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Abdulla MA, Hasan RH, Al-Hyani OH. Radiographic and histologic assessment of osseointegration for surface-treated titanium dental implants: An experimental study in dogs. J Dent Res Dent Clin Dent Prospects 2024; 18:44-54. [PMID: 38881643 PMCID: PMC11179146 DOI: 10.34172/joddd.41009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/23/2024] [Indexed: 06/18/2024] Open
Abstract
Background Modifying the dental implant's surface texture enhances its biological response to the bone and implant‒tissue interface, resulting in the successful support of forces. This study assessed the impact of sandblasting, sandblasting plus acid etching, Er,Cr:YSGG laser, and propolis implant surface treatments and occlusal load on the osseointegration of titanium dental implants in dogs. Methods Seventy-two titanium dental implants with a diameter of 4 mm and a length of 10 mm were divided into four groups according to implant surface modifications (n=18 for each group): group A: sandblasting plus acid etching, group B: sandblasting with Al2 O3, group C: Er,Cr:YSGG laser, group D: propolis coating. Twenty-four local breed male dogs were used. Premolar teeth (P1, P2, and P3) were extracted on the left side of the mandible, and after 12 weeks of bone healing, implants were unilaterally installed. The osseointegration at three study times from implant installation (14, 90, and 180 days) was evaluated. The dog jaws were scanned using an intraoral scanner for the virtual design of screw-retained three-unit crowns after 90 days of osseointegration. Final radiographs were taken before the animals were sacrificed at 14, 90, and 180 days, and the histological analysis was performed. Results Radiographic analysis showed new bone formation (NBF) along and in contact with the implant surface of the treated groups. The histological analysis after 14 days in groups A and B revealed a uniform and ongoing pattern of bone growth and many osteoblasts with few osteocytes within lacunae in new bone trabeculae. Group C showed an increase in the number of osteoblasts lining thin bone trabeculae. Group D showed a generative power concerning bone. At 90 days, there was increased bone ingrowth, and the new bone matured in all the treated implant groups. At 180 days, dense mature bone apposition was in direct contact with delayed-loaded implant surfaces. Conclusion A radiographic examination revealed that surface modification significantly impacted osseointegration, with a strong bond between the implant surface and the surrounding bone. The histological sections at the 14-day interval revealed obvious bone remodeling activity, especially in sandblasting plus acid etching and sandblasting-modified implant surface groups. At the 90-day interval, bone ingrowth had increased, and the new bone became mature, especially in sandblasting and propolis surface modification groups. After 180 days of the delayed-loaded implant osseointegration, differences were observed between different implant-treated groups with a remarkable remodeling of the bone, especially in the propolis coating group.
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Affiliation(s)
- Mohammed A Abdulla
- Department of Prosthetic Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Radhwan H Hasan
- Department of Prosthetic Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Osama Hazim Al-Hyani
- Department of Surgery and Theriogenology, College of Veterinary Medicine, University of Mosul, Mosul, Iraq
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Skiba THI, Kalil EC, Piattelli A, Shibli JA. Human Histological Analysis of Early Bone Response to Immediately Loaded Narrow Dental Implants with Biphasic Calcium Phosphate ® Grid-Blasted Surface Treatment: A Case Report. Dent J (Basel) 2023; 11:177. [PMID: 37504243 PMCID: PMC10377936 DOI: 10.3390/dj11070177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
Implant surface topography using bioactive material provides faster bone-to-implant healing. This histological report described the analysis of human bone tissue around an immediately loaded implant, with BPC® (Biphasic Calcium Phosphate) grit-blasted surface treatment, after two months of healing. Two temporary mini-implants (2.8 × 10 mm) with BPC® grit-blasting surfaces were placed and immediately loaded to retain a complete interim denture. After a 60-day healing period, one mini-implant was removed for histologic analysis. The ground section showed the whole implant surrounded by healthy peri-implant tissues. Implant surface presented a close contact with newly formed bone, showing some areas of osteoblasts secreting mineral matrix. The ground section depicted a bone contact of 60.3 + 8.5%. The BPC® grit-blasted surface was biocompatible and enabled the osseointegration process after a short-term period.
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Affiliation(s)
| | - Eduardo C Kalil
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
| | - Adriano Piattelli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Via di Sant'Alessandro 8, 00131 Rome, Italy
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, SP, Brazil
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Lateral static overload on immediately restored implants decreases the osteocyte index in peri-implant bone: a secondary analysis of a pre-clinical study in dogs. Clin Oral Investig 2020; 25:3297-3303. [PMID: 33150510 DOI: 10.1007/s00784-020-03662-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/27/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES This animal study was conducted to evaluate the osteocyte index in the peri-implant bone around immediately restored implants under static lateral overload. MATERIAL AND METHODS Seven mongrel dogs received three implants on each side of the mandible. Forty-two implants were distributed into three groups (14 implants per group); each animal received two implants connected to a 4.5-mm opened expansion device (experimental group); in the other mandible side, two implants were connected into an expansion device without activation (control group); one implant each side of the mandible was left submerged (unload group). After 4 months under daily mechanical and chemical plaque control, the animals were euthanized; dental implants and surrounding bone were removed and processed to obtain thin ground sections. Histomorphometry was used to evaluate the osteocyte index in the peri-implant bone contact to implant. RESULTS A higher, statistically significant mean number of osteocytes × 10-5 μm2 (54.74 ± 23.91) was found in the control group compared with the test group (22.57 ± 22.55) (p = 0.0221). The correlation between percentage of bone-implant contact and osteocyte index for submerged implants was not statistically significant (p = 0.2667), whereas the value for immediately loaded implants was statistically significant (p = 0.0480). CONCLUSION The lower number of osteocytes in the peri-implant bone around overloaded implants could be related to the need for functional adaptation of the bone tissue to overloading and to the hypothesized involvement of the osteocytes in the maintenance of the bone matrix in the control group. CLINICAL RELEVANCE Osteocytes play a pivotal role in bone adaptation to mechanical loading, and the osteocyte network has been regarded as being the main mechanosensory mechanism.
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Immediate or delayed loading protocols for two-implant mandibular overdentures: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent 2020; 126:742-748. [PMID: 33139056 DOI: 10.1016/j.prosdent.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022]
Abstract
STATEMENT OF PROBLEM The immediate loading protocol for 2-implant mandibular overdentures has been widely reported. Nevertheless, the clinical effects reported in different articles are quite different. PURPOSE The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the clinical effects of immediate and delayed loading of 2-implant mandibular overdentures. MATERIAL AND METHODS The review followed the guidelines of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). PubMed, Cochrane Library, Web of Science, Embase, Scopus, ScienceDirect, CBM, CNKI, and Wan Fang databases were searched electronically for RCTs published before March 25, 2020. Two authors independently conducted literature screening, quality assessment, and data extraction. The outcomes of interest were implant failure rate, marginal bone loss (MBL), implant stability quotient (ISQ), periotest value (PTV), and patient satisfaction. RESULTS A total of 2498 unduplicated records were identified. After full-text analysis, 7 eligible RCTs were included. All studies were followed for at least 12 months, and the meta-analysis was based on this. The meta-analysis showed that the implant failure rate in the immediate group was higher than that in the delayed group, but there was no statistically significant difference (I2=0%; n=7; risk difference [RD]=0.03; 95% confidence interval [CI]=-0.01 to 0.08). The difference of MBL between immediate and delayed loading was not significant (I2=88%; n=6; mean difference [MD]=-0.04; 95% CI=-0.16 to 0.24). Because of the limited articles reporting on ISQ, PTV, and patient satisfaction, no quantitative analysis was conducted for these outcomes. CONCLUSIONS Although the implant failure rate was more likely to favor the delayed group, available evidence indicates no statistical difference in implant failure and marginal bone loss between immediate and delayed loading protocols.
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Hu J, Zhong X, Fu X. Enhanced Bone Remodeling Effects of Low-Modulus Ti-5Zr-3Sn-5Mo-25Nb Alloy Implanted in the Mandible of Beagle Dogs under Delayed Loading. ACS OMEGA 2019; 4:18653-18662. [PMID: 31737825 PMCID: PMC6854559 DOI: 10.1021/acsomega.9b02580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
Titanium (Ti) and its alloys are widely used in the dental and prosthetic implant fields due to their favorable biocompatibility. In this study, porous surface coatings incorporated with nanoscale hydroxyapatite particles on the surface of Ti and Ti-5Zr-3Sn-5Mo-25Nb (TLM) alloy were fabricated by microarc oxidation followed by hydrothermal treatment; the surface roughness and hydrophilicity were obviously enhanced by the surface modification procedure. In vivo, four adult male beagle dogs were selected for an implantation procedure and restored with full metal crowns after healing for 3 months. The bone responses were evaluated via histomorphological observation. Raman spectral analysis and nanoindentation experiments were used to quantitatively and qualitatively estimate the characteristics of the bone formed around the implants. Compared to the Ti group, the TLM titanium alloy group showed a significant increase in the percentage of bone-implant interface contact, bone inside the thread, mineralization, crystallinity, modulus of elasticity, and hardness of the integrated bone after delayed loading in the TLM group. Therefore, the TLM titanium alloy is considered a candidate implant material with desirable biomechanical compatibility, especially under applied stress.
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Affiliation(s)
- Jing Hu
- Chongqing
Key Laboratory of Oral Diseases and Biomedical Sciences and Chongqing
Municipal Key Laboratory of Oral Biomedical Engineering of Higher
Education, Chongqing 401147, China
- Stomatological
Hospital of Chongqing Medical University, Chongqing 401147, China
- College
of Stomatology, Chongqing Medical University, Chongqing 401147, China
| | - Xiaobo Zhong
- Stomatological
Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Xiaoming Fu
- Stomatological
Hospital of Chongqing Medical University, Chongqing 401147, China
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Viganò P, Lang NP, Cesaretti G, Bengazi F, Omori Y, Botticelli D. Immediate loading at single crowns and 2-unit bridges supported by implants installed in a healed alveolar bony ridge or immediately after tooth extraction. An experimental study in dogs. J Oral Rehabil 2018; 45:974-982. [PMID: 30074633 DOI: 10.1111/joor.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/28/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
To evaluate presumptive differences in osseointegration at implants installed in healed sites or extraction sockets, supporting either crowns or bridges that were functionally loaded or left unloaded. In six dogs, the mesial roots of the first mandibular molars were treated endodontically. Bilaterally, the teeth were hemisected, and the distal roots extracted. First and second mandibular premolars were extracted as well. After 3 months, the mandibular third and fourth distal roots were extracted after endodontic treatment of the mesial roots. Four implants were installed bilaterally, two in the healed sites corresponding to the second premolar and first molar regions, and two into the extraction sockets. Cobalt-chrome single crowns were prepared and installed in the two most anterior implants, and bridges at the two most posterior implants, bilaterally. A 3-unit bridge was applied to the premolars in the upper jaw only at the loaded sites. All prostheses had a flat occlusal surface and contacts in centric occlusion only at the loaded sites. Three months later, biopsies were retrieved for histological analysis. Higher levels of osseointegration and bone density were observed at the unloaded sites, both at implants installed in healed and post-extraction sites. However, only at implants installed in the post-extraction sites and supporting single crowns, the difference in bone-to-Implant contact was statistically significant. In implant installation immediately following extraction or delayed after three months, osseointegration and bone density were not affected by occlusal contact schemes.
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Affiliation(s)
| | - Niklaus P Lang
- Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,University of Bern, Bern, Switzerland
| | | | - Franco Bengazi
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | - Yuki Omori
- ARDEC Academy, Rimini, Italy.,Department of Oral Implantology, Osaka Dental University, Osaka, Japan, ARDEC Academy Ariminum Odontologica, Rimini, Italy
| | - Daniele Botticelli
- ARDEC Academy, Rimini, Italy.,Faculty of Dentistry, University of Medical Science, La Habana, Cuba
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Zanetti EM, Pascoletti G, Calì M, Bignardi C, Franceschini G. Clinical Assessment of Dental Implant Stability During Follow-Up: What Is Actually Measured, and Perspectives. BIOSENSORS 2018; 8:E68. [PMID: 30011870 PMCID: PMC6165397 DOI: 10.3390/bios8030068] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 01/02/2023]
Abstract
The optimization of loading protocols following dental implant insertion requires setting up patient-specific protocols, customized according to the actual implant osseointegration, measured through quantitative, objective methods. Various devices for the assessment of implant stability as an indirect measure of implant osseointegration have been developed. They are analyzed here, introducing the respective physical models, outlining major advantages and critical aspects, and reporting their clinical performance. A careful discussion of underlying hypotheses is finally reported, as is a suggestion for further development of instrumentation and signal analysis.
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