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Ko YC, Koo KT, Li L, Lee D, Lee YM, Seol YJ, Kim TH, Lee J. Clinical evaluation of implants placed within or beyond the boundaries of the alveolar ridge preservation: a retrospective case series with 10 weeks of observations in 28 patients. J Periodontal Implant Sci 2024; 54:54.e19. [PMID: 39058351 DOI: 10.5051/jpis.2400800040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/12/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
PURPOSE This study investigated the effect of implant vertical positioning within alveolar ridge preservation (ARP) sites on implant stability quotient (ISQ) values, which were measured 10 weeks post-implantation. METHODS Patients who underwent ARP using collagenized deproteinized bovine bone mineral, followed by implant placement in the posterior area, were divided into 2 groups: the within-ARP group and the beyond-ARP group. In the within-ARP group, osteotomy and implant placement occurred within the ARP boundary. In contrast, in the beyond-ARP group, these procedures were performed beyond the ARP boundary, incorporating 3 mm of pristine bone at the implant's apex. Bone quality was assessed by tactile sense, and both insertion torque during implant surgery and ISQ values at 10 weeks post-implant surgery were measured. Multiple linear regression analysis and Pearson correlation analysis were used to explore the relationship between insertion torque and ISQ values. RESULTS In total, 30 ARP sites in 28 patients were analyzed. There was no significant difference in bone quality, as determined by tactile sense, between the within-ARP and beyond-ARP groups. At the time of implant placement, the beyond-ARP group exhibited a higher insertion torque (33.33±13.39 Ncm) compared to the within-ARP group (17.08±11.17 Ncm). However, the ISQ values were similar between the 2 groups 10 weeks after implant placement. A positive correlation between insertion torque and ISQ values was confirmed at 10 weeks post-implant. CONCLUSIONS The engagement of pristine bone may facilitate high insertion torque during the placement of implants in ARP sites. Nevertheless, by 10 weeks post-implantation, the ISQ values were found to be comparable, irrespective of the implant's position.
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Affiliation(s)
- Young-Chang Ko
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ling Li
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Dongseob Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Tae-Hyung Kim
- Private Practice, Kim & Lee Dental Clinic, Seoul, Korea.
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea.
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Banerjee S, Dasgupta D, Parasrampuria N, Pal D, Gandhi UV. Comparative evaluation of osseodensification drilling versus conventional drilling technique on dental implant stability: A systematic review. J Indian Prosthodont Soc 2024; 24:225-232. [PMID: 38946504 DOI: 10.4103/jips.jips_480_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
AIM The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods. SETTINGS AND DESIGN The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis. MATERIALS AND METHODS Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria. STATISTICAL ANALYSIS USED The risk of bias and quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials. RESULTS A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components. CONCLUSION The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns.
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Affiliation(s)
- Saurav Banerjee
- Department of Prosthodontics and Crown and Bridge, Dr. R. Ahmed Dental College and Hospital, West Bengal, India
| | - Dolanchanpa Dasgupta
- Department of Prosthodontics and Crown and Bridge, Kusum Devi Sunderlal Dugar Jain Dental College and Hospital, West Bengal, India
| | - Nikita Parasrampuria
- Department of Prosthodontics and Crown and Bridge, Kusum Devi Sunderlal Dugar Jain Dental College and Hospital, West Bengal, India
| | - Dipankar Pal
- Department of Dentistry, RG Kar Medical College and Hospital, West Bengal, India
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Liao Y, Xu J, Zheng Z, Fu R, Zhang X, Gan S, Yang S, Hou C, Xu HHK, Chen W. Novel Nonthermal Atmospheric Plasma Irradiation of Titanium Implants Promotes Osteogenic Effect in Osteoporotic Conditions. ACS Biomater Sci Eng 2024; 10:3255-3267. [PMID: 38684056 DOI: 10.1021/acsbiomaterials.4c00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Osteoporosis is a metabolic disease characterized by bone density and trabecular bone loss. Bone loss may affect dental implant osseointegration in patients with osteoporosis. To promote implant osseointegration in osteoporotic patients, we further used a nonthermal atmospheric plasma (NTAP) treatment device previously developed by our research group. After the titanium implant (Ti) is placed into the device, the working gas flow and the electrode switches are turned on, and the treatment is completed in 30 s. Previous studies showed that this NTAP device can remove carbon contamination from the implant surface, increase the hydroxyl groups, and improve its wettability to promote osseointegration in normal conditions. In this study, we demonstrated the tremendous osteogenic enhancement effect of NTAP-Ti in osteoporotic conditions in rats for the first time. Compared to Ti, the proliferative potential of osteoporotic bone marrow mesenchymal stem cells on NTAP-Ti increased by 180% at 1 day (P = 0.004), while their osteogenic differentiation increased by 149% at 14 days (P < 0.001). In addition, the results indicated that NTAP-Ti significantly improved osseointegration in osteoporotic rats in vivo. Compared to the Ti, the bone volume fraction (BV/TV) and trabecular number (Tb.N) values of NTAP-Ti in osteoporotic rats, respectively, increased by 18% (P < 0.001) and 25% (P = 0.007) at 6 weeks and the trabecular separation (Tb.Sp) value decreased by 26% (P = 0.02) at 6 weeks. In conclusion, this study proved a novel NTAP irradiation titanium implant that can significantly promote osseointegration in osteoporotic conditions.
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Affiliation(s)
- Yihan Liao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jia Xu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Zheng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruijie Fu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xinyuan Zhang
- Jinjiang Out-Patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuaiqi Gan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuhan Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chuping Hou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hockin H K Xu
- Biomaterials and Tissue Engineering Division, Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, Maryland 21201, United States
- Center for Stem Cell Biology and Regenerative Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, United States
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, United States
- Department of Biomaterials and Regenerative Dental Medicine, University of Maryland School of Dentistry, Baltimore, Maryland 21201, United States
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Med-X Center for Materials, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Jinjiang Out-Patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Silva-Henao JD, Schober S, Pahr DH, Reisinger AG. Critical loss of primary implant stability in osteosynthesis locking screws under cyclic overloading. Med Eng Phys 2024; 126:104143. [PMID: 38621845 DOI: 10.1016/j.medengphy.2024.104143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 04/17/2024]
Abstract
Primary implant stability, which refers to the stability of the implant during the initial healing period is a crucial factor in determining the long-term success of the implant and lays the foundation for secondary implant stability achieved through osseointegration. Factors affecting primary stability include implant design, surgical technique, and patient-specific factors like bone quality and morphology. In vivo, the cyclic nature of anatomical loading puts osteosynthesis locking screws under dynamic loads, which can lead to the formation of micro cracks and defects that slowly degrade the mechanical connection between the bone and screw, thus compromising the initial stability and secondary stability of the implant. Monotonic quasi-static loading used for testing the holding capacity of implanted screws is not well suited to capture this behavior since it cannot capture the progressive deterioration of peri‑implant bone at small displacements. In order to address this issue, this study aims to determine a critical point of loss of primary implant stability in osteosynthesis locking screws under cyclic overloading by investigating the evolution of damage, dissipated energy, and permanent deformation. A custom-made test setup was used to test implanted 2.5 mm locking screws under cyclic overloading test. For each loading cycle, maximum forces and displacement were recorded as well as initial and final cycle displacements and used to calculate damage and energy dissipation evolution. The results of this study demonstrate that for axial, shear, and mixed loading significant damage and energy dissipation can be observed at approximately 20 % of the failure force. Additionally, at this load level, permanent deformations on the screw-bone interface were found to be in the range of 50 to 150 mm which promotes osseointegration and secondary implant stability. This research can assist surgeons in making informed preoperative decisions by providing a better understanding of the critical point of loss of primary implant stability, thus improving the long-term success of the implant and overall patient satisfaction.
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Affiliation(s)
- Juan D Silva-Henao
- Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-strae 30, 3500, Krems, Austria; Institute of Lightweight Design and Structural Biomechanics, Technische Universität Wien, Vienna, Austria.
| | - Sophie Schober
- Institute of Science and Technology Austria (ISTA), Am Campus 1, 3400 Klosterneuburg, Austria
| | - Dieter H Pahr
- Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-strae 30, 3500, Krems, Austria; Institute of Lightweight Design and Structural Biomechanics, Technische Universität Wien, Vienna, Austria
| | - Andreas G Reisinger
- Karl Landsteiner University of Health Sciences, Department of Anatomy and Biomechanics, Division Biomechanics, Dr. Karl-Dorrek-strae 30, 3500, Krems, Austria; Institute of Lightweight Design and Structural Biomechanics, Technische Universität Wien, Vienna, Austria
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5
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Báskay J, Pénzes D, Kontsek E, Pesti A, Kiss A, Guimarães Carvalho BK, Szócska M, Szabó BT, Dobó-Nagy C, Csete D, Mócsai A, Németh O, Pollner P, Mijiritsky E, Kivovics M. Are Artificial Intelligence-Assisted Three-Dimensional Histological Reconstructions Reliable for the Assessment of Trabecular Microarchitecture? J Clin Med 2024; 13:1106. [PMID: 38398417 PMCID: PMC10889719 DOI: 10.3390/jcm13041106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Objectives: This study aimed to create a three-dimensional histological reconstruction through the AI-assisted classification of tissues and the alignment of serial sections. The secondary aim was to evaluate if the novel technique for histological reconstruction accurately replicated the trabecular microarchitecture of bone. This was performed by conducting micromorphometric measurements on the reconstruction and comparing the results obtained with those of microCT reconstructions. Methods: A bone biopsy sample was harvested upon re-entry following sinus floor augmentation. Following microCT scanning and histological processing, a modified version of the U-Net architecture was trained to categorize tissues on the sections. Detector-free local feature matching with transformers was used to create the histological reconstruction. The micromorphometric parameters were calculated using Bruker's CTAn software (version 1.18.8.0, Bruker, Kontich, Belgium) for both histological and microCT datasets. Results: Correlation coefficients calculated between the micromorphometric parameters measured on the microCT and histological reconstruction suggest a strong linear relationship between the two with p-values of 0.777, 0.717, 0.705, 0.666, and 0.687 for BV/TV, BS/TV, Tb.Pf Tb.Th, and Tb.Sp, respectively. Bland-Altman and mountain plots suggest good agreement between BV/TV measurements on the two reconstruction methods. Conclusions: This novel method for three-dimensional histological reconstruction provides researchers with a tool that enables the assessment of accurate trabecular microarchitecture and histological information simultaneously.
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Affiliation(s)
- János Báskay
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Dorottya Pénzes
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Endre Kontsek
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - Adrián Pesti
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | - András Kiss
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Üllői út 93, 1091 Budapest, Hungary; (E.K.); (A.P.); (A.K.)
| | | | - Miklós Szócska
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi Utca 47, 1088 Budapest, Hungary; (B.T.S.); (C.D.-N.)
| | - Dániel Csete
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Attila Mócsai
- Department of Physiology, Semmelweis University, Tűzoltó u. 34-37, 1094 Budapest, Hungary; (D.C.); (A.M.)
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
| | - Péter Pollner
- Data-Driven Health Division of National Laboratory for Health Security, Health Services Management Training Centre, Semmelweis University, Kútvölgyi út 2, 1125 Budapest, Hungary; (J.B.); (M.S.); (P.P.)
- Department of Biological Physics, Eötvös Loránd University, Pázmány Péter Sétány 1/a, 1117 Budapest, Hungary
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel;
- Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi Utca 40, 1088 Budapest, Hungary; (D.P.); (B.K.G.C.); (O.N.)
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Antonelli A, Barone S, Attanasio F, Salviati M, Cerra MG, Calabria E, Bennardo F, Giudice A. Effect of Implant Macro-Design and Magnetodynamic Surgical Preparation on Primary Implant Stability: An In Vitro Investigation. Dent J (Basel) 2023; 11:227. [PMID: 37886912 PMCID: PMC10605303 DOI: 10.3390/dj11100227] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques in low-density bone. The parameters examined included peak insertion torque (PIT), implant stability quotient (ISQ), and peak removal torque (PRT). METHODS Four groups of 34 implants each were identified in accordance with the surgery and implant shape: T5 group (Five implant and osteotomy using drills); M5 group (Five implant and magnetodynamic osteotomy using Magnetic Mallet); TT group (TiSmart implant and osteotomy with drills); and MT group (TiSmart implant and magnetodynamic osteotomy). Every implant was placed into a low-density bone animal model and scanned using CBCT. The PIT and PRT were digitally measured in Newton-centimeters (Ncm) using a torque gauge device. The ISQ was analyzed by conducting resonance frequency analysis. RESULTS The PIT values were 25.04 ± 4.4 Ncm for T5, 30.62 ± 3.81 Ncm for M5, 30 ± 3.74 Ncm for TT, and 32.05 ± 3.55 Ncm for MT. The average ISQ values were 68.11 ± 3.86 for T5, 71.41 ± 3.69 for M5, 70.88 ± 3.08 for TT, and 73 ± 3.5 for MT. The PRT values were 16.47 ± 4.56 Ncm for T5, 26.02 ± 4.03 Ncm for M5, 23.91 ± 3.28 Ncm for TT, and 26.93 ± 3.96 Ncm for MT. Based on our data analysis using a t-test with α = 0.05, significant differences in PIT were observed between TT and T5 (p < 0.0001), M5 and T5 (p < 0.0001), and MT and TT (p = 0.02). Significant differences in the ISQ were found between TT and T5 (p = 0.001), M5 and T5 (p < 0.001), and MT and TT (p = 0.01). The PRT also exhibited significant differences between TT and T5, M5 and T5, and MT and TT (p < 0.0001). CONCLUSION Our data showed favorable primary implant stability (PS) values for both implant macro-geometries. Furthermore, the magnetodynamic preparation technique appears to be more effective in achieving higher PS values in low-density bone.
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Affiliation(s)
| | | | | | | | | | | | - Francesco Bennardo
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy; (A.A.); (S.B.); (F.A.); (M.S.); (M.G.C.); (E.C.); (A.G.)
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Khorshid HE, Issa NO, Ekram AM. Effect of implant diameter and cantilever length on the marginal bone height changes and stability of implants supporting screw retained prostheses: A randomized double blinded control trial. J Adv Prosthodont 2023; 15:101-113. [PMID: 37441715 PMCID: PMC10333100 DOI: 10.4047/jap.2023.15.3.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/11/2023] [Accepted: 04/16/2023] [Indexed: 07/15/2023] Open
Abstract
PURPOSE This randomized controlled trial aimed to evaluate the effect of implants' two different diameters and cantilever lengths on the marginal bone loss and stability of mplants supporting maxillary prostheses. MATERIALS AND METHODS Ninety-six implants were placed in sixteen completely edentulous maxillary ridges. Patients were randomly divided into two groups: Group A, implants were placed with a cantilever to anterior-posterior AP spread length (CL:AP) at a ratio of 1:3; Group B, implants were placed with a CL:AP at a ratio of 1:2. Patients were further divided into four sub-groups: Groups A1, A2, B1, and B2. Groups A1 and B1 received small diameter implants while Groups A2 and B2 received standard diameter implants. Bone height and stability measurements around each implant were performed at 0, 4, 8 and 24 months after definitive prostheses delivery. RESULTS Statistical analysis of the mean implant stability and height values revealed an insignificant difference between Group A1 and Group A2 at all the different time intervals while significantly higher values in Group B1 in comparison with Group B2. Results also showed significantly higher values in Group A1 in comparison with Group B1 and an insignificant difference between Group A2 and Group B2 at all the different time intervals. CONCLUSION It can be concluded that the use of small diameter implants placed with a CL:AP at a ratio of 1:3 provided predictable results and that the 1:2 CL:AP significantly induced more critical bone loss in the small diameter implants group, which can significantly reduce long term success and survival of implants.
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Affiliation(s)
| | - Noha Ossama Issa
- Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Amr Mohamed Ekram
- Oral and Maxillofacial Surgery Consultant, Private practice, Cairo, Egypt
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8
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Brancacci E, García González S, Galve-Huertas A, Bennani A, Hernández Alfaro F, Aboul-Hosn Centenero S. Influence of Insertion Torques on the Surface Integrity in Different Dental Implants: An Ex Vivo Descriptive Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16062330. [PMID: 36984210 PMCID: PMC10058042 DOI: 10.3390/ma16062330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND The primary objective of this ex vivo study was to assess the influence of increasing insertion torques on three types of dental implants and possible alterations of their microgeometry after the application of three different torque intensities. METHODS 27 implants of 3 different implant brands (Groups A, B and C) were placed in cow ribs using 30 Ncm, 45 Ncm and 55 Ncm insertion torques. The implants were subsequently removed using trephine burs, and SEM analysis was carried out in order to detect implant surface and connection changes, as compared to the implant controls. RESULTS Surface deformations were predominantly observed on the third apical part of the implants. The alterations presented with increasing insertion torques, with 45 Ncm being the threshold value. Prosthetic connections were also compromised. CONCLUSIONS The changes sustained by the implants were proportional to the insertion torque they were subjected to; 45 Ncm and greater insertion torques resulted in more consistent damage, both on the implant surface and the implant connection.
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Affiliation(s)
- Erika Brancacci
- Department of Oral & Maxillofacial Surgery, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vàlles, Spain
- Correspondence:
| | - Susana García González
- Department of Oral & Maxillofacial Surgery, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vàlles, Spain
| | - Andrea Galve-Huertas
- Department of Oral & Maxillofacial Surgery, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vàlles, Spain
| | - Aida Bennani
- Department of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Federico Hernández Alfaro
- Department of Oral & Maxillofacial Surgery, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vàlles, Spain
| | - Samir Aboul-Hosn Centenero
- Department of Oral & Maxillofacial Surgery, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vàlles, Spain
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9
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Goyushov S, Asar NV, Tözüm TF. Assessment of Radiodensity at Mandibular Periapical Bone Sites using Three-Dimensional Cone-Beam Computed Tomography. J Oral Maxillofac Res 2023; 14:e2. [PMID: 37180408 PMCID: PMC10170661 DOI: 10.5037/jomr.2023.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/24/2023] [Indexed: 05/16/2023]
Abstract
Objectives The aims of this retrospective study were to objectively assess bone density values obtained by cone-beam computed tomography and to map the periapical and inter-radicular regions of the mandibular bone. Material and Methods In total, periapical bone regions of 6898 roots scanned by cone-beam computed tomography were evaluated retrospectively, and the results were recorded using Hounsfield units (HU). Results The correlation between periapical HU values of adjacent mandibular teeth were strongly positive (P ˂ 0.01). The anterior region of the mandible yielded highest mean HU value (633.55). The mean periapical HU value of the premolar region (470.58) was higher than that was measured for molar region (374.58). The difference between furcation HU values of the first and second molars was unnoticeable. Conclusions The results of this study have tried to evaluate the periapical regions of all mandibular teeth, which could ease to predict the bone radiodensity before implant surgery. Even though the Hounsfield units provide the average radio-bone density, a site-specific bone tissue evaluation of each case is essential for appropriate cone-beam computed tomography preoperative planning.
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Affiliation(s)
- Samir Goyushov
- Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, IstanbulTurkey
| | - Neset Volkan Asar
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, AnkaraTurkey
| | - Tolga Fikret Tözüm
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IllinoisUSA
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10
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Zhou LP, Shang J, Zhang ZG, Jiang ZF, Zhang HQ, Jia CY, Zhang RJ, Shen CL. Characteristics and Comparisons of Morphometric Measurements and Computed Tomography Hounsfield Unit Values of C2 Laminae for Translaminar Screw Placement Between Patients With and Without Basilar Invagination. Neurospine 2022; 19:899-911. [PMID: 36597627 PMCID: PMC9816593 DOI: 10.14245/ns.2244730.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/24/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Patients with basilar invagination (BI) had high incidences of vertebral variations and high-riding vertebral artery (HRVA) that might restrict the use of pedicle or pars screw and increase the use of translaminar screw on axis. Here, we conducted a radiographic study to investigate the feasibility of translaminar screws and the bone quality of C2 laminae in patients with BI, which were compared with those without BI as control to provide guidelines for safe placement. METHODS In this study, a total of 410 patients (205 consecutive patients with BI and 205 matched patients without BI) and 820 unilateral laminae of the axis were included at a 1:1 ratio. Comparisons with regard to insertion parameters (laminar length, thickness, angle, and height) for C2 translaminar screw placement and Hounsfield unit (HU) values for the assessment of the appropriate bone mineral density of C2 laminae between BI and control groups were performed. Besides, the subgroup analyses based on the Goel A and B classification of BI, HRVA, atlas occipitalization, and C2/3 assimilation were also carried out. Furthermore, the factors that might affect the insertion parameters and HU values were explored through multiple linear regression analyses. RESULTS The BI group showed a significantly smaller laminar length, thickness, height, and HU value than the control group, whereas no significant difference was observed regarding the laminar angle. By contrast, the control group showed significantly higher rates of acceptability for unilateral and bilateral translaminar screw fixations than the BI group. Subgroup analyses showed that the classification of Goel A and B, HRVA, atlas occipitalization, and C2/3 assimilation affected the insertion parameters except the HU values. Multiple linear regression indicated that the laminar length was significantly associated with the male gender (B = 0.190, p < 0.001), diagnoses of HRVA (B = -0.109, p < 0.001), Goel A (B = -0.167, p < 0.001), and C2/3 assimilation (B = -0.079, p = 0.029); the laminar thickness was significantly associated with the male gender (B = 0.353, p < 0.001), diagnoses of HRVA (B = -0.430, p < 0.001), Goel B (B = -0.249, p = 0.026), and distance from the top of odontoid to the Chamberlain line (B = -0.025, p = 0.003); laminar HU values were significantly associated with age (B = -2.517, p < 0.001), Goel A (B = -44.205, p < 0.001), Goel B (B = -25.704, p = 0.014), and laminar thickness (B = -11.706, p = 0.001). CONCLUSION Patients with BI had narrower and smaller laminae with lower HU values and lower unilateral and bilateral acceptability for translaminar screws than patients without BI. Preoperative 3-dimensional computed tomography (CT) and CT angiography were needed for BI patients.
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Affiliation(s)
- Lu-Ping Zhou
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jin Shang
- Department of Radiology, the First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Zhi-Gang Zhang
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhen-Fei Jiang
- Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China
| | - Hua-Qing Zhang
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chong-Yu Jia
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ren-Jie Zhang
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China,Co-corresponding Author Ren-Jie Zhang Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China
| | - Cai-Liang Shen
- Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China,Corresponding Author Cai-Liang Shen Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui 230022, China
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11
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Raz P, Meir H, Levartovsky S, Sebaoun A, Beitlitum I. Primary Implant Stability Analysis of Different Dental Implant Connections and Designs-An In Vitro Comparative Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3072. [PMID: 35591407 PMCID: PMC9104754 DOI: 10.3390/ma15093072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023]
Abstract
Primary implant stability can be evaluated at the time of placement by measuring the insertion torque (IT). However, another method to monitor implant stability over time is resonance frequency analysis (RFA). Our aim was to examine the effect of bone type, implant design, and implant length on implant primary stability as measured by IT and two RFA devices (Osstell and Penguin) in an in vitro model. Ninety-six implants were inserted by a surgical motor in an artificial bone material, resembling soft and dense bone. Two different implant designs-conical connection (CC) and internal hex (IH), with lengths of 13 and 8 mm, were compared. The results indicate that the primary stability as measured by RFA and IT is significantly increased by the quality of bone (dense bone), and implant length and design, where the influence of dense bone is similar to that of CC design. Both the Osstell and Penguin devices recorded higher primary implant stability for long implants in dense bone, favoring the CC over the IH implant design. The CC implant design may compensate for the low stability expected in soft bone, and dense bone may compensate for short implant length if required by the anatomical bone conditions.
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Affiliation(s)
- Perry Raz
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (H.M.); (A.S.); (I.B.)
| | - Haya Meir
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (H.M.); (A.S.); (I.B.)
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel;
| | - Alon Sebaoun
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (H.M.); (A.S.); (I.B.)
| | - Ilan Beitlitum
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (H.M.); (A.S.); (I.B.)
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12
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Heitzer M, Kniha K, Katz MS, Winnand P, Peters F, Möhlhenrich SC, Hölzle F, Modabber A. The primary stability of two dental implant systems in low-density bone. Int J Oral Maxillofac Surg 2022; 51:1093-1100. [PMID: 35339332 DOI: 10.1016/j.ijom.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Abstract
Primary stability in low-density bone is crucial for the long-term success of implants. Tapered implants have shown particularly favourable properties under such conditions. The aim of this study was to compare the primary stability of tapered titanium and novel cylindrical zirconia dental implant systems in low-density bone. Fifty implants (25 tapered, 25 cylindrical) were placed in the anterior maxillary bone of cadavers meeting the criteria of low-density bone. The maximum insertion (ITV) and removal (RTV) torque values were recorded, and the implant stability quotients (ISQ) determined. To establish the isolated influence of cancellous bone on primary stability, the implantation procedure was performed in standardized low-density polyurethane foam bone blocks (cancellous bone model) using the same procedure. The primary stability parameters of both implant types showed significant positive correlations with bone density (Hounsfield units) and cortical thickness. In the cadaver, the cylindrical zirconia implants showed a significantly higher mean ISQ when compared to the tapered titanium implants (50.58 vs 37.26; P < 0.001). Pearson analysis showed significant positive correlations between ITV and ISQ (P = 0.016) and between RTV and ISQ (P = 0.035) for the cylindrical zirconia implants; no such correlations were observed for the tapered titanium implants. Within the limitations of this study, the results indicate that cylindrical zirconia implants represent a comparable viable treatment option to tapered titanium implants in terms of primary implant stability in low-density human bone.
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Affiliation(s)
- M Heitzer
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
| | - K Kniha
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - M S Katz
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - P Winnand
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - F Peters
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - F Hölzle
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - A Modabber
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
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13
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Magat G, Oncu E, Ozcan S, Orhan K. Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis. J Korean Assoc Oral Maxillofac Surg 2022; 48:41-49. [PMID: 35221306 PMCID: PMC8890962 DOI: 10.5125/jkaoms.2022.48.1.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative. Materials and Methods In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants. Results There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05). Conclusion The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.
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Affiliation(s)
- Guldane Magat
- Department of Oral and Maxillofacial Radiology, Konya, Turkey
| | - Elif Oncu
- Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Sevgi Ozcan
- Department of Oral and Maxillofacial Radiology, Konya, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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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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15
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Dekker H, Schulten EAJM, Ten Bruggenkate CM, Bloemena E, van Ruijven LJ, Bravenboer N. Regional differences in microarchitecture and mineralization of the atrophic edentulous mandible: A microcomputed tomography study. Arch Oral Biol 2021; 133:105302. [PMID: 34773733 DOI: 10.1016/j.archoralbio.2021.105302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 10/15/2021] [Accepted: 10/28/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The aim of the present study was to assess mineralization and trabecular microarchitecture in atrophic edentulous mandibles and to identify regional differences and relations with the extent of resorption. METHODS Cortical and trabecular bone volumes in anterior, premolar and molar regions of 10 edentulous cadaveric mandibles (5 males and 5 females; mean age ± SD: 85.4 ± 8.3 years) were assessed by microcomputed tomography. Mandibular height and Cawood & Howell classes were recorded. Concerning trabecular volumes, bone mineral density (BMD), bone volume fraction, trabecular tissue volume fraction, connectivity density, trabecular number, trabecular thickness, trabecular separation, degree of anisotropy, and structural model index were measured; concerning cortical volumes porosity, BMD and cortical thickness were measured. RESULTS In molar regions, the bone volume fraction and trabecular number were lower, whereas trabecular separation, degree of anisotropy and cortical BMD were higher compared to anterior regions. In premolar regions, mandibular height correlated negatively with trabecular number (Spearman's correlation r = 0.73, p = 0.017) and connectivity density (Spearman's correlation r = 0.82, p = 0.004), and correlated positively with trabecular separation (Spearman's correlation r = - 0.65, p = 0.04). Cortical BMD was higher at bucco-inferior cortex of molar and inferior border of premolar region and lower at anterior cranial buccal and lingual surface. CONCLUSIONS In the premolar region, increased resorption coincides with local impairment of trabecular bone quality. Cortical bone BMD is higher in areas with highest strains and lower in areas with most mandibular resorption. Trabecular bone volume and quality is superior in the anterior region of the edentulous mandible, which might explain improved primary stability of dental implants in this region.
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Affiliation(s)
- Hannah Dekker
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Engelbert A J M Schulten
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Christiaan M Ten Bruggenkate
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Leo J van Ruijven
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Nathalie Bravenboer
- Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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16
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Can the Bone Density Estimated by CBCT Predict the Primary Stability of Dental Implants? A New Measurement Protocol. J Craniofac Surg 2021; 32:e171-e174. [PMID: 33705063 DOI: 10.1097/scs.0000000000006991] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The use of dental implants to restore edentulous parts of the jaws is a common and well-documented treatment method. Effective dental implant treatment is known to be affected by both the quality and the quantity of bone required for implant placement, bone quality is a critical factor to consider when predicting stability of implants. Thus, stability of the initial implant and the possibility of early loading could be predicated using cone-beam computed tomography (CBCT) scans and primary stability parameters before implant placement. OBJECTIVES The aim of this study was to objectively assess bone density obtained by CBCT and the correlations with primary stability of dental implants using implant stability meter IST device. METHODS A total of 40 implants were placed in 16 patients (9 males and 7 females with a range of 22 to 61 years (mean age 40.44 ± 12.3 years). The bone densities of implant recipient sites were preoperatively recorded using CBCT. The maximum insertion torque value of each implant was measured by engine during implant placement and compared to the primary stability for every implant using implant stability meter device (IST). RESULTS A statistically significant correlation was found between bone density value from CBCT with the primary implant stability and insertion torque. CONCLUSION Although the small samples size, the study shown bone density assessment using CBCT is an efficient method and significantly correlated with primary stability using implant stability meter device IST and insertion torque.
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17
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Oliveira MR, Gonçalves A, Gabrielli MAC, de Andrade CR, Scardueli CR, Pereira Filho VA. The correlation of different methods for the assessment of bone quality in vivo: an observational study. Int J Oral Maxillofac Surg 2021; 51:388-397. [PMID: 34127353 DOI: 10.1016/j.ijom.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
Different methods for the assessment of bone quality were evaluated in this study. Sixty alveolar bone areas were investigated. Peri-apical and panoramic radiographs were obtained with an aluminium scale to assess optical density. The Lekholm and Zarb (L&Z) classification was determined through radiographic analysis and the surgeon's tactile perception. A trephine was used to obtain a bone biopsy for assessment by micro-computed tomography (micro-CT) and histomorphometry. Primary stability of the implants was assessed using insertion torque (IT) and the implant stability quotient (ISQ). The optical density on peri-apical radiographs was correlated with IT, ISQ, and micro-CT (BV, BV/BT, Tb.Th, Tb.N, BS/BV, Tb.Pf, and SMI) (rho ≤ 0.471, P ≤ 0.028). Panoramic radiography showed a correlation only with bone surface (BS) and bone surface/volume ratio (BS/TV) (rho ≤ 0.290, P ≤ 0.031). IT showed a correlation with ISQ, histometry, and micro-CT (BV, BS/TV, Tb.Th, Tb.N, BS/BV, Tb.Pf, Tb.Sp, BV/BT) (rho ≤ 0.550, P ≤ 0.022). ISQ did not show any correlation with micro-CT. The L&Z classification showed correlations with the optical density obtained in the peri-apical radiographs, histometry, osteocyte count, IT, and micro-CT (BS/BV, Tb.Sp, Tb.Pf, BV, BS/TV, Tb.Th, Tb.N) (rho ≤ 0.344, P ≤ 0.042). The L&Z bone classification and IT are reliable methods, peri-apical radiographs and ISQ are acceptable, and panoramic radiography is not a reliable method for the assessment of bone quality.
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Affiliation(s)
- M R Oliveira
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - A Gonçalves
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - M A C Gabrielli
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - C R de Andrade
- Department of Pathology and Physiology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - C R Scardueli
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
| | - V A Pereira Filho
- Department of Diagnosis and Surgery, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, SP, Brazil.
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18
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Costa ALF, de Souza Carreira B, Fardim KAC, Nussi AD, da Silva Lima VC, Miguel MMV, Jardini MAN, Santamaria MP, de Castro Lopes SLP. Texture analysis of cone beam computed tomography images reveals dental implant stability. Int J Oral Maxillofac Surg 2021; 50:1609-1616. [PMID: 33962826 DOI: 10.1016/j.ijom.2021.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 02/10/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to characterize the alveolar bone of edentulous maxillary sites using texture analysis (TA) of cone beam computed tomography (CBCT) images and to correlate the results to the insertion torque, thus verifying whether TA is a predictive tool of final implant treatment. This study was conducted on patients who had received single implants in the maxilla (46 implants) 1year earlier and whose torque values were properly recorded. Three cross-sections of the sites were selected on CBCT scans. Two regions of interest (ROIs) corresponding to the implant bone site and peri-implant bone were also outlined, according to virtual planning. The CBCT scans were exported to MaZda software, where the two ROIs were delimited following the previously demarcated contours. Values for the co-occurrence matrix were calculated for TA. With regard to the insertion torque value, there was a direct correlation with the contrast of the peri-implant bone (P<0.001) and an inverse correlation with the entropy of the implant bone site (P=0.006). A greater contrast indicates a greater torque value for insertion of the implants, and there is a possible association with a lower entropy value of the implant-bone interface.
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Affiliation(s)
- A L F Costa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, Brazil.
| | - B de Souza Carreira
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - K A C Fardim
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - A D Nussi
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, Brazil
| | - V C da Silva Lima
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - M M V Miguel
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - M A N Jardini
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - M P Santamaria
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - S L P de Castro Lopes
- Department of Diagnosis and Surgery, São José dos Campos School of Dentistry, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
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19
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Hounsfield Unit for Assessing Vertebral Bone Quality and Asymmetrical Vertebral Degeneration in Degenerative Lumbar Scoliosis. Spine (Phila Pa 1976) 2020; 45:1559-1566. [PMID: 32756284 DOI: 10.1097/brs.0000000000003639] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective analysis. OBJECTIVES The aim of this study was to demonstrate the correlation between degenerative lumbar scoliosis (DLS) and osteoporosis based on Hounsfield unit (HU) measurement from computed tomography (CT) scans, and to investigate the asymmetrical vertebral degeneration in DLS. SUMMARY OF BACKGROUND DATA The correlation between DLS and osteoporosis measured by dual-energy x-ray absorptiometry (DEXA) is debated, since T-scores measured by DEXA scan can be overestimated due to abdominal vessel wall calcification, degenerative bony spurs, and facet hypertrophy. The reliability and accuracy of HU to determine osteoporosis are shown in many reports, but it has never been used to assess the vertebral bone quality for DLS patients. METHODS Nighty-five DLS patients were retrospectively reviewed. Regions of interest for HU were measured on three coronal images of the lumbar vertebrae. HU measurement of the whole vertebrae from L1 to L5 was obtained, then HU measurement within concave and convex sides were obtained separately in L5, upper and lower end vertebrae, apex vertebrae, neutral vertebrae, stable vertebrae. RESULTS HU value presented a gradually increasing trend from L1 to L5. No correlation was detected between Cobb angle and mean HU value of the 5 lumbar vertebrae, or between Cobb angle and HU value of every lumbar vertebrae separately. HU value was higher within concavity than that within convexity of the same vertebrae both in major and compensatory curve. Asymmetric HU ratio in apex vertebrae positively correlated with Cobb angle. Stable vertebrae were the first proximal vertebrae that present opposite orientation of asymmetric HU ratio from the other lumbar vertebrae. CONCLUSION Progression of degenerative scoliosis presents no correlation with osteoporosis based on HU measurement but could increase the asymmetrical vertebral degeneration, especially in apex vertebrae. Distraction of the pedicle screws at concave side, instead of compression of pedicle screws at convex side, should be a priority to correct lumbosacral curve. LEVEL OF EVIDENCE 3.
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Zhou Y, Gong C, Hossaini-Zadeh M, Du J. 3D full-field strain in bone-implant and bone-tooth constructs and their morphological influential factors. J Mech Behav Biomed Mater 2020; 110:103858. [PMID: 32501222 DOI: 10.1016/j.jmbbm.2020.103858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/08/2020] [Accepted: 05/10/2020] [Indexed: 01/20/2023]
Abstract
The biomechanics of bone-tooth and bone-implant interfaces affects the outcomes of several dental treatments, such as implant placement, because bone, tooth and periodontal ligament are living tissues that adapt to the changes in mechanical stimulations. In this work, mechanical testing coupled with micro-CT was performed on human cadaveric mandibular bone-tooth and bone-implant constructs. Using digital volume correlation, the 3D full-field strain in bone under implant loading and tooth loading was measured. Concurrently, bone morphology and bone-implant and bone-tooth contact were also measured through the analysis of micro-CT images. The results show that strain in bone increased when a tooth was replaced by a dental implant. Strain concentration was observed in peri-implant bone, as well as in the buccal bone plate, which is also the clinically-observed bone resorption area after implant placement. Decreasing implant stability measurements (resonance frequency analysis and torque test) indicated increased peri-implant strain, but their relationships may not be linear. Peri-implant bone strain linearly increased with decreasing bone-implant contact (BIC) ratio. It also linearly decreased with increasing bone-tooth/bone-implant contact ratio. The high strain in the buccal bone plate linearly increased with decreasing buccal bone plate thickness. The results of this study revealed 3D full-field strain in bone-tooth and bone-implant constructs, as well as their several morphological influential factors.
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Affiliation(s)
- Yuxiao Zhou
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
| | - Chujie Gong
- Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
| | - Mehran Hossaini-Zadeh
- Department of Oral Maxillofacial Pathology, Medicine and Surgery, Temple University, Philadelphia, PA, 19140, United States.
| | - Jing Du
- Department of Mechanical Engineering, Pennsylvania State University, University Park, PA, 16802, United States.
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de Carvalho Silva Leocádio A, Silva Júnior M, José Pimentel Lopes de Oliveira G, da Col Santos Pinto G, Silveira Faeda R, Marques Padovan LE, Marcantonio Júnior É. Evaluation of Implants with Different Macrostructures in Type I Bone-Pre-Clinical Study in Rabbits. MATERIALS 2020; 13:ma13071521. [PMID: 32224982 PMCID: PMC7178163 DOI: 10.3390/ma13071521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/13/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022]
Abstract
The objective of this study was to assess the primary stability and the osseointegration process in implants with different macrostructures (Cylindrical vs. Hybrid Conical) in rabbit tibiae. Twenty-four (24) rabbits were used, divided into 3 experimental periods (2, 4 and 8 weeks) with 8 animals each. Each animal bilaterally received 2 implants from each group in the tibial metaphysis: Cylindrical Implant (CI) and Hybrid Conical Implant (HCI). All implants were assessed for insertion torque. After the experimental periods, one of the implants in each group was submitted to the removal counter-torque test and descriptive histological analysis while the other implant was used for microtomographic and histometric analysis (%Bone-Implant Contact). HCI implants showed higher insertion torque (32.93 ± 10.61 Ncm vs. 27.99 ± 7.80 Ncm) and higher % of bone-implant contact in the 8-week period (79.08 ± 11.31% vs. 59.72 ± 11.29%) than CI implants. However, CI implants showed higher values of removal counter-torque than HCI implants in the 8-week period (91.05 ± 9.32 Ncm vs. 68.62 ± 13.70 Ncm). There were no differences between groups regarding microtomographic data. It can be concluded that HCI implants showed greater insertion torque and bone-implant contact in relation to CI implants in the period of 8 weeks when installed in cortical bone of rabbits.
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Affiliation(s)
- Amanda de Carvalho Silva Leocádio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
- Correspondence: (A.d.C.S.L.); (É.M.J.); Tel.: +55-(35)-99138-5571 (A.d.C.S.L.); +55-(16)-33016378 (É.M.J.)
| | - Matusalém Silva Júnior
- Post Graduation Course in Implantology, Latin American Institute of Dental Research (ILAPEO), Curitiba 80710-150, Brazil; (M.S.J.); (L.E.M.P.)
| | | | - Gustavo da Col Santos Pinto
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
| | - Rafael Silveira Faeda
- Post Graduation Course in Odontology, University of Araraquara/UNIARA, Araraquara 14801-320, Brazil;
| | - Luis Eduardo Marques Padovan
- Post Graduation Course in Implantology, Latin American Institute of Dental Research (ILAPEO), Curitiba 80710-150, Brazil; (M.S.J.); (L.E.M.P.)
| | - Élcio Marcantonio Júnior
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Sao Paulo State University (UNESP), Araraquara 14801-385, Brazil;
- Correspondence: (A.d.C.S.L.); (É.M.J.); Tel.: +55-(35)-99138-5571 (A.d.C.S.L.); +55-(16)-33016378 (É.M.J.)
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Turkyilmaz I, Tozum T. Enhancing primary implant stability by undersizing implant site preparation: A human cadaver study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:58-62. [DOI: 10.1016/j.jormas.2019.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/24/2022]
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Ikeura A, Kushida T, Oe K, Kotani Y, Ando M, Adachi T, Saito T. Correlation between the Computed Tomography Values of the Screw Path and Pedicle Screw Pullout Strength: An Experimental Study in Porcine Vertebrae. Asian Spine J 2020; 14:265-272. [PMID: 31906614 PMCID: PMC7280915 DOI: 10.31616/asj.2019.0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022] Open
Abstract
Study Design Biomechanical study. Purpose To assess the correlation between the computed tomography (CT) values of the pedicle screw path and screw pull-out strength. Overview of Literature The correlation between pedicle screw pull-out strength and bone mineral density has been well established. In addition, several reports have demonstrated a correlation between bone mineral density and CT values. However, no previous biomechanical studies investigated the correlation between CT values and pedicle screw pull-out strength. Methods Sixty fresh-frozen lumbar vertebrae from 6-month-old pigs were used. Before screw insertion, the CT values of the screw path were obtained for each sample. Specimens were then randomly divided into three equal groups. Each group had one of three pedicle screws inserted: 4.0-mm LEGACY (4.0-LEG), 4.5-mm LEGACY (4.5-LEG), or 4.5-mm SOLERA (4.5-SOL) (all from Medtronic Sofamor Danek Inc., Memphis, TN, USA). Each screw had a consistent 30-mm thread length. Axial pull-out testing was performed at a rate of 1.0 mm/min. Correlations between the CT values and pedicle screw pull-out strength were evaluated using Pearson’s correlation coefficient analysis. Results The correlation coefficients between the CT values of the screw path and pedicle screw pull-out strength for the 4.0-LEG, 4.5-LEG, and 4.5-SOL groups were 0.836 (p<0.001), 0.780 (p<0.001), and 0.873 (p<0.001), respectively. Greater CT values were associated with greater screw pull-out strength. Conclusions The CT values of the screw path were strongly positively correlated with pedicle screw pull-out strength, regardless of the screw type and diameter, suggesting that the CT values could be clinically useful for predicting pedicle screw pull-out strength.
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Affiliation(s)
- Atsushi Ikeura
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
| | - Taketoshi Kushida
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
| | - Kenichi Oe
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
| | - Yoshihisa Kotani
- Department of Orthopaedic Surgery, Kansai Medical University Medical Center, Moriguchi, Japan
| | - Muneharu Ando
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
| | - Takashi Adachi
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
| | - Takanori Saito
- Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Japan
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Prediction of insertion torque and stiffness of a dental implant in bovine trabecular bone using explicit micro-finite element analysis. J Mech Behav Biomed Mater 2019; 98:301-310. [DOI: 10.1016/j.jmbbm.2019.06.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/21/2019] [Accepted: 06/26/2019] [Indexed: 01/01/2023]
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25
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Chmielewski K, Ryncarz W, Yüksel O, Goncalves P, Baek KW, Cok S, Dard M. Image analysis of immediate full-arch prosthetic rehabilitations guided by a digital workflow: assessment of the discrepancy between planning and execution. Int J Implant Dent 2019; 5:26. [PMID: 31304566 PMCID: PMC6626765 DOI: 10.1186/s40729-019-0179-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 06/17/2019] [Indexed: 11/18/2022] Open
Abstract
Background A dentition with adequate function and esthetics is essential for the well-being and quality of life. A full implant-retained fixed prosthetics is an ideal solution for fully edentulous arch, however requires complex planning, surgical, and prosthetic procedure. With the help of digital workflow, it becomes a predictable and fast solution for the dentists and the patients. This retrospective study analyzed the most advanced surgical approach in full-arch rehabilitation with dental implants and immediate loading using digital workflow. Methods Patient records of fully edentulous jaws treated in four clinical centers in Warsaw, Poland, were evaluated. Computer-assisted planning and surgical template fabrication were done using the planning software coDiagnostiX™, based on a pre-op cone beam computed tomography (CBCT) and scanned data of a plaster model. A post-op CBCT was acquired after the placement of four to six implants by the guided system. The influence of different surgical variables on the discrepancy between planning and execution was analyzed, together with the biomechanical indices. Results A total of nine patient records were selected of 12 edentulous jaws treated with 62 implants. The overall mean three-dimensional (3D) offset at the implant base was 1.60 mm, at the tip 1.86 mm. The mean angle of deviation was 4.89°, the mean implant stability quotient (ISQ) 70.42, and the insertion torque 35.58 Ncm. The 3D offsets were influenced by the gender of the patient, treated jaw, the diameter, and length of the implant. The angle of deviation was affected only by the treated jaw. Insertion torque was influenced by the treated jaw, the age of the patient, the length of the implant, tooth type, and the side of the jaw. Discussion Bone quality of the patient and implant preparation procedure influenced the discrepancy between the planning and the execution of the digitally guided implant placement. Dense bone—mandible, posterior area, young age, and man—and multiple preparations of the implant bed—wider and longer implant—could be suggested as risk factors. Conclusion Digital workflow successfully enabled the immediate full-arch rehabilitation with a predictable outcome by different surgeons in multiple centers.
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Affiliation(s)
- Krzysztof Chmielewski
- SmileClinic Advanced Implant Center - Klinika Stomatologii Estetycznej i Implantologii, ul. Karola Szymanowskiego 2, 80-280, Gdańsk, Poland
| | - Wojciech Ryncarz
- Stomatologia estetyczna implantologia - Klinika Proimplant, ul. Cecylii Śniegockiej 8, 00-430, Warszawa, Poland
| | - Orcan Yüksel
- YÜKSEL
- GIESENHAGEN Dentale Implantologie, Bockenheimer Landstr. 92, 60323, Frankfurt, Germany
| | - Pedro Goncalves
- Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland
| | - Kyung-Won Baek
- Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland.
| | - Susy Cok
- Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland
| | - Michel Dard
- Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland.,Oral, Diagnosis and Rehabilitation Sciences, College of Dental Medicine, Columbia University, 622 W. 168th St., New York, NY, 10032, USA
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26
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Zhang R, Gao H, Li H, Xing T, Jia C, Zhang J, Dong F, Shen C. Differences in bone mineral density of trajectory between lumbar cortical and traditional pedicle screws. J Orthop Surg Res 2019; 14:128. [PMID: 31072395 PMCID: PMC6507139 DOI: 10.1186/s13018-019-1169-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/26/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cortical bone trajectory (CBT) has been well-known in spine surgery for obtaining improved fixation while minimizing soft tissue dissection. This study was designed to compare the bone mineral density (BMD) between the CBT and traditional trajectory (TT) by using Hounsfield unit (HU) values and identify the ideal decades of patients and the suitable lumbar segments using this CBT technology from a radiological standpoint. METHODS Patients were selected randomly from an institutional database based on age (evenly distributed by a decade of life) and gender. A total of 240 healthy patients had a computed tomography (CT) scan of the chest, abdomen, and pelvis. For each patient, axial slices of every vertebra were cut in two planes: one horizontal to the pedicle representing the plane wherein pedicle screws were inserted using the TT and the other in a caudocranial plane representing the plane wherein pedicle screws were inserted using the CBT. For each trajectory, a region of interest (ROI) was selected within the area wherein the screws were inserted. A CT number (HU values) was then calculated within each ROI to represent bone density. RESULTS HU values measured at the ROI of CBT were significantly greater than those of the traditional pedicle screw in all age groups, and the specific value (ratio of the HU values of CBT/the HU values of TT) between CBT and TT was 1.92. A significant difference was observed between male and female. The HU values of CBT and TT of males were generally higher than those of females (males: CBT/TT 1.89 ± 0.45; Females: CBT/TT 1.95 ± 0.47). The specific value in HU values significantly increased with increasing age (p = 0.000) and cauda lumbar level (p = 0.000) in males and females. CONCLUSION BMD, as measured by HU values for the ROI of the CBT screw, was significantly greater than that of the traditional pedicle screw, especially in old patients and cauda lumbar segments.
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Affiliation(s)
- Renjie Zhang
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Hai Gao
- Department of Orthopedics, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Huimin Li
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Tao Xing
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Chongyu Jia
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jianxiang Zhang
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Fulong Dong
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Cailiang Shen
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China. .,Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
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27
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Voumard B, Maquer G, Heuberger P, Zysset PK, Wolfram U. "Peroperative estimation of bone quality and primary dental implant stability". J Mech Behav Biomed Mater 2018; 92:24-32. [PMID: 30654217 DOI: 10.1016/j.jmbbm.2018.12.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/22/2018] [Accepted: 12/24/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Dental implants are widely used to restore function and appearance. It may be essential to choose the appropriate drilling protocol and implant design in order to optimise primary stability. This could be achieved based on an assessment of the implantation site with respect to bone quality and objective biomechanical descriptors such as stiffness and strength of the bone-implant system. The aim of this ex vivo study is to relate these descriptors with bone quality, with a pre-implantation indicator of implant stability: pilot-hole drilling force (Fdrilling), and with two post-implantation indicators: maximal implantation torque (Timplantation) and resonance frequency analysis (RFA). METHODS Eighty trabecular bone specimens were cored from human vertebrae and bovine tibiae. Bone volume fraction (BV/TV), a representative for bone quality, was obtained through micro-computed tomography scans. Implants were kept in controlled laboratory conditions following standard surgical procedures. Forces and torques were recorded and RFA was assessed after implantation. Off-axis compression tests were conducted on the implants until failure. Implant stability was identified by stiffness and ultimate force (Fultimate). The relationships between BV/TV, Stiffness, Fultimate and Fdrilling, Timplantation, RFA were established. RESULTS Fdrilling correlated well with BV/TV of the implantation site (r2 = 0.81), stiffness (r2 = 0.75) and Fultimate (r2 = 0.80). Timplantation correlated better with stiffness (r2 = 0.86) and Fultimate (r2 = 0.94) than RFA (r2 = 0.77 and r2 = 0.74, respectively). CONCLUSION Our results indicate that BV/TV and bone-implant stability can be directly estimated by the force needed for the pilot drilling that occurs during the site preparation before implantation. Moreover, implantation torque outperforms RFA for evaluating the mechanical competence of the bone-implant system.
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Affiliation(s)
- Benjamin Voumard
- Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland
| | - Ghislain Maquer
- Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland
| | - Peter Heuberger
- Biomechanics Research, Nobel Biocare Services AG, Balsberg Balz Zimmermann-Strasse 7, 8302 Kloten, Switzerland
| | - Philippe K Zysset
- Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland.
| | - Uwe Wolfram
- Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland; Institute for Mechanical, Process and Energy Engineering, Heriot-Watt University, UK EH14 4AS, Edinburgh, United Kingdom
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Carmo Filho LCD, Marcello-Machado RM, Castilhos EDD, Del Bel Cury AA, Faot F. Can implant surfaces affect implant stability during osseointegration? A randomized clinical trial. Braz Oral Res 2018; 32:e110. [PMID: 30379212 DOI: 10.1590/1807-3107bor-2018.vol32.0110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/07/2018] [Indexed: 12/26/2022] Open
Abstract
This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson's correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.
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Affiliation(s)
- Luiz Carlos do Carmo Filho
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Piracicaba, SP, Brazil
| | - Raissa Micaella Marcello-Machado
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Piracicaba, SP, Brazil
| | - Eduardo Dickie de Castilhos
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Social and Preventive Dentistry, elotas, RS, Brazil.,University of Campinas, Piracicaba, Brazil
| | - Altair Antoninha Del Bel Cury
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Piracicaba, SP, Brazil
| | - Fernanda Faot
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
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29
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Ahn H, Patel RR, Hoyt AJ, Lin ASP, Torstrick FB, Guldberg RE, Frick CP, Carpenter RD, Yakacki CM, Willett NJ. Biological evaluation and finite-element modeling of porous poly(para-phenylene) for orthopaedic implants. Acta Biomater 2018; 72:352-361. [PMID: 29563069 DOI: 10.1016/j.actbio.2018.03.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 12/22/2022]
Abstract
Poly(para-phenylene) (PPP) is a novel aromatic polymer with higher strength and stiffness than polyetheretherketone (PEEK), the gold standard material for polymeric load-bearing orthopaedic implants. The amorphous structure of PPP makes it relatively straightforward to manufacture different architectures, while maintaining mechanical properties. PPP is promising as a potential orthopaedic material; however, the biocompatibility and osseointegration have not been well investigated. The objective of this study was to evaluate biological and mechanical behavior of PPP, with or without porosity, in comparison to PEEK. We examined four specific constructs: 1) solid PPP, 2) solid PEEK, 3) porous PPP and 4) porous PEEK. Pre-osteoblasts (MC3T3) exhibited similar cell proliferation among the materials. Osteogenic potential was significantly increased in the porous PPP scaffold as assessed by ALP activity and calcium mineralization. In vivo osseointegration was assessed by implanting the cylindrical materials into a defect in the metaphysis region of rat tibiae. Significantly more mineral ingrowth was observed in both porous scaffolds compared to the solid scaffolds, and porous PPP had a further increase compared to porous PEEK. Additionally, porous PPP implants showed bone formation throughout the porous structure when observed via histology. A computational simulation of mechanical push-out strength showed approximately 50% higher interfacial strength in the porous PPP implants compared to the porous PEEK implants and similar stress dissipation. These data demonstrate the potential utility of PPP for orthopaedic applications and show improved osseointegration when compared to the currently available polymeric material. STATEMENT OF SIGNIFICANCE PEEK has been widely used in orthopaedic surgery; however, the ability to utilize PEEK for advanced fabrication methods, such as 3D printing and tailored porosity, remain challenging. We present a promising new orthopaedic biomaterial, Poly(para-phenylene) (PPP), which is a novel class of aromatic polymers with higher strength and stiffness than polyetheretherketone (PEEK). PPP has exceptional mechanical strength and stiffness due to its repeating aromatic rings that provide strong anti-rotational biaryl bonds. Furthermore, PPP has an amorphous structure making it relatively easier to manufacture (via molding or solvent-casting techniques) into different geometries with and without porosity. This ability to manufacture different architectures and use different processes while maintaining mechanical properties makes PPP a very promising potential orthopaedic biomaterial which may allow for closer matching of mechanical properties between the host bone tissue while also allowing for enhanced osseointegration. In this manuscript, we look at the potential of porous and solid PPP in comparison to PEEK. We measured the mechanical properties of PPP and PEEK scaffolds, tested these scaffolds in vitro for osteocompatibility with MC3T3 cells, and then tested the osseointegration and subsequent functional integration in vivo in a metaphyseal drill hole model in rat tibia. We found that PPP permits cell adhesion, growth, and mineralization in vitro. In vivo it was found that porous PPP significantly enhanced mineralization into the construct and increased the mechanical strength required to push out the scaffold in comparison to PEEK. This is the first study to investigate the performance of PPP as an orthopaedic biomaterial in vivo. PPP is an attractive material for orthopaedic implants due to the ease of manufacturing and superior mechanical strength.
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Affiliation(s)
- Hyunhee Ahn
- Department of Orthopaedics, Emory University, Atlanta, GA, USA; The Atlanta Veterans Affairs Medical Center Atlanta, Decatur, GA, USA
| | - Ravi R Patel
- Department of Mechanical Engineering, University of Colorado, Denver, CO, USA
| | - Anthony J Hoyt
- Department of Mechanical Engineering, University of Wyoming, Laramie, WY, USA
| | - Angela S P Lin
- George W. Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - F Brennan Torstrick
- George W. Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Robert E Guldberg
- George W. Woodruff School of Mechanical Engineering, Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Carl P Frick
- Department of Mechanical Engineering, University of Wyoming, Laramie, WY, USA
| | - R Dana Carpenter
- Department of Mechanical Engineering, University of Colorado, Denver, CO, USA
| | | | - Nick J Willett
- Department of Orthopaedics, Emory University, Atlanta, GA, USA; The Atlanta Veterans Affairs Medical Center Atlanta, Decatur, GA, USA.
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Li W, Song Y, Song B, Yang R, Xing T, Chen Z, Zhang Z, Ouyang Y. Comparison of anterior cruciate ligament reconstruction methods between reverse "Y" plasty reconstruction and traditional single-bundle technique-A cadaveric study. J Orthop Translat 2018; 14:1-7. [PMID: 30123736 PMCID: PMC6093085 DOI: 10.1016/j.jot.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 12/04/2022] Open
Abstract
Background In 2009, a reverse “Y” plasty anterior cruciate ligament (ACL) reconstruction technique was proposed, with double-tibial tunnel and single-femoral tunnel, and the result obtained proved that the reverse “Y” plasty technique was satisfactory. This cadaveric study was designed to compare the reverse “Y” plasty reconstruction method with the conventional single-bundle technique for the first time. Methods In this study, 30 cadaveric knees were used and were randomly divided into five groups with six knees each. Six cadaveric knees with intact ACL were treated as the control group, and another six knees with ruptured ACL were treated as the rupture group. In group A, the single-bundle technique was used. In groups B and C, reverse “Y” plasty technique was used, and the grafts were fixed with absorbable biointerference screws in tibiae and absorbable biointerference screws (Group B) or Endobutton (Group C) in femora. Five groups were tested with an MTS material testing machine (MTS-858) by the use of a cyclic loading of 134 N at 15°, 30°, 60° and 90° of knee flexion and a combined 7-Nm valgus torque and 5-Nm internal tibial rotation torque at 15°, 30°, 45° and 60° of knee flexion. Results Both single-bundle and reverse “Y” plasty groups demonstrated similar anterior–posterior stability compared with the control group, whereas the single-bundle group showed inferior rotational stability tested at 30° and 45° of knee flexion than the reverse “Y” plasty group and control group. These two different fixation methods at the femoral site (Group B and C) showed no difference in anterior–posterior and rotational stability. Conclusions The new reverse “Y” plasty ACL reconstruction method may restore normal knee stability, especially rotational stability, better than single-bundle reconstruction. The translational potential of this article This study provides strong support for the new reverse “Y” plasty ACL reconstruction technique and is expected to propose a new surgical approach with good biomechanical features.
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Affiliation(s)
- Weiping Li
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Yang Song
- Department of Orthopedics, Shunde Hospital, Southern Medical University, Guangzhou, PR China
| | - Bin Song
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Rui Yang
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Tong Xing
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Zhong Chen
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Zhengzheng Zhang
- Sports Medicine Department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
| | - Yi Ouyang
- Department of Orthopedics, Shunde Hospital, Southern Medical University, Guangzhou, PR China
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Schönenberg D, Guggenberger R, Frey D, Pape HC, Simmen HP, Osterhoff G. CT-based evaluation of volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis. Osteoporos Int 2018; 29:459-465. [PMID: 29134241 DOI: 10.1007/s00198-017-4307-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/06/2017] [Indexed: 10/24/2022]
Abstract
UNLABELLED This matched case-control study compared the computed tomography (CT)-based regional bone density of patients with fragility fractures of the sacrum to a control without fracture. Patients with a sacral fracture demonstrated a significantly lower regional bone density of the sacrum, the sacral bone density not being correlated with the BMD by DXA of the spine. INTRODUCTION The aim of this study is to compare the computed tomography-based regional bone density measured by Hounsfield units (HUs) in patients with and without fragility fractures of the sacrum. METHODS Patients aged ≥ 50 years with a fragility fracture of the sacrum were compared to patients of similar age and gender who had a fall from standing height without fracture (n = 46). A matched case-control analysis was conducted by retrospective chart review and assessment of areal bone mineral density by lumbar DXA and by volumetric regional HU measurements in uncalibrated CT scans of the sacrum. RESULTS Patients with a sacral fracture (age 74 ± 11 years) showed a lower bone density in the body of S1 (HU 85 ± 22) when compared to the matched control group without fracture (age 73 ± 10 years, HU 125 ± 37, p < 0.001). The CT-based bone density of S1 did not correlate with the DXA values of the lumbar spine (r = 0.223, p = 0.136), and lumbar spine T-scores did not differ between the groups (- 2.0 ± 1.3 vs. - 1.9 ± 1.2, p = 0.786). All measurements are based on uncalibrated scans, and absolute HU values are restricted to scans made on Siemens SOMATOM Force or SOMATOM Edge scanners. CONCLUSIONS Patients with fragility fractures of the sacrum demonstrated a lower regional volumetric bone density of the sacrum when compared to a cohort without a fracture. Local sacral volumetric bone density as measured by CT seems to be independent from the areal BMD as measured by DXA of the lumbar spine. LEVEL OF EVIDENCE level III.
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Affiliation(s)
- D Schönenberg
- Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - R Guggenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - D Frey
- Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - H-C Pape
- Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - H-P Simmen
- Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - G Osterhoff
- Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
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Matsukawa K, Abe Y, Yanai Y, Yato Y. Regional Hounsfield unit measurement of screw trajectory for predicting pedicle screw fixation using cortical bone trajectory: a retrospective cohort study. Acta Neurochir (Wien) 2018; 160:405-411. [PMID: 29260301 DOI: 10.1007/s00701-017-3424-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 12/03/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The sufficiency of screw anchoring is a critical factor for achieving successful spinal fusion; however, no reliable method for predicting pedicle screw fixation has been established. Recently, Hounsfield units (HU) obtained from computed tomography (CT) was developed as a new reliable tool to determine the bone quality. The purpose of the present study was to demonstrate the utility of regional HU measurement of the screw trajectory to predict the primary and long-term fixation strength of pedicle screws. METHOD The insertional torque of pedicle screws using the cortical bone trajectory technique was measured intraoperatively in 92 consecutive patients who underwent single-level posterior lumbar interbody fusion. The cylindrical area of each screw was plotted on the preoperative CT image by precisely confirming the screw position, and the screw trajectory was measured in HU. First, three parameters: the bone mineral density (BMD) of the femoral neck and lumbar vertebrae, and regional HU values of the screw trajectory, were correlated with the insertional torque and compared among three groups. Next, pedicle screw loosening was evaluated by postoperative CT obtained 12 months after surgery, and clinical and imaging data were analyzed to assess whether regional HU values could be used as a predictor of screw loosening. RESULTS Regional HU values of the screw trajectory (r = 0.75, p < 0.001) had stronger correlation with the insertional torque than the femoral BMD (r = 0.59, p < 0.001) and lumbar BMD (r = 0.55, p < 0.001). The incidence of screw loosening was 4.6% (16/351). Multivariate logistic regression analysis revealed that regional HU value (odds ratio = 0.70; 95% confidence interval = 0.56-0.84; p = 0.018) was an independent risk factor significantly affected screw loosening. CONCLUSIONS Regional HU values of the screw trajectory could be a strong predictor of both primary and long-term screw fixation in vivo.
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Affiliation(s)
- Keitaro Matsukawa
- Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, Musashimurayama, Tokyo, Japan.
| | - Yuichiro Abe
- Department of Orthopaedic Surgery, Wajokai Eniwa Hospital, Eniwa, Hokkaido, Japan
| | - Yoshihide Yanai
- Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, Musashimurayama, Tokyo, Japan
| | - Yoshiyuki Yato
- Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, Musashimurayama, Tokyo, Japan
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Lages FS, Douglas-de Oliveira DW, Costa FO. Relationship between implant stability measurements obtained by insertion torque and resonance frequency analysis: A systematic review. Clin Implant Dent Relat Res 2017; 20:26-33. [PMID: 29194944 DOI: 10.1111/cid.12565] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/04/2017] [Accepted: 11/06/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The primary stability of dental implants can be evaluated by insertion torque (IT) and resonance frequency analysis (RFA). OBJECTIVE Assess the supposed relationship between the IT and RFA. MATERIALS AND METHODS A systematic review was performed based on the PRISMA. The electronic search was performed in the PubMed, Web of Science, SCOPUS, Cochrane Library electronic, OVID, and Scielo databases. Manual searches were also performed. There was no restrictions regarding year of publication or language. The articles identified were assessed independently by 3 trained researchers. Clinical trials reporting the RFA values by means of implant stability quotient (ISQ) and IT were included. RESULTS The electronic and manual searches yielded 2017 studies. Twelve studies were included in the systematic review. There was no statistically significant correlation between ISQ and IT (rs = .366; P = .079). The quality of the evidence was downgraded by risk of bias and indirectness; and the certainty of the evidence was low. CONCLUSION IT and RFA are independent and incomparable methods of measuring primary stability. Is important for clinicians to define only one method of evaluation for each implant.
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Affiliation(s)
- Frederico Santos Lages
- Department of Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Sierra-Rebolledo A, Allais-Leon M, Maurette-OʼBrien P, Gay-Escoda C. Primary Apical Stability of Tapered Implants Through Reduction of Final Drilling Dimensions in Different Bone Density Models: A Biomechanical Study. IMPLANT DENT 2017; 25:775-782. [PMID: 27540846 DOI: 10.1097/id.0000000000000479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE A biomechanical study of the primary apical stability obtained in tapered implants through the reduction of final drilling dimensions in different bone density models. MATERIAL AND METHODS An in vitro study of maximum insertion torque and primary stability based on the resonance frequency analysis (RFA) of 24 conical implants measuring 13 mm in length and 3.75 and 4.20 mm in diameter, randomly inserted in 10-mm sockets prepared in 4 polyurethane blocks with a density of 15, 20, 30, and 40 pounds per cu ft, respectively, reducing the diameter of the final drill at constant speed (400 rpm) to obtain exclusive 4 mm anchoring of the apical third of each implant. RESULTS The decrease in drilling diameter resulted in an increase in the insertion torque and implant stability quotient (ISQ) values in all implants, although without reaching statistical significance. In turn, a significant direct correlation was found between increasing bone analog block density and the insertion torque and ISQ values. CONCLUSIONS Under the conditions of this study, the primary apical stability obtained may be more dependent on bone density than on reduction of the final drilling diameter.
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Affiliation(s)
- Alejandro Sierra-Rebolledo
- *Associate Professor of Oral Surgery and Implantology and Biotechnology Coordinator of Unit of Morphopathological Research, University of Carabobo Dental School, Valencia, Venezuela. †Professor-in-Chief of Oral and Maxillofacial Surgery, Santa Maria University Dental School, Caracas, Venezuela. ‡Assistant Professor of Oral and Maxillofacial Surgery and Dental Research, Dr. Raul Vicentelli Institute, Central of Venezuela Dental School, Caracas, Venezuela. §Cathedratic of Oral and Maxillofacial Surgical Pathology, Chairman of Oral and Maxillofacial Surgery, University of Barcelona Dental School; Coordinator of the Research Group of Maxillofacial Pathology and Dental Therapeutics, IDIBELL, Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, TEKNON Medical Center, Barcelona, Spain
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The Effect of Osteotomy Dimension on Implant Insertion Torque, Healing Mode, and Osseointegration Indicators: A Study in Dogs. IMPLANT DENT 2017; 25:739-743. [PMID: 27513163 DOI: 10.1097/id.0000000000000476] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the effect of the osteotomy diameter for implant placement torque and its effect on the osseointegration. MATERIALS AND METHODS Eight male beagle dogs received 48 implants (3.75 mm × 10 mm) in their right and left radius, 3 implants per side and allowed to heal for 3 weeks. Three experimental groups were evaluated. Group 1: implant with an undersized osteotomy of 3.0 mm; group 2: osteotomy of 3.25 mm, and group 3: osteotomy of 3.5 mm. The insertion torque was recorded for all implants. Histological sectioning and histometric analysis were performed evaluating bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS Implants of group 1 presented statistically higher insertion torque than those of groups 2 and 3 (P < 0.01). No differences in BIC or BAFO were observed between the groups. From a morphologic standpoint, substantial deviations in healing mode were observed between groups. CONCLUSION Based on the present methodology, the experimental alterations of surgical technic can be clinically used with no detrimental effect over the osseointegration process.
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Abstract
PURPOSE Occlusal overload may cause implant biomechanical failures, marginal bone loss, or even complete loss of osseointegration. Thus, it is important for clinicians to understand the role of occlusion in implant long-term stability. This systematic review updates the understanding of occlusion on dental implants, the impact on the surrounding peri-implant tissues, and the effects of occlusal overload on implants. Additionally, recommendations of occlusal scheme for implant prostheses and designs were formulated. MATERIALS AND METHODS Two reviewers completed a literature search using the PubMed database and a manual search of relevant journals. Relevant articles from January 1950 to September 20, 2015 published in the English language were considered. RESULTS Recommendations for implant occlusion are lacking in the literature. Despite this, implant occlusion should be carefully addressed. CONCLUSION Recommendations for occlusal schemes for single implants or fixed partial denture supported by implants include a mutually protected occlusion with anterior guidance and evenly distributed contacts with wide freedom in centric relation. Suggestions to reduce occlusal overload include reducing cantilevers, increasing the number of implants, increasing contact points, monitoring for parafunctional habits, narrowing the occlusal table, decreasing cuspal inclines, and using progressive loading in patients with poor bone quality. Protecting the implant and surrounding peri-implant bone requires an understanding of how occlusion plays a role in influencing long-term implant stability.
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Akoğlan M, Tatli U, Kurtoğlu C, Salimov F, Kürkçü M. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res 2017; 19:624-631. [PMID: 28493347 DOI: 10.1111/cid.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.
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Affiliation(s)
- Mücahide Akoğlan
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Cem Kurtoğlu
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mehmet Kürkçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Primary Stability of Cylindrical and Conical Dental Implants in Relation to Insertion Torque—A Comparative Ex Vivo Evaluation. IMPLANT DENT 2017; 26:250-255. [DOI: 10.1097/id.0000000000000531] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Research of StemBios Cell Therapy on Dental Implants Containing Nanostructured Surfaces: Biomechanical Behaviors, Microstructural Characteristics, and Clinical Trial. IMPLANT DENT 2017; 25:63-73. [PMID: 26473440 DOI: 10.1097/id.0000000000000337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the present study was to examine the osseointegration in low-density bone tissue for SLAffinity-treated implants with StemBios (SB) cell therapy. MATERIALS AND METHODS The morphologies of SLAffinity-treated surfaces were characterized using scanning electron microscopy. In the animal model, implants were installed in the mandibular canine-premolar area of 12 miniature pigs. Each pig received 3 implants of machine, sand blasted, large grit, and acid etched, and SLAffinity-treated implants. In the clinical trial, 10 patients received 1 SLAffinity-treated implant in the maxilla in the posterior area and 1 patient with low bone tissue density received 2 SLAffinity-treated implants with SB cell therapy. Resonance frequency analysis and computed tomography were assessed monthly over the first 3 months after implant placement. RESULTS The results demonstrated that surface treatment significantly affected early osseointegration in patients who received SB cell therapy. SB cell therapy transferred the stress caused by the implant more uniformly, and the stress decreased with healing time. SLAffinity-treated implants also proved clinically successful after the 3 months. CONCLUSION The SLAffinity treatments enhanced osseointegration significantly, especially at early stages of bone tissue healing with SB cell therapy.
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Rapid Osseointegration of Titanium Implant With Innovative Nanoporous Surface Modification: Animal Model and Clinical Trial. IMPLANT DENT 2017; 24:441-7. [PMID: 25946663 DOI: 10.1097/id.0000000000000258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES SLAffinity is the hybrid topography consisting of micropits and nanoporous TiO2 layers through electrochemical oxidation to mimic the natural bony environment. The aim of this study was to examine the rate of osseointegration in animal models and to further investigate the stability for implants with SLAffinity-treated surface in the clinical trial. MATERIALS AND METHODS Implants were installed in the mandibular canine-premolar area of 12 miniature pigs. Each pig received 2 implants with the same shapes but with different chemical surfaces. In the clinical trial, 25 patients were included. Each patient received 1 SLAffinity-treated implant on the posterior area of either arch. Resonance frequency analysis and computed tomography were assessed weekly over the first 12 weeks after implant placement. RESULTS The results found that surface treatment did affect the bone-to-implant contact (BIC) significantly. Comparison of BIC at 3 weeks in animal study showed that the SLAffinity-treated implants presented significantly higher values than machine surface implants. SLAffinity-treated implants also proved clinically successful through 12 months, ready for prosthodontic restoration. CONCLUSION The effect of SLAffinity treatments enhanced osseointegration significantly, especially at early stages of bone healing. Clinical trial finding, furthermore, ensured that the SLAffinity treatment was a reliable surface modification alternative.
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Abstract
STATEMENT OF PROBLEM Evidence is limited on the efficacy of narrow-diameter implants (NDIs) in the posterior jaw. PURPOSE The purpose of this systematic review was to assess the survival of NDIs and provide guidelines for their safe use. MATERIALS AND METHODS Electronic search of the English-language literature enriched by hand search to identify suitable publications was made. Only peer-reviewed clinical studies published from January 1990 through March 2014 were included. RESULTS Seventeen studies with a total of 1644 implants met the inclusion criteria, with an observation period from 1 up to 12 years. The mean survival rate of 98.6% was reported. Technical and other complications were observed. CONCLUSION Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.
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Influence of the Localization of Frontal Bone Defects on Primary Stability Values of 2 Different Implant Designs: An In Vitro Study. IMPLANT DENT 2017; 26:87-94. [PMID: 28079610 DOI: 10.1097/id.0000000000000536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to determine the influence of different frontal bone defect localizations on primary stability values of 2 different implant designs. MATERIALS AND METHODS Eight cow rib segments were prepared before implant installation, as 2 segments with coronal, 2 with middle, and 2 with apical defects and 2 with control. Thirty-two cylindrical and 32 tapered implants were placed in the remaining 4 segments. Implant stability measurements were performed using electronic percussive testing and resonance frequency analysis. RESULTS No significance was detected between the stability values of the 2 implant designs except the implant stability quotient (ISQ) of control groups. The tapered implants control group showed significantly higher lateral ISQs compared with cylindrical implants (P = 0.033). For both implant types, stability values were significantly lower in coronal defects (P < 0.01). No significant differences were detected in other defect types. CONCLUSION Within the limitations of this study, it may be concluded that coronal defects may influence primary stability negatively, compared with middle and apical defects. Although statistically not significant, coronal defects caused lower primary stability values with the tapered design compared with parallel design.
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Möhlhenrich SC, Kniha K, Elvers D, Ayoub N, Goloborodko E, Hölzle F, Modabber A. Intraosseous stability of dental implants in free revascularized fibula and iliac crest bone flaps. J Craniomaxillofac Surg 2016; 44:1935-1939. [DOI: 10.1016/j.jcms.2016.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/08/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022] Open
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Wada M, Tsuiki Y, Suganami T, Ikebe K, Sogo M, Okuno I, Maeda Y. The relationship between the bone characters obtained by CBCT and primary stability of the implants. Int J Implant Dent 2016; 1:3. [PMID: 27747625 PMCID: PMC4981004 DOI: 10.1186/s40729-014-0003-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 11/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study is to investigate the correlation between the thickness of the cortical bone or the voxel values that are obtained by cone beam CT (CBCT) and the insertion torque values (ITVs) or the implant stability quotient (ISQ) values. METHODS A pig's ilium was used as the implant placement site. The implants used in this study were two kinds of diameters (3.8 mm, 5.0 mm) and two kinds of lengths (7.0 mm, 12.0 mm) having a general threadlike shape with a mechanically polished surface. To measure the bone density and the cortical thickness around the implants accurately, the CBCT scanning was performed immediately just after the formation of the implant cavity. The initial stabilities were evaluated by the ITVs and the ISQ values. The bone density and cortical thickness around the implants were measured by an implant simulation software (Landmarker ver. 5.0 with special specifications for this study). The relationships of the thickness of the cortical bone and the voxel values with the ITVs and the ISQ values were analyzed using Pearson's correlation coefficient. To evaluate the influence on the ITVs and the ISQ values among multiple factors, multiple regression analysis was performed. P < 0.05 was considered statistically significant. RESULTS A significant positive correlation was found between the thickness of the cortical bone and the ITVs or the ISQ values in all kinds of implants. In addition, a significant positive correlation was also found between the voxel values and the ITVs. From the multiple regression analysis, the thickness of the cortical bone and the voxel values had a positive influence on the ITVs and the ISQ values. In addition, the length of the implant had a positive influence on the ISQ values at the 3.8-mm-diameter implant. CONCLUSIONS In this limited study, there were correlations between the thickness of the cortical bone or the voxel values obtained from the CBCT scanning and the implant stabilities. Besides, it was confirmed that the thickness of the cortical bone, the voxel value, and the implant length had positive correlations with the ITVs and the ISQ values.
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Affiliation(s)
- Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Yasutane Tsuiki
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tohru Suganami
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Motofumi Sogo
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ikuhisa Okuno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Effect of locally applied bFGF on implant stability: biomechanical evaluation of 2 different implant surfaces in rabbits. IMPLANT DENT 2016; 23:463-70. [PMID: 25051415 DOI: 10.1097/id.0000000000000104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the implant stability with the addition of local application of basic fibroblast growth factor (bFGF) during the osseointegration of 2 different dental implant surfaces using rabbit tibia model. MATERIALS AND METHODS Fifty-six dental implants, 28 of hydrophilic surface (SLActive) and 28 of hydrophobic surface (OsseoSpeed), were placed in 14 mature New Zealand rabbits. The rabbits each received both SLActive and OsseoSpeed implants per tibia, and bFGF was applied locally on 1 randomly selected tibia. Half of the subjects were killed at the fourth week of healing period, and the other half were killed at the twelfth week. Stabilization was assessed using resonance frequency analysis (RFA) and removal torque value (RTV). RESULTS The local application of bFGF was found to enhance osseointegration, especially at the fourth week of healing period after application (P = 0.046). RFAs and RTVs were found to be higher in bFGF-treated implant with hydrophilic surfaces when compared with both bFGF-treated hydrophobic implants and nontreated hydrophilic controls. CONCLUSION Local application of bFGF seems to increase the stabilization values in implants with hydrophilic surfaces and those with hydrophobic surfaces.
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Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. Validation of value of actual micromotion as a direct measure of implant micromobility after healing (secondary implant stability). An in vivo
histologic and biomechanical study. Clin Oral Implants Res 2016; 27:1423-1430. [DOI: 10.1111/clr.12756] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Paolo Trisi
- Biomaterial Clinical Research Association; Pescara Italy
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Abstract
OBJECTIVES The objectives of the present study were to measure the implant stability quotient (ISQ) values at 3 different time points after the surgical insertion and to determine whether the time of osseointegration differs in the maxilla and mandible. MATERIALS AND METHODS To measure implant stability, resonance frequency analysis (RFA) was performed in 44 patients (40 women, 4 men) with a total of 100 Implacil De Bortoli implants; the patients were divided into 2 groups: group 1, implants in the maxilla (22 in the anterior maxilla and 37 in the posterior maxilla); and group 2, implants in the mandible (41 posterior mandibles). Using RFA, implant stability was measured immediately after implant placement to assess the immediate stability (time 1) and at 90 (time 2) and 150 (time 3) days. RESULTS Overall, the mean (SD) ISQ was 63.3 (6.63) (95% confidence interval [CI], 39-79) for time 1, 70.5 (6.32) (95% CI, 46-88) for time 2, and 73.5 (6.03) (95% CI, 58-88) for time 3. In group 1, the mean (SD) ISQ was 61.8 (6.56) (95% CI, 39-79) for time 1, 68.8 (5.19) (95% CI, 57-83) for time 2, and 72.3 (5.91) (95% CI, 58-85) for time 3. In group 2, the mean (SD) ISQ was 65.5 (6.13) (95% CI, 44-75) for time 1, 72.9 (7.02) (95% CI, 46-88) for time 2, and 75.3 (5.80) (95% CI, 60-88) for time 3. CONCLUSIONS The stability of the implants placed in the maxilla and mandible showed a similar evolution in the ISQ values and, consequently, on osseointegration; however, the implants in the mandible presented superior values at all time points.
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Wada M, Suganami T, Sogo M, Maeda Y. Can we predict the insertion torque using the bone density around the implant? Int J Oral Maxillofac Surg 2015; 45:221-5. [PMID: 26482639 DOI: 10.1016/j.ijom.2015.09.013] [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] [Received: 03/04/2015] [Revised: 07/13/2015] [Accepted: 09/17/2015] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to examine the correlation between initial stability and bone density in patients undergoing implant treatment. Twenty-five screw-type dental implants were inserted in 12 patients. All patients underwent multi-detector computed tomography (CT) examination prior to implant insertion. The implant sockets were prepared according to the drilling protocol, and peak insertion torque values were measured. CT values around the implants were measured using preoperatively scanned CT data, which were combined with actual implant positions. Spearman's rank correlation coefficient was used to investigate the correlation between insertion torque values and CT values (in Hounsfield units, HU). Twenty-three implants (8 or 10 mm in length) were inserted in the mandibular molar region and two (10mm length) in the maxillary molar region. The mean CT value of the 8-mm implants was 508.6 ± 187.0 HU and mean insertion torque was 27.2 ± 12.1 N·cm; for the 10-mm implants, these values were 579.6 ± 224.3 HU and 28.1 ± 14.6 N·cm, respectively. Statistical analysis revealed a strong positive correlation between the insertion torque and mean CT values (r=0.699, 8 mm; r=0.771, 10 mm). The results revealed that bone density around the implant is a useful index. This study indicates that preoperative CT may enable the prediction of initial implant stability.
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Affiliation(s)
- M Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University School of Dentistry, Osaka, Japan.
| | - T Suganami
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University School of Dentistry, Osaka, Japan
| | - M Sogo
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University School of Dentistry, Osaka, Japan; iCAT Corporation, Osaka, Japan
| | - Y Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University School of Dentistry, Osaka, Japan
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Möhlhenrich SC, Heussen N, Loberg C, Goloborodko E, Hölzle F, Modabber A. Three-Dimensional Evaluation of Implant Bed Preparation and the Influence on Primary Implant Stability After Using 2 Different Surgical Techniques. J Oral Maxillofac Surg 2015; 73:1723-32. [DOI: 10.1016/j.joms.2015.03.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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Biomechanics and strain mapping in bone as related to immediately-loaded dental implants. J Biomech 2015; 48:3486-94. [PMID: 26162549 DOI: 10.1016/j.jbiomech.2015.05.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 04/20/2015] [Accepted: 05/14/2015] [Indexed: 11/24/2022]
Abstract
The effects of alveolar bone socket geometry and bone-implant contact on implant biomechanics, and resulting strain distributions in bone were investigated. Following extraction of lateral incisors on a cadaver mandible, implants were placed immediately and bone-implant contact area, stability implant biomechanics and bone strain were measured. In situ biomechanical testing coupled with micro X-ray microscopy (µ-XRM) illustrated less stiff bone-implant complexes (701-822 N/mm) compared with bone-periodontal ligament (PDL)-tooth complexes (791-913 N/mm). X-ray tomograms illustrated that the cause of reduced stiffness was due to limited bone-implant contact. Heterogeneous elemental composition of bone was identified by using energy dispersive X-ray spectroscopy (EDS). The novel aspect of this study was the application of a new experimental mechanics method, that is, digital volume correlation, which allowed mapping of strains in volumes of alveolar bone in contact with a loaded implant. The identified surface and subsurface strain concentrations were a manifestation of load transferred to bone through bone-implant contact based on bone-implant geometry, quality of bone, implant placement, and implant design. 3D strain mapping indicated that strain concentrations are not exclusive to the bone-implant contact regions, but also extend into bone not directly in contact with the implant. The implications of the observed strain concentrations are discussed in the context of mechanobiology. Although a plausible explanation of surgical complications for immediate implant treatment is provided, extrapolation of results is only warranted by future systematic studies on more cadaver specimens and/or in vivo models.
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