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Mello-Machado RC, Sartoretto SC, Granjeiro JM, Calasans-Maia JDA, de Uzeda MJPG, Mourão CFDAB, Ghiraldini B, Bezerra FJB, Senna PM, Calasans-Maia MD. Osseodensification enables bone healing chambers with improved low-density bone site primary stability: an in vivo study. Sci Rep 2021; 11:15436. [PMID: 34326400 PMCID: PMC8322171 DOI: 10.1038/s41598-021-94886-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022] Open
Abstract
Primary implant stability is a prerequisite for successful implant osseointegration. The osseodensification technique (OD) is a non-subtractive drilling technique that preserves the bone tissue, increases osteotomy wall density, and improves the primary stability. This study aimed to investigate the hypothesis that OD, through a wider osteotomy, produces healing chambers (HCs) at the implant-bone interface without impacting low-density bone primary stability. Twenty implants (3.5 × 10 mm) with a nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep. Implant beds were prepared as follows: (i) 2.7-mm-wide using subtractive conventional drilling (SCD) technique (n = 10); (ii) 3.8-mm-wide using an OD bur system (n = 10). The sheep were randomized to two groups, with samples collected at either 14-(n = 5) or 28-days (n = 5) post-surgery and processed for histological and histomorphometric evaluation of bone-implant contact (BIC) and bone area fraction occupancy (BAFO). No significant group differences were found with respect to final insertion torque and implant stability quotient (p > 0.050). BIC values were higher for SCD after 14 and 28 days (p < 0.050); however, BAFO values were similar (p > 0.050). It was possible to conclude that the OD technique allowed a wider implant bed preparation without prejudice on primary stability and bone remodeling.
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Affiliation(s)
- Rafael Coutinho Mello-Machado
- Graduate Program, Dentistry School, Universidade Federal Fluminense, Niterói, Brazil.,Implantology Department, Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Suelen Cristina Sartoretto
- Oral Surgery Department, Universidade Iguaçu, Nova Iguaçu, RJ, Brazil.,Post-Graduation Program in Dentistry, Universidade Veiga de Almeida, Rio de Janeiro, RJ, Brazil.,Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Rua Mario Santos Braga, 28/4 Floor, Niterói, RJ, Brazil
| | - Jose Mauro Granjeiro
- Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Rua Mario Santos Braga, 28/4 Floor, Niterói, RJ, Brazil.,National Institute of Metrology, Quality and Technology (INMETRO), Duque de Caxias, RJ, Brazil
| | | | - Marcelo Jose Pinheiro Guedes de Uzeda
- Oral Surgery Department, Universidade Iguaçu, Nova Iguaçu, RJ, Brazil.,Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Rua Mario Santos Braga, 28/4 Floor, Niterói, RJ, Brazil
| | | | - Bruna Ghiraldini
- Dental Research Division, Dentistry School, Universidade Paulista, São Paulo, SP, Brazil
| | | | | | - Mônica Diuana Calasans-Maia
- Clinical Research Laboratory, Dentistry School, Universidade Federal Fluminense, Rua Mario Santos Braga, 28/4 Floor, Niterói, RJ, Brazil.
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Huang G, Pan ST, Qiu JX. The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2647. [PMID: 34070153 PMCID: PMC8158527 DOI: 10.3390/ma14102647] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
Porous tantalum (Ta) is a promising biomaterial and has been applied in orthopedics and dentistry for nearly two decades. The high porosity and interconnected pore structure of porous Ta promise fine bone ingrowth and new bone formation within the inner space, which further guarantee rapid osteointegration and bone-implant stability in the long term. Porous Ta has high wettability and surface energy that can facilitate adherence, proliferation and mineralization of osteoblasts. Meanwhile, the low elastic modulus and high friction coefficient of porous Ta allow it to effectively avoid the stress shield effect, minimize marginal bone loss and ensure primary stability. Accordingly, the satisfactory clinical application of porous Ta-based implants or prostheses is mainly derived from its excellent biological and mechanical properties. With the advent of additive manufacturing, personalized porous Ta-based implants or prostheses have shown their clinical value in the treatment of individual patients who need specially designed implants or prosthesis. In addition, many modification methods have been introduced to enhance the bioactivity and antibacterial property of porous Ta with promising in vitro and in vivo research results. In any case, choosing suitable patients is of great importance to guarantee surgical success after porous Ta insertion.
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Affiliation(s)
| | | | - Jia-Xuan Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China; (G.H.); (S.-T.P.)
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Inchingolo AD, Inchingolo AM, Bordea IR, Xhajanka E, Romeo DM, Romeo M, Zappone CMF, Malcangi G, Scarano A, Lorusso F, Isacco CG, Marinelli G, Contaldo M, Ballini A, Inchingolo F, Dipalma G. The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis. MATERIALS 2021; 14:ma14051147. [PMID: 33671038 PMCID: PMC7957527 DOI: 10.3390/ma14051147] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Edit Xhajanka
- Department of Dental Prosthesis, University of Tirana, Nr 183 Tirana, Albania;
| | - Donato Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Carlo Maria Felice Zappone
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Human Stem Cells Research Center HSC of Ho Chi Minh, Ho Chi Minh 70000, Vietnam
- Embryology and Regenerative Medicine and Immunology, Pham Chau Trinh University of Medicine Hoi An, Hoi An 70000, Vietnam
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy;
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario “Ernesto Quagliariello” University of Bari “Aldo Moro”, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
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Can Bone Compaction Improve Primary Implant Stability? An In Vitro Comparative Study with Osseodensification Technique. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238623] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: This study aims to analyze bone compaction and osseodensification techniques and to investigate how cancellous bone compaction could influence primary implant stability (PS). Methods: Two different surgical protocols (bone compactors—BC; osseodensification drills—OD) were compared by placing 20 implants into 20 fresh pig ribs for each procedure. Peak insertion torque (PIT) and peak removal torque (PRT) were investigated using an MGT-12 digital torque gauge, and implant stability quotient (ISQ) was analyzed using an Osstell® Beacon device. Results: Analysis of our data (T-test p < 0.05) evidenced no statistically significant difference between BC and OD in terms of PIT (p = 0.33) or ISQ (p = 0.97). The comparison of PRT values showed a statistically significant difference between BC and OD protocols (p = 0.009). Conclusions: Cancellous bone compaction seems to improve PS, preserving a significant amount of bone and evenly spreading trabeculae on the entire implant site. While the PIT and ISQ values obtained are similar, the PRT values suggest different physical responses from the surrounding bone tissue. Nevertheless, a larger sample and further in vivo studies are necessary to validate the usefulness of BC protocol in several clinical settings.
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