understood. The aim of this investigation was to compare static and dynamic implant stability measurements concerning three different implant designs when implants were inserted into bovine bone ribs and dynamic parameters were collected using an instantaneous torque measuring implant motor. Standard implant osteotomies were created in segments of bovine ribs. After measuring the bone density using the implant motor, 10 cylindrical, 10 hybrid tapered-cylindrical, and 10 modified cylindrical implants were placed, and their primary stability was assessed by measuring the torque–depth curve integral, along with insertion and removal torque. The relationship between these quantities, bone density, and implant geometry was investigated by means of regression and covariance analysis. The regression lines describing the relationship between the torque–depth integral and bone density differed significantly from those describing the relationship between insertion torque, removal torque, and bone density for all three designs. The torque–depth curve integral provides different information about immediate primary stability than insertion and removal torque and in certain clinical conditions might be more reliable than these static parameters for assessing implant primary stability. Further research should be carried out to investigate the findings of the present study.
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Affiliation(s)
| | - Paolo Arosio
- Private Practitioner, Vimercate, 20871 Monza-Brianza, Italy.
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSi-MeT, University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy.
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Elhadidi M, Aldahouk A, Shawky M, Elbehairy MS, Atef M, El-Gengehi M. Computer-guided calvarial mono-cortical bone blocks harvest: A novel approach for three-dimensional alveolar reconstruction of atrophic maxilla. Clin Implant Dent Relat Res 2019; 21:85-93. [PMID: 30618184 DOI: 10.1111/cid.12714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Calvarial bone grafts have been one of the grafting options that provides predictable results for three-dimensional reconstruction of severely atrophied ridges owing to their low resorption and rapid revascularization, thus providing adequate volume for implant insertion. The aim of this study was to introduce a computer-guided technique for calvarial graft harvest to minimize the complications known with grafting from this donor site. MATERIALS AND METHODS Eight patients, suffering from severely atrophied, completely edentulous maxillary ridges, with an age range (21-30 years) were operated on (six males and two females). A custom-made guide for each patient based on preoperative computed tomography (CT) was fabricated for harvesting the outer table cortical bone blocks from the parietal bone, then particulate bone was collected with an auto-chip maker. Bilateral sinus lifting was indicated in all cases. The bone blocks were fixed intraorally and the bone particulates filled the gaps and the volume created by sinus lifting, then the whole complex was covered with collagen membranes fixed with titanium tacks. Immediate and 6 months CT were requested for evaluation of the guide accuracy and the graft integration, respectively. RESULTS In all cases, the guide was found to accurately fit into its preplanned position and to correctly locate the anticipated harvest site with the needed dimensions of the bone blocks. No intraoperative complications were encountered such as breakage through the inner table or cerebrospinal fluid leakage. Postoperatively, all the cases showed uneventual healing except one case that had an anterior dehiscence. CONCLUSION The computer-guided calvarial bone blocks harvest from the parietal bone is safe and predictable technique for three-dimensional reconstruction of severely atrophic edentulous maxilla.
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Affiliation(s)
- Mohamed Elhadidi
- Department of Oral Implantology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Aldahouk
- Department of Oral Implantology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Shawky
- Department of Oral and maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed S Elbehairy
- Department of Removable Prosthodontics, Faculty of Oral and Dental Medicine, South Valley University, Qena, Egypt
| | - Mohammed Atef
- Department of Oral and maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mostafa El-Gengehi
- Department of Oral and maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Abi-Aad HL, Daher FI, Baba NZ, Cordioli G, Majzoub ZAK. Insertion Torque of Variable-Thread Tapered Implants in the Posterior Maxilla: A Clinical Study. J Prosthodont 2018; 28:e788-e794. [PMID: 30178903 DOI: 10.1111/jopr.12965] [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] [Accepted: 07/13/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Primary stability is a key factor for successful implant osseointegration, especially in poor bone quality and early/immediate loading. In the immediate loading protocol, insertion torque values (ITVs) have been suggested to be the most valid prognostic factor for osseointegration of maxillary implants. The objectives of this study were to: (1) evaluate ITVs achieved by a variable-thread tapered implant in the posterior maxilla; and (2) assess the impact of bone quality, implant dimensions, bicortical anchorage, and implant location on ITVs. MATERIALS AND METHODS Twenty-six adult, systemically healthy patients received 173 variable-thread tapered implants in maxillary premolar and molar healed edentulous sites with a minimum subsinus height of 8 mm. Implant sites were prepared using the bone-quality adjusted drilling sequence according to manufacturer's recommendations. Bone quality was recorded subjectively during drilling based on Misch criteria (D1-D4), and ITVs were measured with a manual torque wrench. Univariate and multivariate analyses were performed at the 0.05 significance level. RESULTS First and second molar sites accounted for 46.8% of all implants. D4 bone was encountered in 61.3% of the sites. Most of the implants were 4.3 mm in diameter (59.5%), and lengths of 11.5 and 13 mm were most commonly used (75.2%). Approximately half of the implants were associated with apical cortical anchorage (51.4%). The overall mean ITV was 44.5 ± 23.0 Ncm, with 65.5 ± 15.6 Ncm, 55.5 ± 19.6 Ncm, and 36.6 ± 21.7 Ncm for D2, D3, and D4 bone, respectively. Bone quality and implant location significantly affected ITVs, while implant dimensions and apical cortical anchorage did not. CONCLUSIONS ITVs of variable-thread implants were significantly influenced by variations in bone quality and implant position in the posterior maxilla. Despite the influence of bone quality on primary stability, the mean ITVs attained with variable-thread tapered implants in poor bone quality were within the recommended range for immediate loading.
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Affiliation(s)
- Habib L Abi-Aad
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
| | - Fadi I Daher
- Department of Periodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
| | - Nadim Z Baba
- Advanced Specialty Education Program in Prosthodontics, School of Dentistry, Loma Linda University
| | | | - Zeina A K Majzoub
- Department of Periodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
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Qamheya AHA, Arısan V, Mutlu Z, Karabaglı M, Soluk Tekkeşin M, Kara K, Erol A, Ersanlı S. Thermal oxidation and hydrofluoric acid treatment on the sandblasted implant surface: A histologic histomorphometric and biomechanical study. Clin Oral Implants Res 2018; 29:741-755. [PMID: 29876965 DOI: 10.1111/clr.13285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study aimed to analyze and compare the topographical, chemical, and osseointegration characteristics of a sandblasted acid-etched surface (SLA group), a sandblasted thermally oxidized surface (SO group), and a surface chemically modified by hydrofluoric (HF) acid (SOF group). MATERIALS AND METHODS Following the preparation and characterization of the relevant surfaces, 90 implants (30 for each group) were placed on the pelvic bone of six sheep. Resonance frequency analysis (RFA), insertion (ITV), removal torque value (RTV), and histomorphometric analyses (BIC%) were performed after three and 8 weeks of healing. The results were analyzed by nonparametric tests (p < 0.05). RESULTS The roughness value (Ra) in the SOF group was significantly lower than the SLA and the SO group (p = 0.136, p < 0.001, respectively). This resulted in a substantially inferior ITV 14.83 N/cm (SD: 4.04) than those achieved in the SLA and SO groups (19.50 (SD: 6.07) and 20.17 N/cm (SD: 8.95), respectively; p = 0.001). A statistically significant change in the RFA from the baseline (47.36 ISQ, SD: 6.93) to the 3rd week (62.56 ISQ, SD: 5.29) was observed in the SOF group only (p = 0.008). The highest postplacement RFA and RTV values were measured from the SLA group (61.11 ISQ, SD: 7.51 and 78.22 N/cm, SD: 28.73). The early-term (3rd week) BIC% was highest in the SO group (39.93%, SD: 16.14). After 8 weeks, the differences in BIC% values were statistically not significant. CONCLUSIONS Adjunct HF acid application on the thermally oxidized surface did not provide an additional benefit compared to the sandblasted and acid-etched surface (SLA group).
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Affiliation(s)
- Ala Hassan A Qamheya
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Volkan Arısan
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Zihni Mutlu
- Department of Surgery, Faculty of Veterinary Medicine, Istanbul University, Avcilar, Turkey
| | - Murat Karabaglı
- Department of Surgery, Faculty of Veterinary Medicine, Istanbul University, Avcilar, Turkey
| | - Merva Soluk Tekkeşin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Kamuran Kara
- Department of Physics, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Ayşe Erol
- Department of Physics, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Selim Ersanlı
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Arosio P, Greco GB, Zaniol T, Iezzi G, Perrotti V, Di Stefano DA. Sinus augmentation and concomitant implant placement in low bone-density sites. A retrospective study on an undersized drilling protocol and primary stability. Clin Implant Dent Relat Res 2017; 20:151-159. [PMID: 29164788 DOI: 10.1111/cid.12558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 09/27/2017] [Accepted: 10/29/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recently, a torque-measuring micromotor has been shown to provide a reliable, quantitative intraoperative evaluation of bone density and implant primary stability. This may be particularly useful for determining bone quality of residual bone and consequently the most appropriate site preparation in the posterior maxilla, where bone often is of low density and quality. PURPOSE This work aimed to assess the medium-term success of implants placed during 1-stage sinus augmentations using an undersized drilling protocol. In case of low bone density, the relationship between residual bone height (RBH) and primary stability was also investigated. MATERIALS AND METHODS Clinical records of patients who underwent sinus augmentation and concomitant implant placement following a 12.5% undersized drilling protocol were retrospectively analyzed. In all patients, bone density measured intraoperatively was ≤ 0.45 g/cm3 . A minimum of 60 months of follow-up was required for inclusion. RESULTS Records of 106 patients who received 253 implants were reviewed. No significant difference in the implant success rate was found for patients who had less than 4 mm of RBH and those who had more. CONCLUSIONS Underpreparation of the implant-placement sites enabled achievement of successful implant-supported rehabilitation of the posterior maxilla even when both RBH and bone density were low.
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Affiliation(s)
| | | | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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Investigation of Effective Modification Treatments for Titanium Membranes. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7101022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Oki Y, Doi K, Makihara Y, Kubo T, Oue H, Tsuga K. Intermittent administration of parathyroid hormone enhances primary stability of dental implants in a bone-reduced rabbit model. J Oral Sci 2017; 58:241-6. [PMID: 27349546 DOI: 10.2334/josnusd.15-0717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of the study was to investigate the effect of parathyroid hormone (PTH) on primary stability of dental implants in a bone-reduced model. Ten female New Zealand white rabbits underwent ovariectomy and were administered glucocorticoid to induce osteoporosis. One group was administered PTH intermittently by subcutaneous injection for 4 weeks (PTH-group) and the other group was given injections of saline for 4 weeks (Osteoporosis; OP-group). After the administration period, implants were inserted into the distal femoral epiphyses of each animal. At implant placement, insertion torque (IT) and implant stability quotient (ISQ) were measured. Histological examination revealed newly formed trabecular bone around the implant socket in the PTH-group but not in the OP-group. The trabecular bone structures in the PTH-group appeared thicker than those in the OP-group. In the PTH-group, the mean IT value was significantly greater than that in the OP-group (29.8 ± 6.2 Ncm and 10.0 ± 2.1 Ncm, respectively; P < 0.05). The ISQ value in the PTH-group was significantly higher than that in the OP-group (74.7 ± 11.2 and 55.9 ± 13.5, respectively; P < 0.05). Intermittent PTH administration could be an effective treatment for achieving favorable primary stability of dental implants in patients with osteoporosis. (J Oral Sci 58, 241-246, 2016).
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Affiliation(s)
- Yoshifumi Oki
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences
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Maxillary sinus grafting with fresh frozen allograft versus bovine bone mineral: A tomographic and histological study. J Craniomaxillofac Surg 2016; 44:708-14. [PMID: 27107475 DOI: 10.1016/j.jcms.2016.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 02/22/2016] [Accepted: 03/14/2016] [Indexed: 01/10/2023] Open
Abstract
We evaluated histologically and tomographically the effects of fresh frozen bone allograft (FFB) or bovine bone mineral (BBM) in maxillary sinus floor augmentations. In total, 30 maxillary sinuses from 30 patients (mean age = 51.17 ± 10.86 years) underwent sinus augmentation. Patients were divided in two test groups (15 sinuses each). The first group was grafted with allograft bone, and the second group received bovine bone mineral. After 6 months, bone samples from each group were collected for histological examination. Implant survival rates were 97.78% (FFB group) and 100% (BBM group) 6 months after functional loading. Median volumetric reductions of 31.2% (11.33-40.56) and 12.22% (9.91-20.59) were observed in the FFB and BBM groups, respectively. Comparisons between the groups for differences in initial and final volumes of bone (p = 0.015) and the rate of resorption (p = 0.009) showed statistically significant differences. The FFB group showed osteoblastic cells in close contact with osteoid matrix, connected through bridges between allograft bone particles and new bone formation. The BBM group showed BBM particles in close contact with new bone, with visible osteoid matrix bridges and osteoblastic cells surrounding it. None showed signs of acute or chronic inflammatory infiltrate. Despite better results with BBM, both FFB and BBM in maxillary sinus augmentation resulted in high percentages of new bone formation, and allowed implant placement with a low rate of failure of osseointegration at a 6-month follow-up.
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Naygovzina NB, Luchinskiy AV. [Analysis of volume and costs of dental care provided in outpatient settings]. STOMATOLOGIIA 2016; 95:76-82. [PMID: 27636768 DOI: 10.17116/stomat201695476-82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A conducted analysis of volume and cost of dental care provided in outpatient settings proves the need for harmonization of Russian Ministry of Health's documentation regulating dental checks in adults and children, and the Programme of state guarantees.
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Affiliation(s)
- N B Naygovzina
- Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - A V Luchinskiy
- Moscow State University of Medicine and Dentistry, Moscow, Russia
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15
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Al-Abedalla K, Torres J, Cortes ARG, Wu X, Nader SA, Daniel N, Tamimi F. Bone Augmented With Allograft Onlays for Implant Placement Could Be Comparable With Native Bone. J Oral Maxillofac Surg 2015; 73:2108-22. [DOI: 10.1016/j.joms.2015.06.151] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 02/08/2023]
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16
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Arosio P, Moschioni M, Banfi LM, Di Stefano AA. An Intraoperative Site-specific Bone Density Device: A Pilot Test Case. J Contemp Dent Pract 2015; 16:697-703. [PMID: 26423508 DOI: 10.5005/jp-journals-10024-1743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM This paper reports a case of all-on-four rehabilitation where bone density at implant sites was assessed both through preoperative computed tomographic (CT) scans and using a micromotor working as an intraoperative bone density measurement device. BACKGROUND Implant-supported rehabilitation is a predictable treatment option for tooth replacement whose success depends on the clinician's experience, the implant characteristics and location and patient-related factors. Among the latter, bone density is a determinant for the achievement of primary implant stability and, eventually, for implant success. The ability to measure bone density at the placement site before implant insertion could be important in the clinical setting. CASE DESCRIPTION A patient complaining of masticatory impairment was presented with a plan calling for extraction of all her compromised teeth, followed by implant rehabilitation. A week before surgery, she underwent CT examination, and the bone density on the CT scans was measured. When the implant osteotomies were created, the bone density was again measured with a micromotor endowed with an instantaneous torque-measuring system. The implant placement protocols were adapted for each implant, according to the intraoperative measurements, and the patient was rehabilitated following an all-on-four immediate loading protocol. CONCLUSION The bone density device provided valuable information beyond that obtained from CT scans, allowing for site-specific, intraoperative assessment of bone density immediately before implant placement and an estimation of primary stability just after implant insertion. CLINICAL SIGNIFICANCE Measuring jaw-bone density could help clinicians to select implant-placement protocols and loading strategies based on site-specific bone features.
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Affiliation(s)
- Paolo Arosio
- Private Practitioner, Department of Tecnologie Biomediche Applicate Alle Scienze Odontostomatologiche, Seconda Universita degli Studi di Napoli, Province: Monza e Brianza (MB), Via Don Lualdi 4c, 20871 Ruginello, Vimercate, MB, Italy, Phone: +39 039 6085229, e-mail:
| | - Monica Moschioni
- Department of Facolta di Medicina e Chirurgia, Universita degli Studi di Brescia, Province: Brescia (BS), Italy
| | - Luca Maria Banfi
- Department of Facolta di Medicina e Chirurgia, Universita degli Studi di Milano, Province: Monza (MB), Italy
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Thoma DS, Zeltner M, Hüsler J, Hämmerle CHF, Jung RE. EAO Supplement Working Group 4 - EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res 2015; 26 Suppl 11:154-69. [DOI: 10.1111/clr.12615] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 11/27/2022]
Affiliation(s)
- D. S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - M. Zeltner
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - J. Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - C. H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - R. E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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18
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Capparé P, Vinci R, Di Stefano DA, Traini T, Pantaleo G, Gherlone EF, Gastaldi G. Correlation between Initial BIC and the Insertion Torque/Depth Integral Recorded with an Instantaneous Torque-Measuring Implant Motor: An in vivo Study. Clin Implant Dent Relat Res 2015; 17 Suppl 2:e613-20. [PMID: 25876078 DOI: 10.1111/cid.12294] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Quantitative intraoperative evaluation of bone quality at implant placement site and postinsertion implant primary stability assessment are two key parameters to perform implant-supported rehabilitation properly. A novel micromotor has been recently introduced allowing to measure bone density at implant placement site and to record implant insertion-related parameters, such as the instantaneous, average and peak insertion torque values, and the insertion torque/depth integral. PURPOSE The aim of this study was to investigate in vivo if any correlation existed between initial bone-to-implant contact (BIC) and bone density and integral values recorded with the instrument. MATERIALS AND METHODS Twenty-five patients seeking for implant-supported rehabilitation of edentulous areas were consecutively treated. Before implant placement, bone density at the insertion site was measured. For each patient, an undersized 3.3 × 8-mm implant was placed, recording the insertion torque/depth integral values. After 15 minutes, the undersized implant was retrieved with a 0.5 mm-thick layer of bone surrounding it. Standard implants were consequently placed. Retrieved implants were analyzed for initial BIC quantification after fixation, dehydration, acrylic resin embedment, sections cutting and grinding, and toluidine-blue and acid fuchsine staining. Correlation between initial BIC values, bone density at the insertion site, and the torque/depth integral values was investigated by linear regression analysis. RESULTS A significant linear correlation was found to exist between initial BIC and (a) bone density at the insertion site (R = 0.96, explained variance R(2) = 0.92) and (b) torque/depth integral at placement (R = 0.81, explained variance R(2) = 0.66). CONCLUSIONS The system provided quantitative, reliable data correlating significantly with immediate postinsertion initial BIC, and could therefore represent a valuable tool both for clinical research and for the oral implantologist in his/her daily clinical practice.
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Affiliation(s)
- Paolo Capparé
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Raffaele Vinci
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | | | - Tonino Traini
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Giuseppe Pantaleo
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
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Linck GKSB, Ferreira GM, De Oliveira RCG, Lindh C, Leles CR, Ribeiro-Rotta RF. The Influence of Tactile Perception on Classification of Bone Tissue at Dental Implant Insertion. Clin Implant Dent Relat Res 2015; 18:601-8. [PMID: 25850635 DOI: 10.1111/cid.12341] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Various ways of using the Lekholm and Zarb (L&Z) classification have added to the lack of scientific evidence of the effectiveness of this clinical method in the evaluation of implant treatment. PURPOSE The study aims to assess subjective jawbone classifications in patients referred for implant treatment, using L&Z classification with and without surgeon's hand perception at implant insertion. The association between bone type classifications and quantitative parameters of primary implant stability was also assessed. MATERIALS AND METHODS One hundred thirty-five implants were inserted using conventional loading protocol. Three surgeons classified bone quality at implant sites using two methods: one based on periapical and panoramic images (modified L&Z) and one based on the same images associated with the surgeon's tactile perception during drilling (original L&Z). Peak insertion torque and implant stability quotient (ISQ) were recorded. RESULTS The modified and original L&Z were strongly correlated (rho = 0.79; p < .001); Wilcoxon signed-rank test showed no significant difference in the distribution of bone type classification between pairs using the two methods (p = .538). Spearman correlation tested the association between primary stability parameters and bone type classifications (-0.34 to -0.57 [p < .001]). CONCLUSIONS Tactile surgical perception has a minor influence on rating of subjective bone type for dental implant treatment using the L&Z classification.
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Influence of implant surface topography on primary stability in a standardized osteoporosis rabbit model study. J Funct Biomater 2015; 6:143-52. [PMID: 25794350 PMCID: PMC4384105 DOI: 10.3390/jfb6010143] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/09/2015] [Indexed: 11/30/2022] Open
Abstract
Evaluating primary stability is important to predict the prognosis of dental implant treatment. Primary stability is decreased in a low bone density site such as osteoporosis. However, it is difficult to apply in small animal and the effect of the different implant surface topography for the primary stability at low bone density site has not yet fully been investigated. The purpose of the present study was to evaluate the influence of implant surface topography on primary stability in a standardized osteoporosis animal model. Six rabbits underwent ovariectomy and administrated glucocorticoid to induce an osteoporosis model. Sham-operations were performed in additional six rabbits. Implants with machined or oxidized-surfaces were inserted into the femur epiphyses and insertion torque (IT) and implant stability quotient (ISQ) were measured. In sham model, the IT and ISQ did not differ significantly between the both implant. However, the IT value of oxidized-surface implant was significantly higher than that of the machined implant in the osteoporosis model. Meanwhile, ISQ did not significantly differ between the machined and oxidized-surfaced implants. In conclusion, the IT of implants is higher with rough than with smooth surfaces but that there are no differences in ISQ value between different surfaces in a standardized osteoporosis bone reduced rabbit model.
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21
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Sehn FP, Dias RR, de Santana Santos T, Silva ER, Salata LA, Chaushu G, Xavier SP. Fresh-frozen allografts combined with bovine bone mineral enhance bone formation in sinus augmentation. J Biomater Appl 2014; 29:1003-13. [PMID: 25245781 DOI: 10.1177/0885328214552709] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated histologically, histomorphometrically, and tomographically the effects of the association of fresh-frozen bone allograft (FFB) with bovine bone mineral (BBM) in maxillary sinus floor augmentation. In total, 34 maxillary sinuses from 29 patients, with a mean age of 51.32 (±6.44) years, underwent sinus augmentation. Patients were divided into control and test groups (17 sinuses each). The controls were grafted with allograft bone, and the test group received a combination of FFB and BBM at a 2:1 ratio. After 6 months, bone samples were collected for histological and histomorphometric examinations. The implant survival rates were 93.02% (control group) and 100% (test group) at 6 months after functional loading. Median volumetric reductions of 28.32% (17.05-44.05) and 12.62% (5.65-16.87) were observed for the control and test groups, respectively. Statistically significant histomorphometric differences were found between the control and test groups regarding newly formed bone 12.54% (10.50-13.33) vs. 24.42% (17.62-35.92), p < 0.001, total bone 48.34% (39.03-54.42) vs. 61.32% (50.61-64.96), p = 0.007, and connective tissue 51.66% (45.57-60.97) vs. 39.30% (35.03-49.37), p = 0.007. The addition of BBM to allograft bone in maxillary sinus augmentation resulted in higher percentages of new bone formation and total bone, and permitted implant placement with a low rate of osseointegration failure at the 6-month follow-up.
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Affiliation(s)
- Felipe Perraro Sehn
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Rafael Rodrigues Dias
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Thiago de Santana Santos
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Erick Ricardo Silva
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Luiz Antonio Salata
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
| | - Gavriel Chaushu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tel Aviv University, Israel
| | - Samuel Porfírio Xavier
- Department of Oral and Maxillofacial Surgery and Periodontology. Ribeirão Preto Dental School, University of São Paulo, São Paulo, Brazil
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Filho LCM, Cirano FR, Hayashi F, Feng HS, Conte A, Dib LL, Casati MZ. Assessment of the correlation between insertion torque and resonance frequency analysis of implants placed in bone tissue of different densities. J ORAL IMPLANTOL 2014; 40:259-62. [PMID: 24914911 DOI: 10.1563/aaid-joi-d-11-00183] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The primary stability of dental implants is fundamental for osseointegration. Therefore, this study aimed to assess the correlation between insertion torque (IT) and resonance frequency analysis (RFA) of implants placed in mandibles and maxillas of different bone densities. Eighty dental implants were placed in maxillas and mandibles, and IT and the implant stability quotient (ISQ) were measured at the time of implant insertion. Bone density was assessed subjectively by the Lekholm and Zarb index. The type I and II densities were grouped together (group A)as were the type III and IV densities (group B). The IT in group A was higher (Student t test, P = .0013) than in group B (46.27 ± 18.51 Ncm, 33.62 ± 14.74 Ncm, respectively). The implants placed in group A showed higher ISQ (Student t test, P = .0004) than those placed in group B (70.09 ± 7.50, 63.66 ± 8.00, respectively). A significant correlation between IT and the ISQ value was observed for group A (Pearson correlation test; r = 0.35; P = .0213) and for group B (r = 0.37; P = .0224). Within the limitations of this study, it was possible to conclude that there is a correlation between IT and RFA of implants placed in mandibles and maxillas of different bone densities.
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23
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Al-Nawas B, Domagala P, Fragola G, Freiberger P, Ortiz-Vigón A, Rousseau P, Tondela J. A Prospective Noninterventional Study to Evaluate Survival and Success of Reduced Diameter Implants Made From Titanium-Zirconium Alloy. J ORAL IMPLANTOL 2014; 41:e118-25. [PMID: 24666383 DOI: 10.1563/aaid-joi-d-13-00149] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Narrow diameter implants may be at increased risk of overload due to occlusal forces; therefore, implants with higher fatigue strength may be beneficial. The aim of this observational study was to evaluate survival and success of narrow diameter (Ø 3.3 mm) TiZr alloy (Roxolid, Institut Straumann AG, Basel, Switzerland) implants for 2 years in daily dental practice. This was a prospective, non-interventional, multicenter study; no specific patient inclusion or exclusion criteria were applied. Each patient received at least one TiZr implant; the treatment plan, including implant loading and final restoration, was at the investigator's discretion. The primary outcome was implant survival and success after 1 year. Secondary outcomes included 2-year survival and success and marginal bone level change. A total of 603 implants were placed in 357 patients. Cumulative survival and success rates were 97.8% and 97.6%, respectively, after 1 year and 97.6% and 97.4%, respectively, after 2 years. Bone levels remained stable in the majority of patients, and soft tissue remained stable up to 2 years. Within the limitations of a non-interventional study design, TiZr implants showed excellent survival and success with minimal bone loss up to 2 years in daily dental practice. The results compare favorably with those of small-diameter implants in controlled clinical trials.
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Affiliation(s)
- Bilal Al-Nawas
- 1 Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Peter Domagala
- 2 Institute of Dental Implants and Periodontics, Gurnee, Ill
| | | | | | | | | | - João Tondela
- 7 Faculty of Medicine of University of Coimbra (FMUC), Coimbra, Portugal
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24
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Iezzi G, Scarano A, Di Stefano DA, Arosio P, Doi K, Ricci L, Piattelli A, Perrotti V. Correlation between the bone density recorded by a computerized implant motor and by a histomorphometric analysis: a preliminary in vitro study on bovine ribs. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e35-44. [PMID: 23879771 DOI: 10.1111/cid.12121] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of the present preliminary in vitro study on bovine ribs was to validate a new intraoperative site-specific classification of bone Density Index (IDI), obtained by an innovative computerized implant motor, by correlating these data with the data obtained by the histomorphometrical evaluation of the same samples. MATERIALS AND METHODS Five segments of bovine ribs were used, and a total of 22 perforations were performed. A computerized implant motor ("Torque Measuring Motor") was used to evaluate the bone density, which was classified into four classes: ID1, ID2, ID3, and ID4. Histomorphometrical analysis of bone density, expressed as percentage of bony trabeculae over the total biopsy area, was also performed. The data of bone density obtained by the implant motor were statistically correlated with the histomorphometrical results. RESULTS A significant positive correlation was found between the bone density measured by the implant motor and the bone density assessed by histomorphometry (r = 0.89, p < .0001). Moreover, a significant positive correlation in D1, D2, and D4, whereas a negative, not significant correlation in D3 was found. CONCLUSION Within the limitations of this in vitro study, the intraoperative site-specific classification of bone density, obtained with this innovative system, could be helpful for the clinician to tailor the surgical protocol to the different situations in implant dentistry.
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Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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25
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Krafft T, Graef F, Winter W, Wichmann M, Karl M. Use of Osteotomes for Implant Bed Preparation—Effect on Material Properties of Bone and Primary Implant Stability. J ORAL IMPLANTOL 2013. [DOI: 10.1563/aaid-joi-d-10-00187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the efficacy of osteotomes in enhancing bone quality as compared to conventional implant bed preparation using burrs. Polyurethane foam blocks differing in density (10 pcf, 20 pcf) and structure (cellular, solid) were used. Ten implant sockets were prepared in each of the materials by means of drilling and by using osteotomes. Bone quality was assessed by measuring implant insertion torque and primary implant stability (resonance frequency analysis). Additionally, a newly designed device (BoneProbe) for bone quality testing during dental implant surgery based on intraoperative compressive tests was applied. Multivariate analysis of variance with Pillai's trace was used as test statistic (level of significance: α = 0.05) and Pearson correlation coefficients were calculated for all combinations of parameters. Whereas a significant influence of bone type on all measurement results (P = 0) could be found, the factor preparation technique only showed a significant effect on BoneProbe measurements in the cortical area (P = 0) and on implant insertion torque (P = 0). The interaction of bone type and preparation technique showed a significant effect on BoneProbe measurements in the trabecular area (P = .002) and on implant insertion torque (P = 0). Significant correlations between all parameters were found. The application of osteotomes leads to higher values for compressive testing of bone in the apical part of an osteotomy depending on the initial density of the bone. Intraoperative compressive testing appears to be sensitive enough for quantifying localized changes in bone quality.
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Affiliation(s)
- Tim Krafft
- University of Erlangen-Nuremberg, Germany
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26
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Villar CC, Huynh-Ba G, Mills MP, Cochran DL. Wound healing around dental implants. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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27
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Cho K, Kim J, Kim M, Kang S, Kim G, Choi S. Scintigraphic Evaluation of Osseointegrative Response around Calcium Phosphate-Coated Titanium Implants in Tibia Bone: Effect of Platelet-Rich Plasma on Bone Healing in Dogs. Eur Surg Res 2013; 51:138-45. [DOI: 10.1159/000357197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/10/2013] [Indexed: 11/19/2022]
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28
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Krafft T, Winter W, Wichmann M, Karl M. Applicability of strain measurements on a contra angle handpiece for the determination of alveolar bone quality during dental implant surgery. J Craniomaxillofac Surg 2012; 40:e144-9. [DOI: 10.1016/j.jcms.2011.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Revised: 07/25/2011] [Accepted: 07/30/2011] [Indexed: 11/25/2022] Open
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29
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Marković A, Mišić T, Miličić B, Calvo-Guirado JL, Aleksić Z, Đinić A. Heat generation during implant placement in low-density bone:effect of surgical technique, insertion torque and implant macro design. Clin Oral Implants Res 2012; 24:798-805. [DOI: 10.1111/j.1600-0501.2012.02460.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Aleksa Marković
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Tijana Mišić
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Biljana Miličić
- Department of Medical Statistics and Informatics, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Jose Luis Calvo-Guirado
- Department of Dental Implantology, Faculty of Medicine and Dentistry; University of Murcia; Murcia, Spain
| | - Zoran Aleksić
- Department of Periodontics, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Ana Đinić
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
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30
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Pantani F, Botticelli D, Garcia IR, Salata LA, Borges GJ, Lang NP. Influence of lateral pressure to the implant bed on osseointegration: an experimental study in dogs. Clin Oral Implants Res 2011; 21:1264-70. [PMID: 20626423 DOI: 10.1111/j.1600-0501.2010.01941.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To study osseointegration and bone-level changes at implants installed using either a standard or a reduced diameter bur for implant bed preparation. MATERIAL AND METHODS In six Labrador dogs, the first and second premolars were extracted bilaterally. Subsequently, mesial roots of the first molars were endodontically treated and distal roots, including the corresponding part of the crown, were extracted. After 3 months of healing, flaps were elevated and recipient sites were prepared in all experimental sites. The control site was prepared using a standard procedure, while the test site was prepared using a drill with a 0.2 mm reduced diameter than the standard one used in the contra-lateral side. After 4 months of healing, the animals were euthanized and biopsies were obtained for histological processing and evaluation. RESULTS With the exception of one implant that was lost, all implants were integrated in mineralized bone. The alveolar crest underwent resorption at control as well as at test sites (buccal aspect ∼1 mm). The most coronal contact of bone-to-implant was located between 1.2 and 1.6 mm at the test and between 1.3 and 1.7 mm at the control sites. Bone-to-implant contact percentage was between 49% and 67%. No statistically significant differences were found for any of the outcome variables. CONCLUSIONS After 4 months of healing, lateral pressure to the implant bed as reflected by higher insertion torques (36 vs. 15 Ncm in the premolar and 19 vs. 7 Ncm in the molar regions) did not affect the bone-to-implant contact.
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Affiliation(s)
- Fabio Pantani
- Faculty of Dentistry of Araçatuba, UNESP - São Paulo State University, São Paulo, Brazil
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31
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Toyoshima T, Wagner W, Klein MO, Stender E, Wieland M, Al-Nawas B. Primary Stability of a Hybrid Self-Tapping Implant Compared to a Cylindrical Non-Self-Tapping Implant with Respect to Drilling Protocols in an Ex Vivo Model. Clin Implant Dent Relat Res 2011; 13:71-8. [DOI: 10.1111/j.1708-8208.2009.00185.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Abdel-Haq J, Karabuda CZ, Arısan V, Mutlu Z, Kürkçü M. Osseointegration and stability of a modified sand-blasted acid-etched implant: an experimental pilot study in sheep. Clin Oral Implants Res 2010; 22:265-74. [DOI: 10.1111/j.1600-0501.2010.01990.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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33
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Degidi M, Daprile G, Piattelli A. Primary stability determination by means of insertion torque and RFA in a sample of 4,135 implants. Clin Implant Dent Relat Res 2010; 14:501-7. [PMID: 20849539 DOI: 10.1111/j.1708-8208.2010.00302.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aims of the present study are to evaluate the primary stability of a sample of 4,135 implants and to investigate the correlations between primary stability and mechanical characteristic of the implant and bone density at insertion time. MATERIAL AND METHODS The study was conducted from March 2002 to January 2009 at a private practice in Bologna (Italy). Patients were eligible for the study if they needed the insertion of single or multiple implants. Bone density, length, and diameter of each implant were recorded. During surgery for each implant, peak insertion torque (IT) was recorded; the resonance frequency analysis (RFA) values were also collected. Finally, it was recorded whether an implant was lost or removed at an early stage (within 6months from insertion surgery). RESULTS A total of 1,045 consecutive patients were included in the study. A total of 4,135 of implants were inserted. The sample presented 1,184 implants inserted in a postextractive site. The mean peak IT was 34.82±19.36. The mean RFA was 71.57±10.63 implant stability quotient. Spearman correlation analysis shows the presence of a weak positive correlation between IT and RFA. The statistical analysis shows a relevant dependency between IT and bone quality and a very weak dependency between RFA and bone quality. Again, the statistical analysis shows a quite weak correlation between length or diameter and IT, but it shows a relevant correlation between length and RFA. Postextractive implants presented a higher mean IT and a lower RFA compared with implants inserted in healed sites. Twenty-eight (0.7%) implants were considered to have failed and removed within 6months. CONCLUSIONS The results show that the implants studied obtain a good primary stability with a standard protocol. The IT and RFA appear as two independent features of primary stability. Data show that only IT is influenced by bone density as well as only RFA is correlated to the length of implants used. Finally, it is possible to obtain a good primary stability also in postextractive sites.
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Affiliation(s)
- Marco Degidi
- Dental School, University of Chieti, Chieti, Italy
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Irinakis T, Wiebe C. Initial Torque Stability of a New Bone Condensing Dental Implant. A Cohort Study of 140 Consecutively Placed Implants. J ORAL IMPLANTOL 2009; 35:277-82. [DOI: 10.1563/aaid-joi-d-09-00020.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
The aim of this paper was to determine the torque resistance of this new implant during placement in different types of bone, immediate placement into sockets, and in grafted bone. The torque at time of placement serves as an indication of initial stability, which is accepted as an important factor for implant osseointegration and immediate loading. Within a 13-month period, 140 NobelActive implants in 84 consecutive patients were placed into types I–IV bone in fresh sockets, and into grafted bone (both in maxillary sinuses and on the facial alveolar surfaces where bone had been lost). The final torque was measured with a manual torque control wrench as manufactured by Nobel Biocare for clinical use with this type of implant. One hundred forty implants with 3.5 to 5 mm diameters and 10 to 15 mm lengths were placed in different types of bone, either as delayed or immediate implants into fresh extraction sockets. These implants demonstrated a mean torque stability value of 50.8 Ncm. The average insertion torque for delayed implants was 49.7 Ncm. For immediate implants the average torque was 52.6 Ncm. Placement into soft bone was also favorable at an average of 47.9 Ncm. Typical straight walled and tapered implants generally exhibit 10 to 35 Ncm insertion torques. The NobelActive implant consistently reaches higher torque levels. This may indicate they are more favorably suited to early provisionalization and loading. Soft bone (type IV) did not seem to decrease significantly the torque of insertion of these implants. Further longer term studies are needed to investigate whether this indeed makes these implants more suited for early provisionalization and loading than traditional root form. Long term studies are also needed to investigate maintenance of bone levels surrounding these implants.
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The Use of Particulate Bone Grafts From the Mandible for Maxillary Sinus Floor Augmentation Before Placement of Surface-Modified Implants: Results From Bone Grafting to Delivery of the Final Fixed Prosthesis. J Oral Maxillofac Surg 2008; 66:780-6. [DOI: 10.1016/j.joms.2007.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 08/27/2007] [Accepted: 11/07/2007] [Indexed: 11/20/2022]
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Alsaadi G, Quirynen M, Michiels K, Jacobs R, van Steenberghe D. A biomechanical assessment of the relation between the oral implant stability at insertion and subjective bone quality assessment. J Clin Periodontol 2007; 34:359-66. [PMID: 17378890 DOI: 10.1111/j.1600-051x.2007.01047.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The study was set to evaluate the validity of subjective jaw bone quality assessment. MATERIALS AND METHODS A total of 298 patients (198 females, mean age 56.4) were treated with oral implants at the Periodontology Department at the University Hospital of KUL. A total of 761 TiUnite implants have been installed. Subjective bone quality assessment was performed on radiographs and by the surgeon's tactile sensation and was compared with torque measurements. In a subset of patients, implant stability was also assessed by implant stability quotient and/or periotest values. RESULTS Subjective assessment of bone quality was related to the PTV, ISQ and placement torque [in the crestal, the second and the apical third (N cm)], respectively; in grade 1: -5.3, 73.3 (4.2, 9.6, 15.2), and grade 3 or 4: -1.6, 55 (3.3, 5.5, 8.4). For the surgeon's tactile sensation, a good correlation was noted for the presence of a thick cortex: -4.6, 70.3 (4.2, 9.7, 15.1), or a thin one: -0.3, 65.9 (3.6, 6.9, 10.1). For dense trabecular bone, the values were -2.8, 69.4 (4.4, 9.7,14.8), while for poor trabecular bone, the values were-1.7, 66.4 (3.6, 6.4, 9.8). CONCLUSIONS Subjective assessment of bone quality is related to PTV, ISQ and placement torque measurements at implant insertion.
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Affiliation(s)
- Ghada Alsaadi
- Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Sjöström M, Sennerby L, Nilson H, Lundgren S. Reconstruction of the Atrophic Edentulous Maxilla with Free Iliac Crest Grafts and Implants: A 3-Year Report of a Prospective Clinical Study. Clin Implant Dent Relat Res 2007; 9:46-59. [PMID: 17362496 DOI: 10.1111/j.1708-8208.2007.00034.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to perform a longitudinal follow-up study of implant stability in grafted maxillae with the aid of clinical, radiological, and resonance frequency analysis (RFA) parameters. MATERIALS AND METHODS The atrophic edentulous maxillae in 29 patients were reconstructed with free iliac crest grafts using onlay/inlay or interpositional grafting techniques. The endpoint of the resorption pattern in the maxilla determined the grafting technique used. Endosteal implants were placed after 6 months of bone-graft healing. Implant stability was measured four times using RFA: when the implants were placed, after 6 to 8 months of healing, after 6 months and 3 years of bridge loading. Individual checkups were performed at the two later RFA registrations after removal of the supraconstructions (Procera Implant Bridge, Nobel Biocare AB, Göteborg, Sweden). Radiological follow up of marginal bone level was performed annually. RESULTS Twenty-five patients remained for the follow-up period. A total of 192 implants were placed and with a survival rate of 90% at the 3-year follow up. Women and an implant position with a class 6 resorption prior to reconstruction were factors with significant increased risk for implant failure (multivariate logistic regression). Twelve of the 20 failed implants were lost before loading (early failures). The change in the marginal bone level was 0.3 +/- 0.3 mm between baseline (bridge delivery) and the 3-year follow up. The implant stability quotient (ISQ) value for all implants differed significantly between abutment connection (60.2 +/- 7.3) and after 6 months of bridge loading (62.5 +/- 5.5) (Wilcoxon signed ranks test for paired data, p=.05) but were nonsignificant between 6 months of bridge loading and 3 years of bridge loading (61.8 +/- 5.5). There was a significant difference between successful and failed implants when the ISQ values were compared for individual implants at placement (Mann-Whitney U test, p=.004). All 25 patients were provided with fixed implant bridges at the time of the 3-year follow up. CONCLUSION This clinical follow up using radiological examinations and RFA measurements indicates a predictable and stable long-term result for patients with atrophic edentulous maxillae reconstructed with autogenous bone and with delayed placement of endosteal implants. The ISQ value at the time of placement can probably serve as an indicator of level of risk for implant failure.
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Affiliation(s)
- Mats Sjöström
- Department of Oral & Maxillofacial Surgery, Umeå University, Umeå, Sweden.
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Abstract
INTRODUCTION To improve patient comfort, deviations from the very successful standard osseointegration protocol are being developed. To keep implant failure rates as low as possible, the most perfect treatment planning and a good patient selection are extremely important. Because bone density plays an important role in implant outcome, known relations of bone density could improve treatment planning. MATERIAL AND METHODS A Pubmed search revealed 66 manuscripts investigating and discussing bone density of human jawbone whether or not related to implant stability or outcome. Forty-five of these will be discussed in this review. RESULTS AND DISCUSSION Many pre-operative methods of jawbone density assessment are available. Most of those techniques correlate well with one another. Some are more elaborate to use in clinical practice. Primary stability measurements show significant correlations with different bone densities and also with implant outcome; however, not many studies investigate both at the same time. CONCLUSION To investigate the outcome of adaptation methods of the surgical protocol with regard to the jawbone density, an objective pre-surgical determination of bone density is necessary.
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Affiliation(s)
- Liene Molly
- Department of Periodontology, Catholic University of Leuven, Leuven, Belgium
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Thor A, Wannfors K, Sennerby L, Rasmusson L. Reconstruction of the severely resorbed maxilla with autogenous bone, platelet-rich plasma, and implants: 1-year results of a controlled prospective 5-year study. Clin Implant Dent Relat Res 2006; 7:209-20. [PMID: 16336912 DOI: 10.1111/j.1708-8208.2005.tb00066.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prosthetic treatment of the edentulous maxilla may require bone augmentation to enable placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occur. The application of autogenous platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. PURPOSE The aim of this controlled clinical study was to evaluate whether PRP in conjunction with grafting of particulated autogenous bone to the maxilla could improve the integration and clinical function of dental implants. An additional aim was to compare block bone grafts without PRP with PRP-treated particulated bone. MATERIAL AND METHODS Nineteen consecutive patients were included in the study and treated with iliac bone grafts and dental implants in the maxilla according to a split-mouth design. In the anterior maxilla, particulated bone mixed with PRP (test) was compared with onlay block grafts without additional PRP (control). In the posterior maxilla, particulated bone grafts with (test) or without (control) PRP were placed as sinus inlay grafts. After 6 months of healing, 152 implants (8 implants/patient) (TiOblast, Astra Tech AB, Mölndal, Sweden) were placed. Test (PRP; 76 implants) and non-PRP (76 implants) sides were evaluated and compared by implant survival rate, marginal bone level, and implant stability using resonance frequency analysis (RFA) during 1 year in function. RESULTS Two control implants in control sites in two patients were lost at abutment connection. After 1 year in function, no further implants were lost, giving an overall survival rate of 98.7%. The marginal bone level measurements showed no significant differences, although there was a tendency toward less resorption on PRP sides. RFA measurements showed statistically significantly higher implant stability quotient values for PRP sites at abutment connection in the anterior but not in the posterior regions. CONCLUSIONS The present clinical study showed that a high implant survival rate and stable marginal bone conditions can be achieved after 1 year of loading in the maxilla following autogenous bone grafting whether or not PRP is used. RFA measurements revealed differences at abutment connection, which could be explained by the type of graft rather than as an effect of PRP. Although no obvious positive effects of PRP on bone graft healing could be demonstrated, the handling of the particulated bone grafts was improved.
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Affiliation(s)
- Andreas Thor
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University Hospital, Sweden.
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