Surface modification of implants in long bone.

Science.gov (United States)

Förster, Yvonne; Rentsch, Claudia; Schneiders, Wolfgang; Bernhardt, Ricardo; Simon, Jan C; Worch, Hartmut; Rammelt, Stefan

2012-01-01

Coatings of orthopedic implants are investigated to improve the osteoinductive and osteoconductive properties of the implant surfaces and thus to enhance periimplant bone formation. By applying coatings that mimic the extracellular matrix a favorable environment for osteoblasts, osteoclasts and their progenitor cells is provided to promote early and strong fixation of implants. It is known that the early bone ongrowth increases primary implant fixation and reduces the risk of implant failure. This review presents an overview of coating titanium and hydroxyapatite implants with components of the extracellular matrix like collagen type I, chondroitin sulfate and RGD peptide in different small and large animal models. The influence of these components on cells, the inflammation process, new bone formation and bone/implant contact is summarized.

Comparison of Audiological Results Between a Transcutaneous and a Percutaneous Bone Conduction Instrument in Conductive Hearing Loss.

Science.gov (United States)

Gerdes, Timo; Salcher, Rolf Benedikt; Schwab, Burkard; Lenarz, Thomas; Maier, Hannes

2016-07-01

In conductive, mixed hearing losses and single-sided-deafness bone-anchored hearing aids are a well-established treatment. The transcutaneous transmission across the intact skin avoids the percutaneous abutment of a bone-anchored device with the usual risk of infections and requires less care.In this study, the audiological results of the Bonebridge transcutaneous bone conduction implant (MED-EL) are compared to the generally used percutaneous device BP100 (Cochlear Ltd., Sydney, Australia). Ten patients implanted with the transcutaneous hearing implant were compared to 10 matched patients implanted with a percutaneous device. Tests included pure-tone AC and BC thresholds and unaided and aided sound field thresholds. Speech intelligibility was determined in quiet using the Freiburg monosyllable test and in noise with the Oldenburg sentence test (OLSA) in sound field with speech from the front (S0). The subjective benefit was assessed with the Abbreviated Profile of Hearing Aid Benefit. In comparison with the unaided condition there was a significant improvement in aided thresholds, word recognition scores (WRS), and speech reception thresholds (SRT) in noise, measured in sound field, for both devices. The comparison of the two devices revealed a minor but not significant difference in functional gain (Bonebridge: PTA = 27.5 dB [mean]; BAHA: PTA = 26.3 dB [mean]). No significant difference between the two devices was found when comparing the improvement in WRSs and SRTs (Bonebridge: improvement WRS = 80% [median], improvement SRT = 6.5 dB SNR [median]; BAHA: improvement WRS = 77.5% [median], BAHA: improvement SRT = 6.9 dB SNR [median]). Our data show that the transcutaneous bone conduction hearing implant is an audiologically equivalent alternative to percutaneous bone-anchored devices in conductive hearing loss with a minor sensorineural hearing loss component.

Managing peri-implant bone loss: current understanding.

Science.gov (United States)

Aljateeli, Manar; Fu, Jia-Hui; Wang, Hom-Lay

2012-05-01

With the improved macro- and micro-designs, dental implants enjoy a high survival rate. However, peri-implant bone loss has recently emerged to be the focus of implant therapy. As such, researchers and clinicians are in need of finding predictable techniques to treat peri-implant bone loss and stop its progression. Literature search on the currently available treatment modalities was performed and a brief description of each modality was provided. Numerous techniques have been proposed and none has been shown to be superior and effective in managing peri-implant bone loss. This may be because of the complex of etiological factors acting on the implant-supported prosthesis hence the treatment approach has to be individually tailored. Due to the lack of high-level clinical evidence on the management of peri-implant bone loss, the authors, through a literature review, attempt to suggest a decision tree or guideline, based on sound periodontal surgical principles, to aid clinicians in managing peri-implantitis associated bone loss. © 2011 Wiley Periodicals, Inc.

Does platform switching really prevent crestal bone loss around implants?

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Yoshiyuki Hagiwara

2010-08-01

Full Text Available To maintain long-term implant stability, it is important to minimize bone loss around the implant. Several clinical studies have shown a mean marginal bone loss around dental implants of 1.5–2 mm in the first year after prosthetic restoration. Currently, concepts to prevent bone loss around dental implants have been reported as the platform switching (PLS. This technique use of prosthetic abutments with reduced width in relation to the implant platform diameter seems to have the greatest potential to limit the crestal resorption. However, there are only a few reports on the mechanism of action or the extent of bone loss prevention, and as such, it is difficult to say that the effect of PLS has been thoroughly examined. Excluding case reports, articles on PLS can be broadly categorized into: (1 radiographic evaluation of crestal bone level in humans, (2 histological and histomorphometrical analysis in animals, or (3 finite element analysis. This review revealed a shortage of published data for above three categories related PLS. Researchers have attempted to explain the mechanism of action of PLS; however, it is necessary to conduct further studies, including histological studies using animals, to clarify the mechanism fully.

Influence of controlled immediate loading and implant design on peri-implant bone formation.

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Vandamme, Katleen; Naert, Ignace; Geris, Liesbet; Vander Sloten, Jozef; Puers, Robert; Duyck, Joke

2007-02-01

Tissue formation at the implant interface is known to be sensitive to mechanical stimuli. The aim of the study was to compare the bone formation around immediately loaded versus unloaded implants in two different implant macro-designs. A repeated sampling bone chamber with a central implant was installed in the tibia of 10 rabbits. Highly controlled loading experiments were designed for a cylindrical (CL) and screw-shaped (SL) implant, while the unloaded screw-shaped (SU) implant served as a control. An F-statistic model with alpha=5% determined statistical significance. A significantly higher bone area fraction was observed for SL compared with SU (pimplant contact occurred was the highest for SL and significantly different from SU (pimplant contact was observed, a loading (SL versus SU: p=0.0049) as well as an implant geometry effect (SL versus CL: p=0.01) was found, in favour of the SL condition. Well-controlled immediate implant loading accelerates tissue mineralization at the interface. Adequate bone stimulation via mechanical coupling may account for the larger bone response around the screw-type implant compared with the cylindrical implant.

Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

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Martin Lanzer

2015-09-01

Full Text Available Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001. There was a statistical significant increase in bone density in cortical (P < 0.001 and cancellous (P = 0.004 bone. Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.

Bone Morphogenetic Protein Coating on Titanium Implant Surface: a Systematic Review

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Haim Haimov

2017-06-01

Full Text Available Objectives: The purpose of the study is to systematically review the osseointegration process improvement by bone morphogenetic protein coating on titanium implant surface. Material and Methods: An electronic literature search was conducted through the MEDLINE (PubMed and EMBASE databases. The search was restricted for articles published during the last 10 years from October 2006 to September 2016 and articles were limited to English language. Results: A total of 41 articles were reviewed, and 8 of the most relevant articles that are suitable to the criteria were selected. Articles were analysed regarding concentration of bone morphogenetic protein (BMP, delivery systems, adverse reactions and the influence of the BMP on the bone and peri-implant surface in vivo. Finally, the present data included 340 implants and 236 models. Conclusions: It’s clearly shown from most of the examined studies that bone morphogenetic protein increases bone regeneration. Further studies should be done in order to induce and sustain bone formation activity. Osteogenic agent should be gradually liberated and not rapidly released with priority to three-dimension reservoir (incorporated titanium implant surface in order to avoid following severe side effects: inflammation, bleeding, haematoma, oedema, erythema, and graft failure.

Hearing outcomes of the active bone conduction system Bonebridge® in conductive or mixed hearing loss.

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Carnevale, Claudio; Til-Pérez, Guillermo; Arancibia-Tagle, Diego J; Tomás-Barberán, Manuel D; Sarría-Echegaray, Pedro L

2018-05-18

The active transcutaneous bone conduction implant Bonebridge ® , is indicated for patients affected by bilateral conductive/mixed hearing loss or unilateral sensorineural hearing loss, showing hearing outcomes similar to other percutaneous bone conduction implants, but with a lower rate of complications. The aim of this study was to analyze the hearing outcomes in a series of 26 patients affected by conductive or mixed hearing loss and treated with Bonebridge ® . 26 of 30 patients implanted with Bonebridge ® between October 2012 and May 2017, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000Hz, the SRT50% and the percentage of correct answers at an intensity of 50dB with and without the implant. "Pure tone average" with the implant was 34.91dB showing an average gain of 33.46dB. Average SRT 50% with the implant was 34.33dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50dB. The percentage of correct answers at 50dB changed from 11% without the implant to 85% with it. We only observed one complication consisting of an extrusion of the implant in a patient with a history of 2 previous rhytidectomies. The hearing outcomes obtained in our study are similar to those published in the literature. Bonebridge ® represents an excellent alternative in the treatment of conductive or mixed hearing loss, and with a lower rate of complications. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Magnetic resonance imaging investigation of the bone conduction implant - a pilot study at 1.5 Tesla.

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Jansson, Karl-Johan Fredén; Håkansson, Bo; Reinfeldt, Sabine; Rigato, Cristina; Eeg-Olofsson, Måns

2015-01-01

The objective of this pilot study was to investigate if an active bone conduction implant (BCI) used in an ongoing clinical study withstands magnetic resonance imaging (MRI) of 1.5 Tesla. In particular, the MRI effects on maximum power output (MPO), total harmonic distortion (THD), and demagnetization were investigated. Implant activation and image artifacts were also evaluated. One implant was placed on the head of a test person at the position corresponding to the normal position of an implanted BCI and applied with a static pressure using a bandage and scanned in a 1.5 Tesla MRI camera. Scanning was performed both with and without the implant, in three orthogonal planes, and for one spin-echo and one gradient-echo pulse sequence. Implant functionality was verified in-between the scans using an audio processor programmed to generate a sequence of tones when attached to the implant. Objective verification was also carried out by measuring MPO and THD on a skull simulator as well as retention force, before and after MRI. It was found that the exposure of 1.5 Tesla MRI only had a minor effect on the MPO, ie, it decreased over all frequencies with an average of 1.1±2.1 dB. The THD remained unchanged above 300 Hz and was increased only at lower frequencies. The retention magnet was demagnetized by 5%. The maximum image artifacts reached a distance of 9 and 10 cm from the implant in the coronal plane for the spin-echo and the gradient-echo sequence, respectively. The test person reported no MRI induced sound from the implant. This pilot study indicates that the present BCI may withstand 1.5 Tesla MRI with only minor effects on its performance. No MRI induced sound was reported, but the head image was highly distorted near the implant.

New bone formation and trabecular bone microarchitecture of highly porous tantalum compared to titanium implant threads: A pilot canine study.

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Lee, Jin Whan; Wen, Hai Bo; Gubbi, Prabhu; Romanos, Georgios E

2018-02-01

This study evaluated new bone formation activities and trabecular bone microarchitecture within the highly porous region of Trabecular Metal™ Dental Implants (TM) and between the threads of Tapered Screw-Vent® Dental Implants (TSV) in fresh canine extraction sockets. Eight partially edentulated dogs received four implants (4.1 mmD × 13 mmL) bilaterally in mandibular fresh extraction sockets (32 TM, 32 TSV implants), and allowed to heal for 2, 4, 8, and 12 weeks. Calcein was administered to label mineralizing bone at 11 and 4 days before euthanasia for dogs undergoing all four healing periods. Biopsies taken at each time interval were examined histologically. Histomorphometric assay was conducted for 64 unstained and 64 stained slides at the region of interest (ROI) (6 mm long × 0.35 mm deep) in the midsections of the implants. Topographical and chemical analyses were also performed. Histomorphometry revealed significantly more new bone in the TM than in the TSV implants at each healing time (p = .0014, .0084, .0218, and .0251). Calcein-labeled data showed more newly mineralized bone in the TM group than in the TSV group at 2, 8, and 12 weeks (p = .045, .028, .002, respectively) but not at 4 weeks (p = .081). Histologically TM implants exhibited more bone growth and dominant new immature woven bone at an earlier time point than TSV implants. The parameters representing trabecular bone microarchitecture corroborated faster new bone formation in the TM implants when compared to the TSV implants. TM exhibited an irregular faceted topography compared to a relatively uniform microtextured surface for TSV. Chemical analysis showed peaks associated with each implant's composition material, and TSV also showed peaks reflecting the elements of the calcium phosphate blasting media. Results suggest that the healing pathway associated with the highly porous midsection of TM dental implant could enable faster and stronger secondary implant stability than

Impact of dental implant insertion method on the peri-implant bone tissue: Experimental study

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Stamatović Novak

2013-01-01

Full Text Available Background/Aim. The function of dental implants depends on their stability in bone tissue over extended period of time, i.e. on osseointegration. The process through which osseointegration is achieved depends on several factors, surgical insertion method being one of them. The aim of this study was to histopathologically compare the impact of the surgical method of implant insertion on the peri-implant bone tissue. Methods. The experiment was performed on 9 dogs. Eight weeks following the extraction of lower premolars implants were inserted using the one-stage method on the right mandibular side and two-stage method on the left side. Three months after implantation the animals were sacrificed. Three distinct regions of bone tissue were histopathologically analyzed, the results were scored and compared. Results. In the specimens of one-stage implants increased amount of collagen fibers was found in 5 specimens where tissue necrosis was also observed. Only moderate osteoblastic activity was found in 3 sections. The analysis of bone-to-implant contact region revealed statistically significantly better results regarding the amount of collagen tissue fibers for the implants inserted in the two-stage method (Wa = 59 105, α = 0.05. No necrosis and osteoblastic activity were observed. Conclusion. Better results were achieved by the two-stage method in bone-to-implant contact region regarding the amount of collagen tissue, while the results were identical regarding the osteoblastic activity and bone tissue necrosis. There was no difference between the methods in the bone-implant interface region. In the bone tissue adjacent to the implant the results were identical regarding the amount of collagen tissue, osteoblastic reaction and bone tissue necrosis, while better results were achieved by the two-stage method regarding the number of osteocytes.

A Bone-Implant Interaction Mouse Model for Evaluating Molecular Mechanism of Biomaterials/Bone Interaction.

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Liu, Wenlong; Dan, Xiuli; Wang, Ting; Lu, William W; Pan, Haobo

2016-11-01

The development of an optimal animal model that could provide fast assessments of the interaction between bone and orthopedic implants is essential for both preclinical and theoretical researches in the design of novel biomaterials. Compared with other animal models, mice have superiority in accessing the well-developed transgenic modification techniques (e.g., cell tracing, knockoff, knockin, and so on), which serve as powerful tools in studying molecular mechanisms. In this study, we introduced the establishment of a mouse model, which was specifically tailored for the assessment of bone-implant interaction in a load-bearing bone marrow microenvironment and could potentially allow the molecular mechanism study of biomaterials by using transgenic technologies. The detailed microsurgery procedures for developing a bone defect (Φ = 0.8 mm) at the metaphysis region of the mouse femur were recorded. According to our results, the osteoconductive and osseointegrative properties of a well-studied 45S5 bioactive glass were confirmed by utilizing our mouse model, verifying the reliability of this model. The feasibility and reliability of the present model were further checked by using other materials as objects of study. Furthermore, our results indicated that this animal model provided a more homogeneous tissue-implant interacting surface than the rat at the early stage of implantation and this is quite meaningful for conducting quantitative analysis. The availability of transgenic techniques to mechanism study of biomaterials was further testified by establishing our model on Nestin-GFP transgenic mice. Intriguingly, the distribution of Nestin + cells was demonstrated to be recruited to the surface of 45S5 glass as early as 3 days postsurgery, indicating that Nestin + lineage stem cells may participate in the subsequent regeneration process. In summary, the bone-implant interaction mouse model could serve as a potential candidate to evaluate the early stage tissue

Evaluation of peri-implant bone using fractal analysis

International Nuclear Information System (INIS)

Jung, Yun Hoa

2005-01-01

The purpose of this study was to investigate whether the fractal dimension of successive panoramic radiographs of bone after implant placement is useful in the characterization of structural change in alveolar bone. Twelve subjects with thirty-five implants were retrospectively followed-up from one week to six months after implantation. Thirty-six panoramic radiographs from twelve patients were classified into 1 week. 1-2 months and 3-6 months after implantation and digitized. The windows of bone apical and mesial or distal to the implant were defined as peri apical region of interest (ROI) and inter dental ROI; the fractal dimension of the image was calculated. There was not a statistically significant difference in fractal dimensions during the period up to 6 months after implantation. The fractal dimensions were higher in 13 and 15 mm than 10 and 11.5 mm implant length at inter dental ROIs in 3-6 months after implantation (p<0.01). Longer fixtures showed the higher fractal dimension of bone around implant. This investigation needs further exploration with large numbers of implants for longer follow-up periods.

Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year.

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Shin, Young-Kyu; Han, Chong-Hyun; Heo, Seong-Joo; Kim, Sunjai; Chun, Heoung-Jae

2006-01-01

To evaluate the influence of macro- and microstructure of the implant surface at the marginal bone level after functional loading. Sixty-eight patients were randomly assigned to 1 of 3 groups. The first group received 35 implants with a machined neck (Ankylos); the second group, 34 implants with a rough-surfaced neck (Stage 1); and the third, 38 implants with a rough-surfaced neck with microthreads (Oneplant). Clinical and radiographic examinations were conducted at baseline (implant loading) and 3, 6, and 12 months postloading. Two-way repeated analysis of variance (ANOVA) was used to test the significance of marginal bone change of each tested group at baseline, 3, 6, and 12 month follow-ups and 1-way ANOVA was also used to compare the bone loss of each time interval within the same implant group (P implant neck not only reduce crestal bone loss but also help with early biomechanical adaptation against loading in comparison to the machined neck design. A rough surface with microthreads at the implant neck was the most effective design to maintain the marginal bone level against functional loading.

[Researches on biomechanics of micro-implant-bone interface and optimum design of micro implant's neck].

Science.gov (United States)

Deng, Feng; Zhang, Lei; Zhang, Yi; Song, Jin-lin; Fan, Yuboa

2007-07-01

To compare and analyze the stress distribution at the micro-implant-bone interface based on the different micro-implant-bone conditioned under orthodontic load, and to optimize the design of micro implant's neck. An adult skull with all tooth was scanned by spiral CT, and the data were imported into computer for three-dimensional reconstruction with software Mimics 9.0. The three dimensional finite element models of three micro-implant-bone interfaces(initial stability, full osseointegration and fibrous integration) were analyzed by finite element analysis software ABAQUS6.5. The primary stress distributions of different micro-implant-bone conditions were evaluated when 2N force was loaded. Then the diameter less than 1.5 mm of the micro implant's neck was added with 0.2 mm, to compare the stress distribution of the modified micro-implant-bone interface with traditional type. The stress mostly concentrated on the neck of micro implant and the full osseointegration interface in all models showed the lowest strain level. Compared with the traditional type, the increasing diameter neck of the micro implant obviously decreased the stress level in all the three conditions. The micro-implant-bone interface and the diameter of micro implant's neck both are the important influence factors to the stress distribution of micro implant.

Survival of Dental Implants Placed in Grafted and Nongrafted Bone: A Retrospective Study in a University Setting.

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Tran, Duong T; Gay, Isabel C; Diaz-Rodriguez, Janice; Parthasarathy, Kavitha; Weltman, Robin; Friedman, Lawrence

2016-01-01

To compare dental implant survival rates when placed in native bone and grafted sites. Additionally, risk factors associated with dental implant loss were identified. This study was based on the hypothesis that bone grafting has no effect on implant survival rates. A retrospective chart review was conducted for patients receiving dental implants at the University of Texas, School of Dentistry from 1985 to 2012. Exclusion criteria included patients with genetic diseases, radiation and chemotherapy, or an age less than 18 years. To avoid misclassification bias, implants were excluded if bone grafts were only done at the same time of placement. Data on age, sex, tobacco use, diabetes, osteoporosis, anatomical location of the implant, implant length and width, bone graft, and professional maintenance were collected for analysis. A total of 1,222 patients with 2,729 implants were included. The cumulative survival rates at 5 and 10 years were 92% and 87% for implants placed in native bone and 90% and 79% for implants placed in grafted bone, respectively. The results from multivariate analysis (Cox regression) indicated no significant difference in survival between the two groups; having maintenance therapy after implant placement reduced the failure rate by 80% (P dental implant survival rate when implants were placed in native bone or bone-grafted sites. Smoking and lack of professional maintenance were significantly related to increased implant loss.

Mecanobiología de la interfase hueso-implante dental Mechanobiology of bone-dental implant interphase

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Juan Carlos Vanegas Acosta

2010-03-01

Full Text Available La osteointegración es la conexión estructural y funcional entre el hueso y un implante. Cuando un implante se inserta en el hueso, se crea la denominada interfase hueso-implante, una zona de unión entre la superficie del biomaterial del implante y el hueso circundante. La cicatrización de esta interfase depende de las condiciones biológicas del hueso, las características de diseño del implante y la distribución de cargas entre hueso e implante. En este artículo se hace una revisión del proceso de cicatrización de la interfase hueso-implante para el caso de un implante dental. El objetivo es describir la secuencia de eventos biológicos iniciados con la lesión causada por la inserción del implante y que concluyen con la formación de nuevo hueso en la interfase. Esta descripción incluye una novedosa clasificación de los fenómenos mecánicos que intervienen durante el proceso de cicatrización de los tejidos lesionados. Esta descripción mecanobiológica de la interfase hueso-implante dental se utiliza para determinar las características más relevantes a tener en cuenta en la formulación de un modelo matemático de la osteointegración de implantes dentales.The osteointegration is the structural and functional connection between bone and implant. When an implant is inserted in bone, it creates the so-called bone-implant interphase, a joint zone between implant biomaterial surface and the surrounding bone. The healing of this interphase depends on bone biological conditions, characteristic of implant design and the distribution of loads between bone and implant. The aim of present article is to review of healing process of bone-implant interphase for a dental implant and also to describe the sequence of biological events beginning with lesion caused by implant insertion and leading to the formation of a new bone in the interphase. This description includes a novel classification of mechanical phenomena present in the healing

Bone-Implant Contact around Crestal and Subcrestal Dental Implants Submitted to Immediate and Conventional Loading

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Ana Emília Farias Pontes

2014-01-01

Full Text Available The present study aims to evaluate the influence of apicocoronal position and immediate and conventional loading in the percentage of bone-implant contact (BIC. Thus, 36 implants were inserted in the edentulous mandible from six dogs. Three implants were installed in each hemimandible, in different positions in relation to the ridge: Bone Level (at crestal bone level, Minus 1 (one millimeter apical to crestal bone, and Minus 2 (two millimeters apical to crestal bone. In addition, each hemimandible was submitted to a loading protocol: immediate (prosthesis installed 24 hours after implantation or conventional (prosthesis installed 120 days after implantation. Ninety days after, animals were killed, and implant and adjacent tissues were prepared for histometric analysis. BIC values from immediate loaded implants were 58.7%, 57.7%, and 51.1%, respectively, while conventional loaded implants were 61.8%, 53.8%, and 68.4%. Differences statistically significant were not observed among groups (P=0.10, ANOVA test. These findings suggest that different apicocoronal positioning and loading protocols evaluated did not interfere in the percentage of bone-implant contact, suggesting that these procedures did not jeopardize osseointegration.

Osseointegration of zirconia implants: an SEM observation of the bone-implant interface.

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Depprich, Rita; Zipprich, Holger; Ommerborn, Michelle; Mahn, Eduardo; Lammers, Lydia; Handschel, Jörg; Naujoks, Christian; Wiesmann, Hans-Peter; Kübler, Norbert R; Meyer, Ulrich

2008-11-06

The successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics, biocompatibility, and bright tooth-like color, zirconia (zirconium dioxide, ZrO2) has the potential to become a substitute for titanium as dental implant material. The present study aimed at investigating the osseointegration of zirconia implants with modified ablative surface at an ultrastructural level. A total of 24 zirconia implants with modified ablative surfaces and 24 titanium implants all of similar shape and surface structure were inserted into the tibia of 12 Göttinger minipigs. Block biopsies were harvested 1 week, 4 weeks or 12 weeks (four animals each) after surgery. Scanning electron microscopy (SEM) analysis was performed at the bone implant interface. Remarkable bone attachment was already seen after 1 week which increased further to intimate bone contact after 4 weeks, observed on both zirconia and titanium implant surfaces. After 12 weeks, osseointegration without interposition of an interfacial layer was detected. At the ultrastructural level, there was no obvious difference between the osseointegration of zirconia implants with modified ablative surfaces and titanium implants with a similar surface topography. The results of this study indicate similar osseointegration of zirconia and titanium implants at the ultrastructural level.

Bonebridge Implantation for Conductive Hearing Loss in a Patient with Oval Window Atresia.

Science.gov (United States)

Kim, Minbum

2015-08-01

The occurrence of oval window atresia is a rare anomaly with conductive hearing loss. Traditional atresia surgeries involve challenging surgical techniques with risks of irreversible inner ear damage. Recent reports on Bonebridge (Medel, Innsbruck, Austria), a novel implantable bone conduction hearing aid system, assert that the device is safe and effective for conductive hearing loss. We present a case of Bonebridge implantation in an eight-year-old girl with bilateral oval window atresia.

Osseointegration of subperiosteal implants using bovine bone substitute and various membranes

DEFF Research Database (Denmark)

Aaboe, Merete; Schou, S.; Hjørting-Hansen, E.

2000-01-01

Osseointegration, subperiosteal implant, bone substitute, bovine bone, guided bone, regeneration, histology, rabbits......Osseointegration, subperiosteal implant, bone substitute, bovine bone, guided bone, regeneration, histology, rabbits...

Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant.

Science.gov (United States)

Petersen, Richard C

2011-05-03

Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P engineering potential.

Objective and subjective outcome of a new transcutaneous bone conduction hearing device

DEFF Research Database (Denmark)

Eberhard, Kristine Elisabeth; Olsen, Steen Østergaard; Miyazaki, Hidemi

2016-01-01

Objective: To examine the objective and subjective outcome of a new transcutaneous bone conduction hearing device. Study Design: Prospective, consecutive case series. Patients: Twelve patients were implanted. Eight patients had a conductive/mixed (con/mix) hearing loss. Four had single sided...... to beneficial outcome. In Speech, Spatial and Qualities of Hearing Scale 12, ''quality of hearing'' scored especially high. The con/mix hearing loss group showed larger benefit especially in SDS, SRT50% in noise and the subjective evaluations, whereas frequency and duration of use were similar. Conclusion......: This study on the first 12 Nordic patients implanted with a new transcutaneous bone conduction hearing device demonstrates significant objective, as well as subjective hearing benefit. Patient satisfaction was high, as was the frequency of use....

Ion implantation induced nanotopography on titanium and bone cell adhesion

Energy Technology Data Exchange (ETDEWEB)

Braceras, Iñigo, E-mail: inigo.braceras@tecnalia.com [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Vera, Carolina; Ayerdi-Izquierdo, Ana [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Muñoz, Roberto [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); Lorenzo, Jaione; Alvarez, Noelia [Tecnalia, Mikeletegi Pasealekua 2, 20009 Donostia-San Sebastian (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (Ciber-BBN) (Spain); Maeztu, Miguel Ángel de [Private Practice, P° San Francisco, 43 A-1°, 20400 Tolosa (Spain)

2014-08-15

Graphical abstract: Titanium surfaces modified by inert ion implantation affect cell adhesion through modification of the nanotopography in the same dimensional range of that of human bone inorganic phases. - Highlights: • Inert ion implantation on Ti modifies surface nanotopography and bone cell adhesion. • Ion implantation can produce nanostructured surfaces on titanium in the very same range as of those of the mineral phase of the human bone. • Appropriate tool for studying the relevance of nanostructured surfaces on bone mineralization and implant osseointegration. • Ion implantation induced nanotopography have a statistically significant influence on bone cell adhesion. - Abstract: Permanent endo-osseous implants require a fast, reliable and consistent osseointegration, i.e. intimate bonding between bone and implant, so biomechanical loads can be safely transferred. Among the parameters that affect this process, it is widely admitted that implant surface topography, surface energy and composition play an important role. Most surface treatments to improve osseointegration focus on micro-scale features, as few can effectively control the effects of the treatment at nanoscale. On the other hand, ion implantation allows controlling such nanofeatures. This study has investigated the nanotopography of titanium, as induced by different ion implantation surface treatments, its similarity with human bone tissue structure and its effect on human bone cell adhesion, as a first step in the process of osseointegration. The effect of ion implantation treatment parameters such as energy (40–80 keV), fluence (1–2 e17 ion/cm{sup 2}) and ion species (Kr, Ar, Ne and Xe) on the nanotopography of medical grade titanium has been measured and assessed by AFM and contact angle. Then, in vitro tests have been performed to assess the effect of these nanotopographies on osteoblast adhesion. The results have shown that the nanostructure of bone and the studied ion implanted

Ion implantation induced nanotopography on titanium and bone cell adhesion

International Nuclear Information System (INIS)

Braceras, Iñigo; Vera, Carolina; Ayerdi-Izquierdo, Ana; Muñoz, Roberto; Lorenzo, Jaione; Alvarez, Noelia; Maeztu, Miguel Ángel de

2014-01-01

Graphical abstract: Titanium surfaces modified by inert ion implantation affect cell adhesion through modification of the nanotopography in the same dimensional range of that of human bone inorganic phases. - Highlights: • Inert ion implantation on Ti modifies surface nanotopography and bone cell adhesion. • Ion implantation can produce nanostructured surfaces on titanium in the very same range as of those of the mineral phase of the human bone. • Appropriate tool for studying the relevance of nanostructured surfaces on bone mineralization and implant osseointegration. • Ion implantation induced nanotopography have a statistically significant influence on bone cell adhesion. - Abstract: Permanent endo-osseous implants require a fast, reliable and consistent osseointegration, i.e. intimate bonding between bone and implant, so biomechanical loads can be safely transferred. Among the parameters that affect this process, it is widely admitted that implant surface topography, surface energy and composition play an important role. Most surface treatments to improve osseointegration focus on micro-scale features, as few can effectively control the effects of the treatment at nanoscale. On the other hand, ion implantation allows controlling such nanofeatures. This study has investigated the nanotopography of titanium, as induced by different ion implantation surface treatments, its similarity with human bone tissue structure and its effect on human bone cell adhesion, as a first step in the process of osseointegration. The effect of ion implantation treatment parameters such as energy (40–80 keV), fluence (1–2 e17 ion/cm 2 ) and ion species (Kr, Ar, Ne and Xe) on the nanotopography of medical grade titanium has been measured and assessed by AFM and contact angle. Then, in vitro tests have been performed to assess the effect of these nanotopographies on osteoblast adhesion. The results have shown that the nanostructure of bone and the studied ion implanted

The influence of bone graft procedures on primary stability and bone change of implants placed in fresh extraction sockets.

Science.gov (United States)

Jun, Sang Ho; Park, Chang-Joo; Hwang, Suk-Hyun; Lee, Youn Ki; Zhou, Cong; Jang, Hyon-Seok; Ryu, Jae-Jun

2018-12-01

This study was to evaluate the effect of bone graft procedure on the primary stability of implants installed in fresh sockets and assess the vertical alteration of peri-implant bone radiographically. Twenty-three implants were inserted in 18 patients immediately after tooth extraction. The horizontal gap between the implant and bony walls of the extraction socket was grafted with xenografts. The implant stability before and after graft procedure was measured by Osstell Mentor as implant stability quotient before bone graft (ISQ bbg) and implant stability quotient after bone graft (ISQ abg). Peri-apical radiographs were taken to measure peri-implant bone change immediately after implant surgery and 12 months after implant placement. Data were analyzed by independent t test; the relationships between stability parameters (insertion torque value (ITV), ISQ abg, and ISQ bbg) and peri-implant bone changes were analyzed according to Pearson correlation coefficients. The increase of ISQ in low primary stability group (LPSG) was 6.87 ± 3.62, which was significantly higher than the increase in high primary stability group (HPSG). A significant correlation between ITV and ISQ bbg ( R  = 0.606, P  = 0.002) was found; however, age and peri-implant bone change were not found significantly related to implant stability parameters. It was presented that there were no significant peri-implant bone changes at 1 year after bone graft surgery. Bone graft procedure is beneficial for increasing the primary stability of immediately placed implants, especially when the ISQ of implants is below 65 and that bone grafts have some effects on peri-implant bone maintenance.

Lithium chloride enhances bone regeneration and implant osseointegration in osteoporotic conditions.

Science.gov (United States)

Jin, Yifan; Xu, Lihua; Hu, Xiaohui; Liao, Shixian; Pathak, Janak L; Liu, Jinsong

2016-10-06

Osteoporotic patients have a high risk of dental and orthopedic implant failure. Lithium chloride (LiCl) has been reported to enhance bone formation. However, the role of LiCl in the success rate of dental and orthopedic implants in osteoporotic conditions is still unknown. We investigated whether LiCl enhances implant osseointegration, implant fixation, and bone formation in osteoporotic conditions. Sprague-Dawley female rats (n = 18) were ovariectomized (OVX) to induce osteoporosis, and another nine rats underwent sham surgery. Three months after surgery, titanium implants were implanted in the tibia of the OVX and sham group rats. After implantation, the OVX rats were gavaged with 150 mg/kg/2 days of LiCl (OVX + LiCl group) or saline (OVX group), and sham group rats were gavaged with saline for 3 months. Implant osseointegration and bone formation were analyzed using histology, biomechanical testing, and micro computed tomography (micro-CT). More bone loss was observed in the OVX group compared to the control, and LiCl treatment enhanced bone formation and implant fixation in osteoporotic rats. In the OVX group, bone-implant contact (BIC) was decreased by 81.2 % compared to the sham group. Interestingly, the OVX + LiCl group showed 4.4-fold higher BIC compared to the OVX group. Micro-CT data of tibia from the OVX + LiCl group showed higher bone volume, trabecular thickness, trabecular number, and osseointegration compared to the OVX group. Maximum push-out force and implant-bone interface shear strength were 2.9-fold stronger in the OVX + LiCl group compared to the OVX group. In conclusion, LiCl enhanced implant osseointegration, implant fixation, and bone formation in osteoporotic conditions, suggesting LiCl as a promising therapeutic agent to prevent implant failure and bone loss in osteoporotic conditions.

Influence of Different Implant Geometry in Clinical Longevity and Maintenance of Marginal Bone: A Systematic Review.

Science.gov (United States)

Lovatto, Sabrina Telles; Bassani, Rafaela; Sarkis-Onofre, Rafael; Dos Santos, Mateus Bertolini Fernandes

2018-03-26

To assess, through a systematic review, the influence of different implant geometries on clinical longevity and maintenance of marginal bone tissue. An electronic search was conducted in MEDLINE, Scopus, and Web of Science databases, limited to studies written in English from 1996 to 2017 using specific search strategies. Only randomized controlled trials (RCTs) that compared dental implants and their geometries were included. Two reviewers independently selected studies, extracted data, and assessed the risk of bias of included studies. From the 4006 references identified by the search, 24 were considered eligible for full-text analysis, after which 10 studies were included in this review. A similar behavior of marginal bone loss between tapered and cylindrical geometries was observed; however, implants that had micro-threads in the neck presented a slight decrease of marginal bone loss compared to implants with straight or smooth neck. Success and survival rates were high, with cylindrical implants presenting higher success and survival rates than tapered ones. Implant geometry seems to have little influence on marginal bone loss (MBL) and survival and success rates after 1 year of implant placement; however, the evidence in this systematic review was classified as very low due to limitations such as study design, sample size, and publication bias. Thus, more well-designed RCTs should be conducted to provide evidence regarding the influence of implant geometry on MBL and survival and success rates after 1 year of implant placement. © 2018 by the American College of Prosthodontists.

Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant

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Richard C. Petersen

2011-01-01

Full Text Available Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P<10−4, and 19.3% to 77.7% at 0.1 mm, P<10−8. Carbon-fiber fragments planned to occur in the test designs, instead of producing an inflammation, stimulated bone formation and increased bone integration to the implant. In addition, low-thermal polymer processing allows incorporation of minerals and pharmaceuticals for future major tissue-engineering potential.

Biomechanics and strain mapping in bone as related to immediately-loaded dental implants

Science.gov (United States)

Du, Jing; Lee, Jihyun; Jang, Andrew; Gu, Allen; Hossaini-Zadeh, Mehran; Prevost, Richard; Curtis, Don; Ho, Sunita

2015-01-01

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, immediate implants were placed and bone-implant contact area, stability and bone strain were measured. In situ biomechanical testing coupled with micro X-ray microscope (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 reduced and 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 small scale animal models. PMID:26162549

Comparison of bone-implant contact and bone-implant volume between 2D-histological sections and 3D-SRµCT slices

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R Bernhardt

2012-04-01

Full Text Available Histological imaging is still considered the gold standard for analysing bone formation around metallic implants. Generally, a limited number of histological sections per sample are used for the approximation of mean values of peri-implant bone formation. In this study we compared statistically the results of bone-implant contact (BIC and bone-implant volume (BIV obtained by histological sections, with those obtained by X-ray absorption images from synchrotron radiation micro-computed tomography (SRµCT using osseointegrated screw-shaped implants from a mini-pig study. Comparing the BIC results of 3-4 histological sections per implant sample with the appropriate 3-4 SRµCT slices showed a non-significant difference of 1.9 % (p = 0.703. The contact area assessed by the whole 3D information from the SRµCT measurement in comparison to the histomorphometric results showed a non-significant difference in BIC of 4.9 % (p = 0.171. The amount of the bone-implant volume in the histological sections and the appropriate SRµCT slices showed a non-significant difference by only 1.4 % (p = 0.736 and also remains non-significant with 2.6 % (p = 0.323 using the volumetric SRµCT information. We conclude that for a clinical evaluation of implant osseointegration with histological imaging at least 3-4 sections per sample are sufficient to represent the BIC or BIV for a sample. Due to the fact that in this study we have found a significant intra-sample variation in BIC of up to ± 35 % the selection of only one or two histological sections per sample may strongly influence the determined BIC.

Observation of the bone mineral density of newly formed bone using rabbits. Compared with newly formed bone around implants and cortical bone

International Nuclear Information System (INIS)

Nakada, Hiroshi; Numata, Yasuko; Sakae, Toshiro; Tamaki, Hiroyuki; Kato, Takao

2009-01-01

There have been many studies reporting that newly formed bone around implants is spongy bone. However, although the morphology is reported as being like spongy bone, it is difficult to discriminate whether the bone quality of newly formed bone appears similar to osteoid or cortical bone; therefore, evaluation of bone quality is required. The aims of this study were to measure the bone mineral density (BMD) values of newly formed bone around implants after 4, 8, 16, 24 and 48 weeks, to represent these values on three-dimensional color mapping (3Dmap), and to evaluate the change in bone quality associated with newly formed bone around implants. The animal experimental protocol of this study was approved by the Ethics Committee for Animal Experiments of our University. This experiment used 20 surface treatment implants (Ti-6Al-4V alloy: 3.1 mm in diameter and 30.0 mm in length) by grit-blasting. They were embedded into surgically created flaws in femurs of 20 New Zealand white rabbits (16 weeks old, male). The rabbits were sacrificed with an ear intravenous overdose of pentobarbital sodium under general anesthesia each period, and the femurs were resected. We measured BMD of newly formed bone around implants and cortical bone using Micro-CT, and the BMD distribution map of 3Dmap (TRI/3D Bon BMD, Ratoc System Engineering). The BMD of cortical bone was 1,026.3±44.3 mg/cm 3 at 4 weeks, 1,023.8±40.9 mg/cm 3 at 8 weeks, 1,048.2±45.6 mg/cm 3 at 16 weeks, 1,067.2±60.2 mg/cm 3 at 24 weeks, and 1,069.3±50.7 mg/cm 3 at 48 weeks after implantation, showing a non-significant increase each period. The BMD of newly formed bone around implants was 296.8±25.6 mg/cm 3 at 4 weeks, 525.0±72.4 mg/cm 3 at 8 weeks, 691.2±26.0 mg/cm 3 at 16 weeks, 776.9±27.7 mg/cm 3 at 24 weeks, and 845.2±23.1 mg/cm 3 at 48 weeks after implantation, showing a significant increase after each period. It was revealed that the color scale of newly formed bone was Low level at 4 weeks, and then it

Biocompatibility of orthopaedic implants on bone forming cells

OpenAIRE

Kapanen, A. (Anita)

2002-01-01

Abstract Reindeer antler was studied for its possible use as a bone implant material. A molecular biological study showed that antler contains a growth factor promoting bone formation. Ectopic bone formation assay showed that antler is not an equally effective inducer as allogenic material. Ectopic bone formation assay was optimised for biocompatibility studies of orthopaedic NiTi implants. Ti-6Al-4V and stainless steel were used as reference materials. The assay...

Magnetic resonance imaging investigation of the bone conduction implant – a pilot study at 1.5 Tesla

Science.gov (United States)

Jansson, Karl-Johan Fredén; Håkansson, Bo; Reinfeldt, Sabine; Rigato, Cristina; Eeg-Olofsson, Måns

2015-01-01

Purpose The objective of this pilot study was to investigate if an active bone conduction implant (BCI) used in an ongoing clinical study withstands magnetic resonance imaging (MRI) of 1.5 Tesla. In particular, the MRI effects on maximum power output (MPO), total harmonic distortion (THD), and demagnetization were investigated. Implant activation and image artifacts were also evaluated. Methods and materials One implant was placed on the head of a test person at the position corresponding to the normal position of an implanted BCI and applied with a static pressure using a bandage and scanned in a 1.5 Tesla MRI camera. Scanning was performed both with and without the implant, in three orthogonal planes, and for one spin-echo and one gradient-echo pulse sequence. Implant functionality was verified in-between the scans using an audio processor programmed to generate a sequence of tones when attached to the implant. Objective verification was also carried out by measuring MPO and THD on a skull simulator as well as retention force, before and after MRI. Results It was found that the exposure of 1.5 Tesla MRI only had a minor effect on the MPO, ie, it decreased over all frequencies with an average of 1.1±2.1 dB. The THD remained unchanged above 300 Hz and was increased only at lower frequencies. The retention magnet was demagnetized by 5%. The maximum image artifacts reached a distance of 9 and 10 cm from the implant in the coronal plane for the spin-echo and the gradient-echo sequence, respectively. The test person reported no MRI induced sound from the implant. Conclusion This pilot study indicates that the present BCI may withstand 1.5 Tesla MRI with only minor effects on its performance. No MRI induced sound was reported, but the head image was highly distorted near the implant. PMID:26604836

Osteoporotic rat models for evaluation of osseointegration of bone implants

NARCIS (Netherlands)

Alghamdi, H.S.A.; Beucken, J.J.J.P van den; Jansen, J.A.

2014-01-01

Osseointegration of dental and orthopedic bone implants is the important process that leads to mechanical fixation of implants and warrants implant functionality. In view of increasing numbers of osteoporotic patients, bone implant surface optimization strategies with instructive and drug-loading

Contemporary guided bone regeneration therapy for unaesthetic anterior peri-implantitis case

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Benso Sulijaya

2016-12-01

Full Text Available Background: Dental implant is one of an alternative solutions reconstruction therapy for missing teeth. Complication of dental implant could occurs and leading to implant failure. In order to restore the complication, surgical treatment with guided bone regeneration (GBR is indicated. The potential use of bone substitutes is widely known to be able to regenerate the bone surrounding the implant and maintain bone volume. Purpose: The study aimed to demonstrate the effectiveness of implant-bone fully coverage by using sandwich technique of biphasic calcium phosphate (BCP and demineralized freeze-dried bone allografts (DFDBA bone substitutes combined with collagen resorbable membrane. Case: A 24-year-old male came with diagnosis of peri-implantitis on implant #11. Clinical finding indicated that implant thread was exposed on the labial aspect. Case management: After initial therapy including oral hygiene improvement performed, an operator did a contemporary GBR to correct the defect. Bone graft materials used were 40% β-tri calcium phosphate (β-TCP-60% hydroxyapatite (HA on the outer layer and DFDBA on the inner layer of the defect. Resorbable collagen membrane was used to cover the graft. Conclusion: GBR with sandwich technique could serve as one of the treatment choices for correcting an exposed anterior implant that would enhance the successful aesthetic outcome.

Histological study on the new bone formation of the implanted bone allograft in sheep

International Nuclear Information System (INIS)

Li Youchen; Sun Guiying; Shi Zhancheng

1999-01-01

The purpose of this study is to compare the formation of new bone in the implanted frozen irradiated bone allograft with the fresh bone autograft. The work on animal model included resection and implantation of sheep's tibial diaphysis and intramedullary nail fixation, with total number 20. Tibias were harvested at 6, 12, and 24 months after operation. Sheep were fed with tetracycline I week before bone harvesting. Bones were examined with usual and fluorescence microscopes. The results showed that the progress of graft incorporation in allografts were generally similar to that of autografts. Capillaries penetration and callus formation extended from the host end to surround the host-graft junction in 6 months. Incorporation of new bone was nearly completed in 12 months; then the speed of new bone formation was decreased, and the implanted bone graft was almost completely substituted with non-nal bone structure in 24 months

An Unusual Bone Loss Around Implants

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Amirreza Rokn

2013-01-01

Full Text Available AbstractPre-implant disease is an inflammatory process, which can affect the surrounding tissues of a functional Osseointegrated implant that is usually as a result of a disequilibrium between the micro-flora and the body defense system.This case reports a 57 years old male with unusual bone loss around dental implants.This was an unusual case of peri-implantitis which occurred only in the implants on one side of the mouth although they all were unloaded implants.

Bone reactions at implants subjected to experimental peri-implantitis and static load. A study in the dog

DEFF Research Database (Denmark)

Gotfredsen, K; Berglundh, T; Lindhe, J

2002-01-01

during a 12-week interval, the screws were reactivated. Thus, the model included 3 different experimental sites of each surface group: group M+L (mucositis+load); group P (peri-implantitis); group P+L (peri-implantitis+load). Fluorochrome labels were injected and standardized radiographs obtained....... The animals were sacrificed and block biopsies of all implant sites dissected and prepared for histological analysis. RESULTS: It was demonstrated that the lateral static load failed to induce peri-implant bone loss at implants with mucositis and failed to enhance the bone loss at implants with experimental...... peri-implantitis. The proportion of bone labels and the bone density in the interface zone were significantly higher in group P+L than in group P. CONCLUSION: It is suggested that a lateral static load with controlled forces may not be detrimental to implants exhibiting mucositis or peri-implantitis....

[Osteoclasts and early bone remodeling after orthodontic micro-implant placement].

Science.gov (United States)

Zhang, Wei; Guo, Jia-jia; Zhu, Wen-qian; Tang, Guo-hua

2013-08-01

To observe the incidence of osteoclasts during early bone remodeling after orthodontic micro-implant placement. Twenty New Zealand rabbits were randomly allotted into 4 groups. One micro-implant was implanted proximal to the epiphyseal plate of the tibia. Animals were sacrificed on day 3, 7, 14 and 28 (n=5). The sequence of histological changes around the micro-implants were evaluated by hematoxylin and eosin (HE) staining. Osteoclasts were identified by TRAP staining. The differences of the number of the osteoclasts among each time point were analyzed by one way ANOVA with SPSS 19.0 software package. After 3 days of implantation, a large number of erythrocytes, inflammatory cells, mesenchymal cells and bone debris were seen at the implant bone interfaces. Few osteoclasts were observed. On day 7, granular woven bone was formed and some osteoclasts were found in the Howship's lacunae. New bone formation and mineralization were apparent on day 14. Meanwhile, large amounts of osteoclasts were found in the latticed woven bone. On day 28, woven trabeculae with lamellate structures connected to lamellar bone and fewer osteoclasts were identified. Semi-quantitative analysis showed that the number of the osteoclasts was at peak on day 14. There were significant differences among each time point (Pmicro-implant insertion.

Fiber glass-bioactive glass composite for bone replacing and bone anchoring implants.

Science.gov (United States)

Vallittu, Pekka K; Närhi, Timo O; Hupa, Leena

2015-04-01

Although metal implants have successfully been used for decades, devices made out of metals do not meet all clinical requirements, for example, metal objects may interfere with some new medical imaging systems, while their stiffness also differs from natural bone and may cause stress-shielding and over-loading of bone. Peer-review articles and other scientific literature were reviewed for providing up-dated information how fiber-reinforced composites and bioactive glass can be utilized in implantology. There has been a lot of development in the field of composite material research, which has focused to a large extent on biodegradable composites. However, it has become evident that biostable composites may also have several clinical benefits. Fiber reinforced composites containing bioactive glasses are relatively new types of biomaterials in the field of implantology. Biostable glass fibers are responsible for the load-bearing capacity of the implant, while the dissolution of the bioactive glass particles supports bone bonding and provides antimicrobial properties for the implant. These kinds of combination materials have been used clinically in cranioplasty implants and they have been investigated also as oral and orthopedic implants. The present knowledge suggests that by combining glass fiber-reinforced composite with particles of bioactive glass can be used in cranial implants and that the combination of materials may have potential use also as other types of bone replacing and repairing implants. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effect of healing time on bone-implant contact of orthodontic micro-implants: a histologic study.

Science.gov (United States)

Ramazanzadeh, Barat Ali; Fatemi, Kazem; Dehghani, Mahboobe; Mohtasham, Nooshin; Jahanbin, Arezoo; Sadeghian, Hamed

2014-01-01

Objectives. This study aimed to evaluate the effect of immediate and delayed loading of orthodontic micro-implants on bone-implant contact. Materials and Methods. Sixty four micro-implants were implanted in dog's jaw bone. The micro-implants were divided into loaded and unloaded (control) groups. The control group had two subgroups: four and eight weeks being implanted. The loaded group had two subgroups of immediate loading and delayed (after four weeks healing) loading. Loaded samples were subjected to 200g load for four weeks. After sacrificing the animals micro-implants and surrounding tissues were observed histologically. Bone-implant contact ratios (BIC) were calculated and different groups' results were compared by three-way ANOVA. Results. Mean survival rate was 96.7% in general. Survival rates were 96.7%, 94.4% and 100% for control, immediate and delayed loaded groups, respectively. BIC values were not significantly different in loaded and control groups, immediate and delayed loading groups, and pressure and tension sides. Mandibular micro-implants had significantly higher BIC than maxillary ones in immediate loading, 4-weeks control, and 8-weeks control groups (P = 0.021, P = 0.009, P = 0.003, resp.). Conclusion Immediate or delayed loading of micro-implants in dog did not cause significant difference in Bone-implant contact which could be concluded that healing time had not significant effect on micro-implant stability.

Development and application of a direct method to observe the implant/bone interface using simulated bone.

Science.gov (United States)

Yamaguchi, Yoko; Shiota, Makoto; FuJii, Masaki; Sekiya, Michi; Ozeki, Masahiko

2016-01-01

Primary stability after implant placement is essential for osseointegration. It is important to understand the bone/implant interface for analyzing the influence of implant design on primary stability. In this study rigid polyurethane foam is used as artificial bone to evaluate the bone-implant interface and to identify where the torque is being generated during placement. Five implant systems-Straumann-Standard (ST), Straumann-Bone Level (BL), Straumann-Tapered Effect (TE), Nobel Biocare-Brånemark MKIII (MK3), and Nobel Biocare-Brånemark MKIV (MK4)-were used for this experiment. Artificial bone blocks were prepared and the implant was installed. After placement, a metal jig and one side artificial bone block were removed and then the implant embedded in the artificial bone was exposed for observing the bone-implant interface. A digital micro-analyzer was used for observing the contact interface. The insertion torque values were 39.35, 23.78, 12.53, 26.35, and 17.79 N cm for MK4, BL, ST, TE, and MK3, respectively. In ST, MK3, TE, MK4, and BL the white layer areas were 61 × 103 μm(2), 37 × 103 μm(2), 103 × 103 μm(2) in the tapered portion and 84 × 03 μm(2) in the parallel portion, 134 × 103 μm(2), and 98 × 103 μm(2) in the tapered portion and 87 × 103 μm(2) in the parallel portion, respectively. The direct observation method of the implant/artificial bone interface is a simple and useful method that enables the identification of the area where implant retention occurs. A white layer at the site of stress concentration during implant placement was identified and the magnitude of the stress was quantitatively estimated. The site where the highest torque occurred was the area from the thread crest to the thread root and the under and lateral aspect of the platform. The artificial bone debris created by the self-tapping blade accumulated in both the cutting chamber and in the space between the threads and artificial bone.

Interruption of Electrical Conductivity of Titanium Dental Implants Suggests a Path Towards Elimination Of Corrosion.

Science.gov (United States)

Pozhitkov, Alex E; Daubert, Diane; Brochwicz Donimirski, Ashley; Goodgion, Douglas; Vagin, Mikhail Y; Leroux, Brian G; Hunter, Colby M; Flemmig, Thomas F; Noble, Peter A; Bryers, James D

2015-01-01

Peri-implantitis is an inflammatory disease that results in the destruction of soft tissue and bone around the implant. Titanium implant corrosion has been attributed to the implant failure and cytotoxic effects to the alveolar bone. We have documented the extent of titanium release into surrounding plaque in patients with and without peri-implantitis. An in vitro model was designed to represent the actual environment of an implant in a patient's mouth. The model uses actual oral microbiota from a volunteer, allows monitoring electrochemical processes generated by biofilms growing on implants and permits control of biocorrosion electrical current. As determined by next generation DNA sequencing, microbial compositions in experiments with the in vitro model were comparable with the compositions found in patients with implants. It was determined that the electrical conductivity of titanium implants was the key factor responsible for the biocorrosion process. The interruption of the biocorrosion current resulted in a 4-5 fold reduction of corrosion. We propose a new design of dental implant that combines titanium in zero oxidation state for osseointegration and strength, interlaid with a nonconductive ceramic. In addition, we propose electrotherapy for manipulation of microbial biofilms and to induce bone healing in peri-implantitis patients.

Interruption of Electrical Conductivity of Titanium Dental Implants Suggests a Path Towards Elimination Of Corrosion.

Directory of Open Access Journals (Sweden)

Alex E Pozhitkov

Full Text Available Peri-implantitis is an inflammatory disease that results in the destruction of soft tissue and bone around the implant. Titanium implant corrosion has been attributed to the implant failure and cytotoxic effects to the alveolar bone. We have documented the extent of titanium release into surrounding plaque in patients with and without peri-implantitis. An in vitro model was designed to represent the actual environment of an implant in a patient's mouth. The model uses actual oral microbiota from a volunteer, allows monitoring electrochemical processes generated by biofilms growing on implants and permits control of biocorrosion electrical current. As determined by next generation DNA sequencing, microbial compositions in experiments with the in vitro model were comparable with the compositions found in patients with implants. It was determined that the electrical conductivity of titanium implants was the key factor responsible for the biocorrosion process. The interruption of the biocorrosion current resulted in a 4-5 fold reduction of corrosion. We propose a new design of dental implant that combines titanium in zero oxidation state for osseointegration and strength, interlaid with a nonconductive ceramic. In addition, we propose electrotherapy for manipulation of microbial biofilms and to induce bone healing in peri-implantitis patients.

Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant

OpenAIRE

Petersen, Richard C.

2011-01-01

Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats reve...

Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses.

Science.gov (United States)

Hsu, J T; Huang, H L; Tsai, M T; Wu, A Y J; Tu, M G; Fuh, L J

2013-02-01

This study investigated the effects of bone stiffness (elastic modulus) and three-dimensional (3D) bone-to-implant contact ratio (BIC%) on the primary stabilities of dental implants using micro-computed tomography (micro-CT) and resonance frequency analyses. Artificial sawbone models with five values of elastic modulus (137, 123, 47.5, 22, and 12.4 MPa) comprising two types of trabecular structure (solid-rigid and cellular-rigid) were investigated for initial implant stability quotient (ISQ), measured using the wireless Osstell resonance frequency analyzer. Bone specimens were attached to 2 mm fibre-filled epoxy sheets mimicking the cortical shell. ISQ was measured after placing a dental implant into the bone specimen. Each bone specimen with an implant was subjected to micro-CT scanning to calculate the 3D BIC% values. The similarity of the cellular type of artificial bone to the trabecular structure might make it more appropriate for obtaining accurate values of primary implant stability than solid-bone blocks. For the cellular-rigid bone models, the ISQ increased with the elastic modulus of cancellous bone. The regression correlation coefficient was 0.96 for correlations of the ISQ with the elasticity of cancellous bone and with the 3D BIC%. The initial implant stability was moderately positively correlated with the elasticity of cancellous bone and with the 3D BIC%. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Bone Cells Dynamics during Peri-Implantitis: a Theoretical Analysis

Directory of Open Access Journals (Sweden)

Maria Helena Fernandes

2016-09-01

Full Text Available Objectives: The present manuscript aims a detailed characterization of the bone cells dynamics during physiological bone remodelling and, subsequently, to address the cellular and molecular mechanisms that play a fundamental role in the immune-inflammatory-induced uncoupled bone remodelling observed in peri-implantitis. Results: An intimate relationship between the immune system and bone is acknowledged to be determinant for bone tissue remodelling and integrity. Due to the close interaction of immune and bone cells, the two systems share a number of surface receptors, cytokines, signalling pathways and transcription factors that are involved in mutual regulatory mechanisms. This physiological equilibrium is disturbed in pathological conditions, as verified in peri-implantitis establishment and development. Activation of the innate and adaptive immune response, challenged by the local bacterial infection, induces the synthesis of high levels of a variety of pro- and anti-inflammatory cytokines that disturb the normal functioning of the bone cells, by uncoupling bone resorption and formation, ending up with a net alveolar bone loss and subsequent implant failure. Most data points to an immune-inflammatory induced osteoclast differentiation and function, as the major underlying mechanism to the uncoupled bone resorption to bone formation. Further, the disturbed functioning of osteoblasts, reflected by the possible expression of a fibro-osteoblastic phenotype, may also play a role. Conclusions: Alveolar bone loss is a hallmark of peri-implantitis. A great deal of data is still needed on the cellular and humoral crosstalk in the context of an integrated view of the osteoimmunologic interplay occurring in the peri-implantitis environment subjacent to the bone loss outcome.

Implantation of tetrapod-shaped granular artificial bones or β-tricalcium phosphate granules in a canine large bone-defect model.

Science.gov (United States)

Choi, Sungjin; Liu, I-Li; Yamamoto, Kenichi; Honnami, Muneki; Sakai, Takamasa; Ohba, Shinsuke; Echigo, Ryosuke; Suzuki, Shigeki; Nishimura, Ryouhei; Chung, Ung-Il; Sasaki, Nobuo; Mochizuki, Manabu

2014-03-01

We investigated biodegradability and new bone formation after implantation of tetrapod-shaped granular artificial bone (Tetrabone®) or β-tricalcium phosphate granules (β-TCP) in experimental critical-size defects in dogs, which were created through medial and lateral femoral condyles. The defect was packed with Tetrabone® (Tetrabone group) or β-TCP (β-TCP group) or received no implant (control group). Computed tomography (CT) was performed at 0, 4 and 8 weeks after implantation. Micro-CT and histological analysis were conducted to measure the non-osseous tissue rate and the area and distribution of new bone tissue in the defect at 8 weeks after implantation. On CT, β-TCP was gradually resorbed, while Tetrabone® showed minimal resorption at 8 weeks after implantation. On micro-CT, non-osseous tissue rate of the control group was significantly higher compared with the β-TCP and Tetrabone groups (Pbone tissue of the β-TCP group was significantly greater than those of the Tetrabone and control groups (Pbone distribution of the Tetrabone group was significantly greater than those of the β-TCP and control groups (Pbone defects in dogs.

Transforming growth factor-beta1 adsorbed to tricalciumphosphate coated implants increases peri-implant bone remodeling

DEFF Research Database (Denmark)

Lin, M.; Overgaard, S; Glerup, H

2001-01-01

inserted bilaterally into the femoral condyles of 10 skeletally mature mongrel dogs. The implants were initially surrounded by a 2 mm gap. Implants with 0.3 microg rhTGF-beta1 were compared with implants without growth factor. The dogs were sacrificed after six weeks. Bone remodeling was evaluated...... by histomorphometry on Goldner-stained undecalcified sections. The bone volume in the gap was increased significantly from 17.6% in the control group to 25.6% in the rhTGF-beta1 group (p = 0.03). Also bone surface was increased in the rhTGF-beta1 group. The osteoclast covered surfaces were increased from 3.......6% in the control group to 5.9% in the rhTGF-beta1 group (p = 0.02). In the surrounding trabecular bone no significant changes in bone remodeling parameters was demonstrated. This study suggests that rhTGF-beta1 adsorbed onto TCP-ceramic coated implants accelerates repair activity in the newly formed bone close...

Peri-implant stress correlates with bone and cement morphology: Micro-FE modeling of implanted cadaveric glenoids.

Science.gov (United States)

Wee, Hwabok; Armstrong, April D; Flint, Wesley W; Kunselman, Allen R; Lewis, Gregory S

2015-11-01

Aseptic loosening of cemented joint replacements is a complex biological and mechanical process, and remains a clinical concern especially in patients with poor bone quality. Utilizing high resolution finite element analysis of a series of implanted cadaver glenoids, the objective of this study was to quantify relationships between construct morphology and resulting mechanical stresses in cement and trabeculae. Eight glenoid cadavers were implanted with a cemented central peg implant. Specimens were imaged by micro-CT, and subject-specific finite element models were developed. Bone volume fraction, glenoid width, implant-cortex distance, cement volume, cement-cortex contact, and cement-bone interface area were measured. Axial loading was applied to the implant of each model and stress distributions were characterized. Correlation analysis was completed across all specimens for pairs of morphological and mechanical variables. The amount of trabecular bone with high stress was strongly negatively correlated with both cement volume and contact between the cement and cortex (r = -0.85 and -0.84, p implant-cortex distance. Contact between the cement and underlying cortex may dramatically reduce trabecular bone stresses surrounding the cement, and this contact depends on bone shape, cement amount, and implant positioning. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Transcription factor and bone marrow stromal cells in osseointegration of dental implants

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SG Yan

2018-05-01

Full Text Available Titanium implants are widely used in dental clinics and orthopaedic surgery. However, bone formation surrounding the implant is relatively slow after inserting the implant. The current study assessed the effects of bone marrow stromal cells (BMSCs with forced expression of special AT-rich sequence-binding protein 2 (SATB2 on the osseointegration of titanium implants. To determine whether SATB2 overexpression in BMSCs can enhance the osseointegration of implants, BMSCs were infected with the retrovirus encoding Satb2 (pBABE-Satb2 and were locally applied to bone defects before implanting the titanium implants in the mouse femur. Seven and twenty-one days after implantation, the femora were isolated for immunohistochemical (IHC staining, haematoxylin eosin (H&E staining, real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR, and micro-computed tomography (μCT analysis. IHC staining analysis revealed that SATB2-overexpressing BMSCs were intensely distributed in the bone tissue surrounding the implant. Histological analysis showed that SATB2-overexpressing BMSCs significantly enhanced new bone formation and bone-to-implant contact 3 weeks after implantation. Real-time qRT-PCR results showed that the local delivery of SATB2-overexpressing BMSCs enhanced expression levels of potent osteogenic transcription factors and bone matrix proteins in the implantation sites. μCT analysis demonstrated that SATB2-overexpressing BMSCs significantly increased the density of the newly formed bone surrounding the implant 3 weeks post-operatively. These results conclude that local delivery of SATB2-overexpressing BMSCs significantly accelerates osseointegration of titanium implants. These results provide support for future pharmacological and clinical applications of SATB2, which accelerates bone regeneration around titanium implants.

Implant stability and marginal bone level of microgrooved zirconia dental implants: A 3-month experimental study on dogs

Directory of Open Access Journals (Sweden)

Delgado-Ruíz Rafael Arcesio

2014-01-01

Full Text Available Background/Aim. The modification of implant surfaces could affect mechanical implant stability as well as dynamics and quality of peri-implant bone healing. The aim of this 3-month experimental study in dogs was to investigate implant stability, marginal bone levels and bone tissue response to zirconia dental implants with two laser-micro-grooved intraosseous surfaces in comparison with nongrooved sandblasted zirconia and sandblasted, high-temperature etched titanium implants. Methods. Implant surface characterization was performed using optical interferometric profilometry and energy dispersive X-ray spectroscopy. A total of 96 implants (4 mm in diameter and 10 mm in length were inserted randomly in both sides of the lower jaw of 12 Fox Hound dogs divided into groups of 24 each: the control (titanium, the group A (sandblasted zirconia, the group B (sandblasted zirconia plus microgrooved neck and the group C (sandblasted zirconia plus all microgrooved. All the implants were immediately loaded. Insertion torque, periotest values, radiographic crestal bone level and removal torque were recorded during the 3-month follow-up. Qualitative scanning electon micro-scope (SEM analysis of the bone-implant interfaces of each group was performed. Results. Insertion torque values were higher in the group C and control implants (p the control > the group B > the group A (p the control > the group B > the group A (p < 0.05. SEM showed that implant surfaces of the groups B and C had an extra bone growth inside the microgrooves that corresponded to the shape and direction of the microgrooves. Conclusion. The addition of micro-grooves to the entire intraosseous surface of zirconia dental implants enhances primary and secondary implant stability, promotes bone tissue ingrowth and preserves crestal bone levels.

Influence of Implant Positions and Occlusal Forces on Peri-Implant Bone Stress in Mandibular Two-Implant Overdentures: A 3-Dimensional Finite Element Analysis.

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Alvarez-Arenal, Angel; Gonzalez-Gonzalez, Ignacio; deLlanos-Lanchares, Hector; Brizuela-Velasco, Aritza; Dds, Elena Martin-Fernandez; Ellacuria-Echebarria, Joseba

2017-12-01

The aim of this study was to evaluate and compare the bone stress around implants in mandibular 2-implant overdentures depending on the implant location and different loading conditions. Four 3-dimensional finite element models simulating a mandibular 2-implant overdenture and a Locator attachment system were designed. The implants were located at the lateral incisor, canine, second premolar, and crossed-implant levels. A 150 N unilateral and bilateral vertical load of different location was applied, as was 40 N when combined with midline load. Data for von Mises stress were produced numerically, color coded, and compared between the models for peri-implant bone and loading conditions. With unilateral loading, in all 4 models much higher peri-implant bone stress values were recorded on the load side compared with the no-load side, while with bilateral occlusal loading, the stress distribution was similar on both sides. In all models, the posterior unilateral load showed the highest stress, which decreased as the load was applied more mesially. In general, the best biomechanical environment in the peri-implant bone was found in the model with implants at premolar level. In the crossed-implant model, the load side greatly altered the biomechanical environment. Overall, the overdenture with implants at second premolar level should be the chosen design, regardless of where the load is applied. The occlusal loading application site influences the bone stress around the implant. Bilateral occlusal loading distributes the peri-implant bone stress symmetrically, while unilateral loading increases it greatly on the load side, no matter where the implants are located.

Effect of Integration Patterns Around Implant Neck on Stress Distribution in Peri-Implant Bone: A Finite Element Analysis.

Science.gov (United States)

Han, Jingyun; Sun, Yuchun; Wang, Chao

2017-08-01

To investigate the biomechanical performance of different osseointegration patterns between cortical bone and implants using finite element analysis. Fifteen finite element models were constructed of the mandibular fixed prosthesis supported by implants. Masticatory loads (200 N axial, 100 N oblique, 40 N horizontal) were applied. The cortical bone/implant interface was divided equally into four layers: upper, upper-middle, lower-middle, and lower. The bone stress and implant displacement were calculated for 5 degrees of uniform integration (0, 20%, 40%, 60%, and 100%) and 10 integration patterns. The stress was concentrated in the bone margin and gradually decreased as osseointegration progressed, when the integrated and nonintegrated areas were alternated on the bone-implant surface. Compared with full integration, the integration of only the lower-middle layer or lower half layers significantly decreased von Mises, tensile, and compressive stresses in cortical bone under oblique and horizontal loads, and these patterns did not induce higher stress in the cancellous bone. For the integration of only the upper or upper-middle layer, stress in the cortical and cancellous bones significantly increased and was considerably higher than in the case of nonintegration. In addition, the maximum stress in the cortical bone was sensitive to the quantity of integrated nodes at the bone margin; lower quantity was associated with higher stress. There was no significant difference in the displacement of implants among 15 models. Integration patterns of cortical bone significantly affect stress distribution in peri-implant bone. The integration of only the lower-middle or lower half layers helps to increase the load-bearing capacity of peri-implant bone and decrease the risk of overloading, while upper integration may further increase the risk of bone resorption. © 2016 by the American College of Prosthodontists.

Usage of demineralized bone powder in dental implant surgery

International Nuclear Information System (INIS)

Chang Joon Yim

1999-01-01

While there is much concern in the dental community about the risk of disease transfer with processed bone a] iografts, there has never been a case of disease transfer with DFDB. Exclusionary techniques and chemical processing of the allogeneic bone has rendered these grafts safe for human implantation. The literature indicates that there has been considerable interest in the biology and applied science of osteoinduction. The accumulated evidence supports the concept of cartilage and bone cell differentiation induced by a unique bone motphogenetic protein (BMP). Currently clinical usage has been focused on the alveolar bone defects associated with the dental implant surgery, which has become one of the most important areas in dental outpatient clinic. Increased application of the endosseous dental implant system results in a lot of demands to regenerate the alveolar bone defects around the dental implants. Anderegg et al.(1991) reported the excellent results from the combination of DFDB powder and expanded PTFE (polytetrafluorethylene) membranes. Since 1980 the author experienced the human DFDB powders for the oral and maxillofacial surgery and the dental implant surgery. Yim and Kim(1993) evaluated 93 surgical sites where DFDB was used and found 96.7% of success rates at re-entry surgery. Mellonig and Triplett (1993) reported 97% of success rates, and Gelb (1993) obtained 98% of success rates. Fugazzotto (1994) placed 59 dental implants at the time of sinus lifts with the composite graft of DFDB and resorbable tricalcium phosphate and none of implants was lost on uncovering and only one was lost while functioning. Yim (1994) placed 44 dental implants at the time of sinus lifts with DFDB, and none of implants was lost on uncovering. Zinner and Small (1996) placed 215 dental implants at the time of sinus lifts (52 sinuses) with the composite graft of DFDB, and other materials, 3 implants of which were failed on uncovering. To date, maxillary sinus lift graft with

The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

  The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants IN SHEEP   Ph.D. Student, Hassan Babiker; Associate Professor, Ph.D. Ming Ding; Professor, dr.med., Soren Overgaard. Department of Orthopaedic Surgery, Odense University Hospital......, Odense, Denmark   Background: Hydroxyapatite and collagen composites (HA/coll) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effect of newly developed HA/coll-composites with and without bone marrow aspirate (BMA) in order to enhance the fixation...... of bone implants.   Materials and Methods: Titanium alloy implants were inserted into bilateral femoral condyles of 8 skeletally mature sheep, four in each sheep. The implant has a circumferential gap of 2 mm. The gap was filled with: HA/coll; HA/coll-BMA; autograft or allograft. Allograft was served...

Bone compaction enhances implant fixation in a canine gap model

DEFF Research Database (Denmark)

Kold, Søren; Rahbek, Ole; Toft, Marianne

2005-01-01

A new bone preparation technique, compaction, has increased fixation of implants inserted with exact-fit or press-fit to bone. Furthermore, a demonstrated spring-back effect of compacted bone might be of potential value in reducing the initial gaps that often exist between clinical inserted...... implants and bone. However, it is unknown whether the compression and breakage of trabeculae during the compaction procedure results in impaired gap-healing of compacted bone. Therefore, we compared compaction with conventional drilling in a canine gap model. Grit-blasted titanium implants (diameter 6 mm...... that the beneficial effect of reduced gap size, as compacted bone springs back, is not eliminated by an impaired gap-healing of compacted bone....

Hearing improvement with softband and implanted bone-anchored hearing devices and modified implantation surgery in patients with bilateral microtia-atresia.

Science.gov (United States)

Wang, Yibei; Fan, Xinmiao; Wang, Pu; Fan, Yue; Chen, Xiaowei

2018-01-01

To evaluate auditory development and hearing improvement in patients with bilateral microtia-atresia using softband and implanted bone-anchored hearing devices and to modify the implantation surgery. The subjects were divided into two groups: the softband group (40 infants, 3 months to 2 years old, Ponto softband) and the implanted group (6 patients, 6-28 years old, Ponto). The Infant-Toddler Meaning Auditory Integration Scale was used conducted to evaluate auditory development at baseline and after 3, 6, 12, and 24 months, and visual reinforcement audiometry was used to assess the auditory threshold in the softband group. In the implanted group, bone-anchored hearing devices were implanted combined with the auricular reconstruction surgery, and high-resolution CT was used to assess the deformity preoperatively. Auditory threshold and speech discrimination scores of the patients with implants were measured under the unaided, softband, and implanted conditions. Total Infant-Toddler Meaning Auditory Integration Scale scores in the softband group improved significantly and approached normal levels. The average visual reinforcement audiometry values under the unaided and softband conditions were 76.75 ± 6.05 dB HL and 32.25 ± 6.20 dB HL (P hearing devices is effective for auditory development and hearing improvement in infants with bilateral microtia-atresia. Wearing softband bone-anchored hearing devices before auricle reconstruction and combining bone-anchored hearing device implantation with auricular reconstruction surgery may bethe optimal clinical choice for these patients, and results in more significant hearing improvement and minimal surgical and anesthetic injury. Copyright © 2017 Elsevier B.V. All rights reserved.

Biomaterial strategies for engineering implants for enhanced osseointegration and bone repair

Science.gov (United States)

Agarwal, Rachit; García, Andrés J.

2015-01-01

Bone tissue has a remarkable ability to regenerate and heal itself. However, large bone defects and complex fractures still present a significant challenge to the medical community. Current treatments center on metal implants for structural and mechanical support and auto- or allo-grafts to substitute long bone defects. Metal implants are associated with several complications such as implant loosening and infections. Bone grafts suffer from donor site morbidity, reduced bioactivity, and risk of pathogen transmission. Surgical implants can be modified to provide vital biological cues, growth factors and cells in order to improve osseointegration and repair of bone defects. Here we review strategies and technologies to engineer metal surfaces to promote osseointegration with the host tissue. We also discuss strategies for modifying implants for cell adhesion and bone growth via integrin signaling and growth factor and cytokine delivery for bone defect repair. PMID:25861724

Osseointegration Of Implants In Rabbit Bone With A Low Calcium Diet And Irradiation

International Nuclear Information System (INIS)

Kim, So Jung; Hwang, Eui Hwan; Lee, Sang Rae

2000-01-01

To investigate osseointergration of titanium implants into the tibia of rabbits, which were fed a low calcium diet and irradiated. To prepare the experimental model, control group was fed a normal diet and experimental group was fed a low calcium diet for 4 weeks. And then, titanium implants were inserted into the tibia of each rabbit. Experimental group was subdivided into two groups; low calcium diet/non-irradiation group and low calcium diet/irradiation group. The low calcium diet/irradiation group was irradiated with a single absorbed dose of 15 Gy at the 5th postoperative days. On the 12th, 19th, 33rd, 47th, and 61st days after implantation(1, 2, 4, 6, and 8 weeks after irradiation), the bone formation in the bone-implant interface area was examined by light microscopy and fluorescent microscopy. 1. In the control group, there began to form woven bone in the bone-implant interface area on the 12th days after implantation. As the experimental time was going on, the amount of bone which was in contact with the implant was increased. 2. In the low calcium diet/non-irradiation group, there began to form woven bone in the bone-implant interface area on the 19th days after implantation. Although the amount of bone which was in contact with the implant was increased as the experimental time was going on, the extent of increased bone was slightly weak as compared with control group. 3. In the low calcium diet/irradiation group, there began to form woven bone incompletely in the bone-implant interface area on the 19th days after implantation, but there were vascular connective tissues in the bone- implant interface area over the entire experimental period. 4. In the control group and low calcium diet/non-irradiation group, bone labeling bands were observed on the 33rd days after implantation, which suggests that the bone formation and remodeling was in process, but interstitial bone remodeling was not observed in the low calcium diet/irradiation group.

Hydroxyapatite particles maintain peri-implant bone mantle during osseointegration in osteoporotic bone

NARCIS (Netherlands)

Tami, A.E.; Leitner, M.M.; Baucke, M.G.; Mueller, T.L.; Lenthe, van G.H.; Müller, R.; Ito, K.

2009-01-01

In osteoporotic bones, resorption exceeds formation during the remodelling phase of bone turnover. As a consequence, decreased bone volume and bone contact result in the peri-implant region. This may subsequently lead to loss of fixation. In this study we investigated whether the presence of

Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis.

Science.gov (United States)

Buddula, Aravind; Assad, Daniel A; Salinas, Thomas J; Garces, Yolanda I

2011-01-01

To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76). Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

Three-phase bone scintigraphy of hydroxyapatite ocular implants

International Nuclear Information System (INIS)

Leitha, T.; Staudenherz, A.; Scholz, U.

1995-01-01

Hydroxyapatite ocular implants are replicas of lamellar bone tissue derived from the exoskeleton of a reef-building coral by a hydrothermal chemical exchange reaction. Attached to the eye muscles, they act as a passive framework for fibrovascular ingrowth and can be drilled to hold the visible part of the artificial eye and allow synchronous eye movement. Fibrovascular ingrowth has to be confirmed by bone scintigraphy before the drilling procedure. This study monitored the vascular ingrowth into the implant in ten patients over 12 months to establish a clinically feasible imaging protocol. Tracer accumulation was monitored visually and quantitatively in dynamic and single-photon emission tomography (SPET) scans after the intravenous administration of 600 MBq of 99m Tc-DPD. The implants showed no tracer accumulation in the arterial or blood pool phase. Accordingly, dynamic scintigraphy can be omitted from the imaging protocol. Delayed tracer accumulation appeared no earlier than 2 and no later than 6 months after surgery. Planar scintigraphy is not recommended as high-resolution SPET is necessary to separate the implant from the surrounding bone. We conclude that imaging can be confined to high-resolution SPET 3 h after tracer injection, no earlier than 3 months after surgery. The vascularized hydroxyapatite orbital implant is an important in vivo model for bone-seeking agents to study their uptake kinetics independently of any soft tissue and bone disease. Our results provide evidence that in normal bones the chemical adsorption of 99m Tc-DPD into the crystalline structure of hydroxyapatite is the only quantitatively relevant uptake mechanism. (orig.)

Three-phase bone scintigraphy of hydroxyapatite ocular implants

Energy Technology Data Exchange (ETDEWEB)

Leitha, T. [Univ. Clinic of Nuclear Medicine, Univ. of Vienna (Austria); Staudenherz, A. [Univ. Clinic of Nuclear Medicine, Univ. of Vienna (Austria); Scholz, U. [First Univ. Clinic of Ophthalmology, Univ. of Vienna (Austria)

1995-04-01

Hydroxyapatite ocular implants are replicas of lamellar bone tissue derived from the exoskeleton of a reef-building coral by a hydrothermal chemical exchange reaction. Attached to the eye muscles, they act as a passive framework for fibrovascular ingrowth and can be drilled to hold the visible part of the artificial eye and allow synchronous eye movement. Fibrovascular ingrowth has to be confirmed by bone scintigraphy before the drilling procedure. This study monitored the vascular ingrowth into the implant in ten patients over 12 months to establish a clinically feasible imaging protocol. Tracer accumulation was monitored visually and quantitatively in dynamic and single-photon emission tomography (SPET) scans after the intravenous administration of 600 MBq of {sup 99m}Tc-DPD. The implants showed no tracer accumulation in the arterial or blood pool phase. Accordingly, dynamic scintigraphy can be omitted from the imaging protocol. Delayed tracer accumulation appeared no earlier than 2 and no later than 6 months after surgery. Planar scintigraphy is not recommended as high-resolution SPET is necessary to separate the implant from the surrounding bone. We conclude that imaging can be confined to high-resolution SPET 3 h after tracer injection, no earlier than 3 months after surgery. The vascularized hydroxyapatite orbital implant is an important in vivo model for bone-seeking agents to study their uptake kinetics independently of any soft tissue and bone disease. Our results provide evidence that in normal bones the chemical adsorption of {sup 99m}Tc-DPD into the crystalline structure of hydroxyapatite is the only quantitatively relevant uptake mechanism. (orig.)

Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck.

Science.gov (United States)

Liu, Yang; Wang, Jiawei

2017-11-01

To review the influences and clinical implications of micro-gap and micro-motion of implant-abutment interface on marginal bone loss around the neck of implant. Literatures were searched based on the following Keywords: implant-abutment interface/implant-abutment connection/implant-abutment conjunction, microgap, micromotion/micromovement, microleakage, and current control methods available. The papers were then screened through titles, abstracts, and full texts. A total of 83 studies were included in the literature review. Two-piece implant systems are widely used in clinics. However, the production error and masticatory load result in the presence of microgap and micromotion between the implant and the abutment, which directly or indirectly causes microleakage and mechanical damage. Consequently, the degrees of microgap and micromotion further increase, and marginal bone absorption finally occurs. We summarize the influences of microgap and micromotion at the implant-abutment interface on marginal bone loss around the neck of the implant. We also recommend some feasible methods to reduce their effect. Clinicians and patients should pay more attention to the mechanisms as well as the control methods of microgap and micromotion. To reduce the corresponding detriment to the implant marginal bone, suitable Morse taper or hybrid connection implants and platform switching abutments should be selected, as well as other potential methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of bone marrow aspirate, bone graft, and collagen composites on fixation of titanium implants

DEFF Research Database (Denmark)

Babiker, Hassan; Ding, Ming; Sandri, Monica

2012-01-01

Replacement of extensive local bone loss especially in revision joint arthroplasty and spine fusion is a significant clinical challenge. Allograft and autograft have been considered as gold standards for bone replacement. However, there are several disadvantages such as donor site pain, bacterial...... contamination, and non union as well as the potential risk of disease transmission. Hydroxyapatite and collagen composites (HA/Collagen) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effects of newly developed HA/Collagen-composites with and without bone...... marrow aspirate (BMA) on enhancement of bone implant fixation. Method: Titanium alloy implants were inserted into bilateral femoral condyles of eight skeletally mature sheep, four implants per sheep. The implant had a circumferential gap of 2 mm. The gap was filled with: HA/Collagen; HA...

Effects of orthopedic implants with a polycaprolactone polymer coating containing bone morphogenetic protein-2 on osseointegration in bones of sheep.

Science.gov (United States)

Niehaus, Andrew J; Anderson, David E; Samii, Valerie F; Weisbrode, Steven E; Johnson, Jed K; Noon, Mike S; Tomasko, David L; Lannutti, John J

2009-11-01

To determine elution characteristics of bone morphogenetic protein (BMP)-2 from a polycaprolactone coating applied to orthopedic implants and determine effects of this coating on osseointegration. 6 sheep. An in vitro study was conducted to determine BMP-2 elution from polycaprolactone-coated implants. An in vivo study was conducted to determine the effects on osseointegration when the polycaprolactone with BMP-2 coating was applied to bone screws. Osseointegration was assessed via radiography, measurement of peak removal torque and bone mineral density, and histomorphometric analysis. Physiologic response was assessed by measuring serum bone-specific alkaline phosphatase activity and uptake of bone markers. Mean +/- SD elution on day 1 of the in vitro study was 263 +/- 152 pg/d, which then maintained a plateau at 59.8 +/- 29.1 pg/d. Mean peak removal torque for screws coated with polycalprolactone and BMP-2 (0.91 +/- 0.65 dN x m) and screws coated with polycaprolactone alone (0.97 +/- 1.30 dN.m) did not differ significantly from that for the control screws (2.34 +/- 1.62 dN x m). Mean bone mineral densities were 0.535 +/- 0.060 g/cm(2), 0.596 +/- 0.093 g/cm(2), and 0.524 +/- 0.142 g/cm(2) for the polycaprolactone-BMP-2-coated, polycaprolactone-coated, and control screws, respectively, and did not differ significantly among groups. Histologically, bone was in closer apposition to the implant with the control screws than with either of the coated screws. BMP-2 within the polycaprolactone coating did not stimulate osteogenesis. The polycaprolactone coating appeared to cause a barrier effect that prevented formation of new bone. A longer period or use of another carrier polymer may result in increased osseointegration.

Comparative study of longitudinal changes in peri-implant bone microstructure

International Nuclear Information System (INIS)

Suzuki, Yusuke; Matsunaga, Satoru; Abe, Shinichi; Ide, Yoshinobu; Usami, Akinobu

2010-01-01

The load applied to an implant is directly transmitted to the jaw and is considered to be one of the causes of remodeling of internal trabecular bones. However, the longitudinal changes during loading and the rearrangement of the trabecular bone structure are mostly unknown. The aim of this study was to clarify the changes in internal jaw bone structure longitudinally during natural tooth eruption as well as tooth extraction and post-implantation periods in a dog model by micro computed tomography (micro-CT). Maxillae of 16 male beagle dogs were used in this study. First, 4 dogs with all maxillary molar teeth erupted were euthanized as a control group. Next, 6 teeth consisting of the bilateral maxillary fourth premolars, and first and second molars were extracted from each of the 12 dogs. Then, 4 dogs of the tooth-extracted group were euthanized 3 months after extraction of the teeth. At this time, three implants were inserted in the left side of the maxilla of the remaining 8 dogs, and the superstructures were placed after 3 months. Four of these 8 dogs with implants were euthanized at 3 months and the other 4 at 1 year after placement of the superstructure. Then, the maxillary bone was removed from each dog as a specimen and sequential micro-CT images were taken. After reconstruction of three-dimensional images, morphological and metrical observation of the jaw trabecular bone structure was performed. A decrease of the trabecular bone in the tooth-extracted group was morphologically and morphometrically observed, whereas the implanted group showed thick, rich trabecular bone. Although a longitudinal decrease in the bone tissue volume was recognized both in the tooth-extracted and the implanted groups, the amount was smaller in the implanted group than in the tooth-extracted group. The results suggested that the application of load by implants in the case of tooth loss inhibits resorption of the alveolar bone and prevents thinning of the jaw. (author)

Peri-implant soft tissue and marginal bone adaptation on implant with non-matching healing abutments: micro-CT analysis.

Science.gov (United States)

Finelle, Gary; Papadimitriou, Dimitrios E V; Souza, André B; Katebi, Negin; Gallucci, German O; Araújo, Mauricio G

2015-04-01

To assess (i) the outcome of changing the horizontal-offset dimension on the peri-implant soft tissues and the crestal bone and (ii) the effect of different healing abutments (flared vs. straight) on the marginal peri-implant soft tissues and crestal bone. Two-piece dental implants diameters of 3.5 and 4.5 mm were placed at least 1 mm subcrestal in five beagle dogs. Three different investigational groups: (i) 3.5-mm-diameter implant with narrow healing abutment (3.5N), (ii) 4.5-mm-diameter implant with narrow healing abutment (4.5N), and (iii) 3.5-mm-diameter implant with wide healing abutment (3.5W), were assessed. After 4 months of healing, the vertical distance from the marginal crestal bone (MB) to the implant shoulder (IS); the vertical distance from the IS to the first bone-to-implant contact; and the horizontal distance of bone ingrowth on the implant platform were measured with a high-resolution micro-CT (Xradia MicroXCT-200 system). Implants with a narrow healing caps showed an interproximal MB located between 0 and 1 mm above the implant shoulder, while the 3.5W group exhibits a mean value -0.50 mm. As all implants in group 3.5N presented a fBIC located at the level of the IS. For the 4.5N group, the mean fBIC-IS distance was -0.52 mm apically to the IS. For the 3.5WC group, the mean fBIC-IS distance was -1.42 mm. Horizontal bone apposition was only observed for the 3.5N group and the 4.5N group. The dimension of the horizontal offset would play a minimal role in reducing bone remodeling, whereas the configuration of the transmucosal component would directly influence marginal bone remodeling. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Bone attachment to glass-fibre-reinforced composite implant with porous surface.

Science.gov (United States)

Mattila, R H; Laurila, P; Rekola, J; Gunn, J; Lassila, L V J; Mäntylä, T; Aho, A J; Vallittu, P K

2009-06-01

A method has recently been developed for producing fibre-reinforced composites (FRC) with porous surfaces, intended for use as load-bearing orthopaedic implants. This study focuses on evaluation of the bone-bonding behaviour of FRC implants. Three types of cylindrical implants, i.e. FRC implants with a porous surface, solid polymethyl methacrylate (PMMA) implants and titanium (Ti) implants, were inserted in a transverse direction into the intercondular trabeculous bone area of distal femurs and proximal tibias of New Zealand White rabbits. Animals were sacrificed at 3, 6 and 12 weeks post operation, and push-out tests (n=5-6 per implant type per time point) were then carried out. At 12 weeks the shear force at the porous FRC-bone interface was significantly higher (283.3+/-55.3N) than the shear force at interfaces of solid PMMA/bone (14.4+/-11.0 N; pshielding effect.

Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: A retrospective analysis

Directory of Open Access Journals (Sweden)

Aravind Buddula

2011-01-01

Full Text Available Aim: To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. Materials and Methods: A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. Results: A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76. Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. Conclusion: There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior.

Time Course of Peri-Implant Bone Regeneration around Loaded and Unloaded Implants in a Rat Model

Science.gov (United States)

Jariwala, Shailly H.; Wee, Hwabok; Roush, Evan P.; Whitcomb, Tiffany L.; Murter, Christopher; Kozlansky, Gery; Lakhtakia, Akhlesh; Kunselman, Allen R.; Donahue, Henry J.; Armstrong, April D.; Lewis, Gregory S.

2018-01-01

The time-course of cancellous bone regeneration surrounding mechanically loaded implants affects implant fixation, and is relevant to determining optimal rehabilitation protocols following orthopaedic surgeries. We investigated the influence of controlled mechanical loading of titanium-coated polyether-ether ketone (PEEK) implants on osseointegration using time-lapsed, non-invasive, in vivo micro-computed tomography (micro-CT) scans. Implants were inserted into proximal tibial metaphyses of both limbs of eight female Sprague-Dawley rats. External cyclic loading (60 μm or 100 μm displacement, 1 Hz, 60 seconds) was applied every other day for 14 days to one implant in each rat, while implants in contralateral limbs served as the unloaded controls. Hind limbs were imaged with high-resolution micro-CT (12.5 μm voxel size) at 2, 5, 9, and 12 days post-surgery. Trabecular changes over time were detected by 3D image registration allowing for measurements of bone-formation rate (BFR) and bone-resorption rate (BRR). At day 9, mean %BV/TV for loaded and unloaded limbs were 35.5 ± 10.0 % and 37.2 ± 10.0 %, respectively, and demonstrated significant increases in bone volume compared to day 2. BRR increased significantly after day 9. No significant differences between bone volumes, BFR, and BRR were detected due to implant loading. Although not reaching significance (p = 0.16), an average 119 % increase in pull-out strength was measured in the loaded implants. PMID:27381807

Adhesive bone bonding prospects for lithium disilicate ceramic implants

Science.gov (United States)

Vennila Thirugnanam, Sakthi Kumar

Temporomandibular Joint (TMJ) implants articulating mandible with temporal bone in humans have a very high failure rate. Metallic TMJ implants available in the medical market are not osseointegrated, but bond only by mechanical interlocking using screws which may fail, mandating a second surgery for removal. Stress concentration around fixture screws leads to aseptic loosening or fracture of the bone. It has been proposed that this problem can be overcome by using an all-ceramic TMJ implant bonded to bone with dental adhesives. Structural ceramics are promising materials with an excellent track record in the field of dentis.

Bone Adaptation Around Orthopaedic Implants of Varying Materials

DEFF Research Database (Denmark)

Bagge, Mette

1998-01-01

The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

Functional results after Bonebridge implantation in adults and children with conductive and mixed hearing loss.

Science.gov (United States)

Rahne, Torsten; Seiwerth, Ingmar; Götze, Gerrit; Heider, Cornelia; Radetzki, Florian; Herzog, Michael; Plontke, Stefan K

2015-11-01

In patients with conductive hearing loss caused by middle ear disorders or atresia of the ear canal, a Bonebridge implantation can improve hearing by providing vibratory input to the temporal bone. The expected results are improved puretone thresholds and speech recognition. In the European Union, approval of the Bonebridge implantation was recently extended to children. We evaluated the functional outcome of a Bonebridge implantation for eight adults and three children. We found significant improvement in the puretone thresholds, with improvement in the air-bone gap. Speech recognition after surgery was significantly higher than in the best-aided situation before surgery. The Bonebridge significantly improved speech recognition in noisy environments and sound localization. In situations relevant to daily life, hearing deficits were nearly completely restored with the Bonebridge implantation in both adults and children.

Low-intensity pulsed ultrasound enhances bone formation around miniscrew implants.

Science.gov (United States)

Ganzorig, Khaliunaa; Kuroda, Shingo; Maeda, Yuichi; Mansjur, Karima; Sato, Minami; Nagata, Kumiko; Tanaka, Eiji

2015-06-01

Miniscrew implants (MSIs) are currently used to provide absolute anchorage in orthodontics; however, their initial stability is an issue of concern. Application of low-intensity pulsed ultrasound (LIPUS) can promote bone healing. Therefore, LIPUS application may stimulate bone formation around MSIs and enhance their initial stability. To investigate the effect of LIPUS exposure on bone formation after implantation of titanium (Ti) and stainless steel (SS) MSIs. MSIs made of Ti-6Al-4V and 316L SS were placed on rat tibiae and treated with LIPUS. The bone morphology around MSIs was evaluated by scanning electron microscopy and three-dimensional micro-computed tomography. MC3T3-E1 cells cultured on Ti and SS discs were treated with LIPUS, and the temporary expression of alkaline phosphatase (ALP) was examined. Bone-implant contact increased gradually from day 3 to day 14 after MSI insertion. LIPUS application increased the cortical bone density, cortical bone thickness, and cortical bone rate after implantation of Ti and SS MSIs (P<0.05). LIPUS exposure induced ALP upregulation in MC3T3-E1 cells at day 3 (P<0.05). LIPUS enhanced bone formation around Ti and SS MSIs, enhancing the initial stability of MSIs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Surface Engineering for Bone Implants: A Trend from Passive to Active Surfaces

Directory of Open Access Journals (Sweden)

John Jansen

2012-07-01

Full Text Available The mechanical and biological properties of bone implants need to be optimal to form a quick and firm connection with the surrounding environment in load bearing applications. Bone is a connective tissue composed of an organic collagenous matrix, a fine dispersion of reinforcing inorganic (calcium phosphate nanocrystals, and bone-forming and -degrading cells. These different components have a synergistic and hierarchical structure that renders bone tissue properties unique in terms of hardness, flexibility and regenerative capacity. Metallic and polymeric materials offer mechanical strength and/or resilience that are required to simulate bone tissue in load-bearing applications in terms of maximum load, bending and fatigue strength. Nevertheless, the interaction between devices and the surrounding tissue at the implant interface is essential for success or failure of implants. In that respect, coatings can be applied to facilitate the process of bone healing and obtain a continuous transition from living tissue to the synthetic implant. Compounds that are inspired by inorganic (e.g., hydroxyapatite crystals or organic (e.g., collagen, extracellular matrix components, enzymes components of bone tissue, are the most obvious candidates for application as implant coating to improve the performance of bone implants. This review provides an overview of recent trends and strategies in surface engineering that are currently investigated to improve the biological performance of bone implants in terms of functionality and biological efficacy.

Immediately loaded mini dental implants as overdenture retainers: 1-Year cohort study of implant stability and peri-implant marginal bone level.

Science.gov (United States)

Šćepanović, Miodrag; Todorović, Aleksandar; Marković, Aleksa; Patrnogić, Vesna; Miličić, Biljana; Moufti, Adel M; Mišić, Tijana

2015-05-01

This 1-year cohort study investigated stability and peri-implant marginal bone level of immediately loaded mini dental implants used to retain overdentures. Each of 30 edentulous patients received 4 mini dental implants (1.8 mm × 13 mm) in the interforaminal mandibular region. The implants were immediately loaded with pre-made overdentures. Outcome measures included implant stability and bone resorption. Implant stability was measured using the Periotest Classic(®) device immediately after placement and on the 3rd and 6th weeks and the 4th, 6th and 12th months postoperatively. The peri-implant marginal bone level (PIBL) was evaluated at the implant's mesial and distal sides from the polished platform to the marginal crest. Radiographs were taken using a tailored film holder to reproducibly position the X-ray tube at the 6th week, 4th and 12th months postoperatively. The primary stability (Periotest value, PTV) measured -0.27 ± 3.41 on a scale of -8 to + 50 (lower PTV reflects higher stability). The secondary stability decreased significantly until week 6 (mean PTV = 7.61 ± 7.05) then increased significantly reaching (PTV = 6.17 ± 6.15) at 12 months. The mean PIBL measured -0.40 mm after 1 year of functional loading, with no statistically significant differences at the various follow-ups (p = 0.218). Mini dental implants placed into the interforaminal region could achieve a favorable primary stability for immediate loading. The follow-up Periotest values fluctuated, apparently reflecting the dynamics of bone remodeling, with the implants remaining clinically stable (98.3%) after 1 year of function. The 1-year bone resorption around immediately loaded MDIs is within the clinically acceptable range for standard implants. Copyright © 2014 Elsevier GmbH. All rights reserved.

Preventing Bacterial Infections using Metal Oxides Nanocoatings on Bone Implant

Science.gov (United States)

Duceac, L. D.; Straticiuc, S.; Hanganu, E.; Stafie, L.; Calin, G.; Gavrilescu, S. L.

2017-06-01

Nowadays bone implant removal is caused by infection that occurs around it possibly acquired after surgery or during hospitalization. The purpose of this study was to reveal some metal oxides applied as coatings on bone implant thus limiting the usual antibiotics-resistant bacteria colonization. Therefore ZnO, TiO2 and CuO were synthesized and structurally and morphologically analized in order to use them as an alternative antimicrobial agents deposited on bone implant. XRD, SEM, and FTIR characterization techniques were used to identify structure and texture of these nanoscaled metal oxides. These metal oxides nanocoatings on implant surface play a big role in preventing bacterial infection and reducing surgical complications.

Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

Science.gov (United States)

Romanos, Georgios E; Basha-Hijazi, Abdulaziz; Gupta, Bhumija; Ren, Yan-Fang; Malmstrom, Hans

2014-04-01

Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p bone. © 2012 Wiley Periodicals, Inc.

Bone Texture Fractal Dimension Analysis of Ultrasound-Treated Bone around Implant Site: A Double-Blind Clinical Trial

Directory of Open Access Journals (Sweden)

Elaf Akram Abdulhameed

2018-01-01

Full Text Available Objectives. To evaluate the efficacy of bone texture fractal dimension (FD analysis method in predicting implant stability from intraoral periapical radiographs using two implant protocols. Materials and Methods. A double-blind clinical trial was conducted on 22 subjects who needed dental implants. The participants were randomized into two groups, the control group with standard implant protocol treatment and the intervention group with added low-intensity power ultrasound treatment (LIPUS besides the standard implant protocol. The FD values of bone density were carried out on the mesial and distal sides of the implant on digital intraoral radiographs using the box-counting method. Both resonance frequency (RF and fractal dimension (FD were assessed in three time intervals: after surgery and before and after loading. Results. FD on both the mesial and distal sides serve as very good-to-excellent tests with high validity (ROC area exceeding 0.8 in predicting high implant stability (ISQ ≥ 70. The mesial side measurements were consistently better than the distal side among the intervention groups. The optimum cutoff value for the FD-mesial side that predicts a highly stable implant (ISQ ≥ 70 is ≥1.505. At this optimum cutoff value, the mesial side FD is associated with a perfect sensitivity (100% and fairly high specificity (86.5%. Conclusion. The FD analysis could be recommended as an adjunctive quantitative method in prediction of the implant stability with very high sensitivity and specificity. This trial is registered with ISRCTN72648040.

Correlation between radiographic analysis of alveolar bone density around dental implant and resonance frequency of dental implant

Science.gov (United States)

Prawoko, S. S.; Nelwan, L. C.; Odang, R. W.; Kusdhany, L. S.

2017-08-01

The histomorphometric test is the gold standard for dental implant stability quantification; however, it is invasive, and therefore, it is inapplicable to clinical patients. Consequently, accurate and objective alternative methods are required. Resonance frequency analysis (RFA) and digital radiographic analysis are noninvasive methods with excellent objectivity and reproducibility. To analyze the correlation between the radiographic analysis of alveolar bone density around a dental implant and the resonance frequency of the dental implant. Digital radiographic images for 35 samples were obtained, and the resonance frequency of the dental implant was acquired using Osstell ISQ immediately after dental implant placement and on third-month follow-up. The alveolar bone density around the dental implant was subsequently analyzed using SIDEXIS-XG software. No significant correlation was reported between the alveolar bone density around the dental implant and the resonance frequency of the dental implant (r = -0.102 at baseline, r = 0.146 at follow-up, p > 0.05). However, the alveolar bone density and resonance frequency showed a significant difference throughout the healing period (p = 0.005 and p = 0.000, respectively). Conclusion: Digital dental radiographs and Osstell ISQ showed excellent objectivity and reproducibility in quantifying dental implant stability. Nonetheless, no significant correlation was observed between the results obtained using these two methods.

3D printed Ti6Al4V implant surface promotes bone maturation and retains a higher density of less aged osteocytes at the bone-implant interface.

Science.gov (United States)

Shah, Furqan A; Snis, Anders; Matic, Aleksandar; Thomsen, Peter; Palmquist, Anders

2016-01-01

For load-bearing orthopaedic applications, metal implants having an interconnected pore structure exhibit the potential to facilitate bone ingrowth and the possibility for reducing the stiffness mismatch between the implant and bone, thus eliminating stress-shielding effects. 3D printed solid and macro-porous Ti6Al4V implants were evaluated after six-months healing in adult sheep femora. The ultrastructural composition of the bone-implant interface was investigated using Raman spectroscopy and electron microscopy, in a correlative manner. The mineral crystallinity and the mineral-to-matrix ratios of the interfacial tissue and the native bone were found to be similar. However, lower Ca/P ratios, lower carbonate content, but higher proline, phenylalanine and tyrosine levels indicated that the interfacial tissue remained less mature. Bone healing was more advanced at the porous implant surface (vs. the solid implant surface) based on the interfacial tissue ν1 CO3(2-)/ν2 PO4(3-) ratio, phenylalanine and tyrosine levels approaching those of the native bone. The mechanosensing infrastructure in bone, the osteocyte lacuno-canalicular network, retained ∼40% more canaliculi per osteocyte lacuna, i.e., a 'less aged' morphology at the interface. The osteocyte density per mineralised surface area was ∼36-71% higher at the interface after extended healing periods. In osseointegration research, the success of an implant surface or design is commonly determined by quantifying the amount of new bone, rather than its maturation, composition and structure. This work describes a novel correlative methodology to investigate the ultrastructure and composition of bone formed around and within 3D printed Ti6Al4V implants having an interconnected open-pore structure. Raman spectroscopy demonstrates that the molecular composition of the interfacial tissue at different implant surfaces may vary, suggesting differences in the extent to which bone maturation occurs even after long

Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin?

Science.gov (United States)

van Hoof, Marc; Wigren, Stina; Duimel, Hans; Savelkoul, Paul H M; Flynn, Mark; Stokroos, Robert Jan

2015-01-01

Percutaneous implants, such as bone conduction hearing implants, suffer from complications that include inflammation of the surrounding skin. A sealed skin-abutment interface can prevent the ingress of bacteria, which should reduce the occurrence of peri-abutment dermatitis. It was hypothesized that a hydroxyapatite (HA)-coated abutment in conjunction with soft tissue preservation surgery should enable integration with the adjacent skin. Previous research has confirmed that integration is never achieved with as-machined titanium abutments. Here, we investigate, in vivo, if skin integration is achievable in patients using a HA-coated abutment. One titanium abutment (control) and one HA-coated abutment (case) together with the surrounding skin were surgically retrieved from two patients who had a medical indication for this procedure. Histological sections of the skin were investigated using light microscopy. The abutment was qualitatively analyzed using scanning electron microscopy. The titanium abutment only had a partial and thin layer of attached amorphous biological material. The HA-coated abutment was almost fully covered by a pronounced thick layer of organized skin, composed of different interconnected structural layers. Proof-of-principle evidence that the HA-coated abutment can achieve integration with the surrounding skin was presented for the first time.

Influence of simulated bone-implant contact and implant diameter on secondary stability: a resonance frequency in vitro study.

Science.gov (United States)

Veltri, Mario; González-Martín, Oscar; Belser, Urs C

2014-08-01

This study tested the hypothesis of no differences in resonance frequency for standardized amounts of simulated bone-implant contact around implants with different diameters. In addition, it was evaluated if resonance frequency is able to detect a difference between stable and rotation mobile ("spinning") implants. Implants with diameters of 3.3, 4.1 and 4.8 mm were placed in a purposely designed metal mould where liquid polyurethane resin was then poured to obtain a simulated bone-implant specimen. By regulating the mould, it was possible to create the following simulated bone-implant contact groups: 3.3 mm (198.6 mm(2)); 4.1 mm (198.8 mm(2)); 4.8 mm (200.2 mm(2)); 4.8 mm (231.7 mm(2)); 4.8 mm (294.7 mm(2)). Each group included 10 specimens. After resin setting, resonance frequency was measured. On the last group, measurements were repeated after establishing implant rotational mobility. One-way ANOVA tests with post hoc comparisons, a Pearson's correlation coefficient and a t-test for repeated measurements were used to evaluate statistically significant differences. Implants with different diameters but with the same amount of simulated osseointegration revealed no differences in resonance frequency. On the contrary, an increase of simulated bone-implant contact resulted in significantly higher resonance frequency. A clear direct linear correlation resulted between resonance frequency and simulated bone-implant contact. Furthermore, a significant difference resulted between resonance frequency measured before and after creation of rotational mobility. Within the conditions of this study, the secondary stability was correlated with the simulated bone-implant contact. In addition, resonance frequency was able to discern between stable and rotation mobile implants. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Implant failure in osteosynthesis of fractures of long bones ...

African Journals Online (AJOL)

Patients who had open operative treatment of fractures of long bones were reviewed retrospectively to identify the incidence of and risk factors for implant failure. One hundred and five patients had open reduction and internal fixation of 117 fractures of long bones, out of which four patients suffered implant failure.

[Influence of implants prepared by selective laser melting on early bone healing].

Science.gov (United States)

Liu, J Y; Chen, F; Ge, Y J; Wei, L; Pan, S X; Feng, H L

2018-02-18

To evaluate the influence of the rough surface of dental implants prepared by selective laser melting (SLM) on early bone healing around titanium implants. A total of sixteen titanium implants were involved in our research, of which eight implants were prepared by SLM (TIXOS Cylindrical, Leader-Novaxa, Milan, Italy; 3.3 mm×10 mm, internal hex) and the other eight were sandblasted, large-grit and acid-etched (SLA) implants (IMPLUS Cylindrical, Leader-Novaxa, Milan, Italy; 3.3 mm×10 mm, internal hex). All of the dental implants were inserted into the healed extraction sockets of the mandible of two adult male Beagle dogs. Half of the dental implants were designed to be healed beneath the mucosa and the other half were intended to be healed transgingivally and were immediately loaded by acrylic resin bridge restoration. Three types of tetracycline fluorescent labels, namely calcein blue, alizarin complexone and calcein, were administered into the veins of the Beagle dogs 2, 4, and 8 weeks after implant placement respectively for fluorescent evaluation of newly formed bone peri-implant. Both Beagle dogs were euthanized 12 weeks after implant insertion and the mandible block specimens containing the titanium implants and surrounding bone and soft tissue of each dog were carefully sectioned and dissected. A total of 16 hard tissue slices were obtained and stained with toluidine blue for microscopic examination and histomorphometric measurements. Histological observation was made for each slice under light microscope and laser scanning confocal microscope (LSCM). Comparison on new bone formation around titanium implants of each group was made and mineral apposition rate (MAR) was calculated for each group. Dental implants prepared by selective laser melting had achieved satisfying osseointegration to surrounding bone tissue after the healing period of 12 weeks. Newly formed bone tissue was observed creeping on the highly porous surface of the SLM implant and growing

The Effects of Subcrestal Implant Placement on Crestal Bone Levels and Bone-to-Abutment Contact: A Microcomputed Tomographic and Histologic Study in Dogs.

Science.gov (United States)

Fetner, Michael; Fetner, Alan; Koutouzis, Theofilos; Clozza, Emanuele; Tovar, Nick; Sarendranath, Alvin; Coelho, Paulo G; Neiva, Kathleen; Janal, Malvin N; Neiva, Rodrigo

2015-01-01

Implant design and the implant-abutment interface have been regarded as key influences on crestal bone maintenance over time. The aim of the present study was to determine crestal bone changes around implants placed at different depths in a dog model. Thirty-six two-piece dental implants with a medialized implant-abutment interface and Morse taper connection (Ankylos, Dentsply) were placed in edentulous areas bilaterally in six mongrel dogs. On each side of the mandible, three implants were placed randomly at the bone crest, 1.5 mm subcrestally, or 3.0 mm subcrestally. After 3 months, the final abutments were torqued into place. At 6 months, the animals were sacrificed and samples taken for microcomputed tomographic (micro-CT) and histologic evaluations. Micro-CT analysis revealed similar crestal or marginal bone loss among groups. Both subcrestal implant groups lost significantly less crestal and marginal bone than the equicrestal implants. Bone loss was greatest on the buccal of the implants, regardless of implant placement depth. Histologically, implants placed subcrestally were found to have bone in contact with the final abutment and on the implant platform. Implants with a centralized implant-abutment interface and Morse taper connection can be placed subcrestally without significant loss of crestal or marginal bone. Subcrestal placement of this implant system appears to be advantageous in maintaining bone height coronal to the implant platform.

Review of recent publications on bone implant interactions

International Nuclear Information System (INIS)

Moseke, C.

2001-01-01

Review of recent development in bone implant manufacturing and properties have been reported. The desirable implant mechanical, chemical, biological and surface properties have been discussed. Implant materials as well as their surface treatment and coating for achievement of best therapeutic results have been also presented

Remodeling of the Mandibular Bone Induced by Overdentures Supported by Different Numbers of Implants.

Science.gov (United States)

Li, Kai; Xin, Haitao; Zhao, Yanfang; Zhang, Zhiyuan; Wu, Yulu

2016-05-01

The objective of this study was to investigate the process of mandibular bone remodeling induced by implant-supported overdentures. computed tomography (CT) images were collected from edentulous patients to reconstruct the geometry of the mandibular bone and overdentures supported by implants. Based on the theory of strain energy density (SED), bone remodeling models were established using the user material subroutine (UMAT) in abaqus. The stress distribution in the mandible and bone density change was investigated to determine the effect of implant number on the remodeling of the mandibular bone. The results indicated that the areas where high Mises stress values were observed were mainly situated around the implants. The stress was concentrated in the distal neck region of the distal-most implants. With an increased number of implants, the biting force applied on the dentures was almost all taken up by implants. The stress and bone density in peri-implant bone increased. When the stress reached the threshold of remodeling, the bone density began to decrease. In the posterior mandible area, the stress was well distributed but increased with decreased implant numbers. Changes in bone density were not observed in this area. The computational results were consistent with the clinical data. The results demonstrate that the risk of bone resorption around the distal-most implants increases with increased numbers of implants and that the occlusal force applied to overdentures should be adjusted to be distributed more in the distal areas of the mandible.

Comparison of Marginal Bone Loss Between Implants with Internal and External Connections: A Systematic Review.

Science.gov (United States)

Palacios-Garzón, Natalia; Mauri-Obradors, Elisabeth; Roselló-LLabrés, Xavier; Estrugo-Devesa, Albert; Jané-Salas, Enric; López-López, José

The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010. A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale. From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections. According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.

Plasma-sprayed titanium coating to polyetheretherketone improves the bone-implant interface.

Science.gov (United States)

Walsh, William R; Bertollo, Nicky; Christou, Chrisopher; Schaffner, Dominik; Mobbs, Ralph J

2015-05-01

Rapid and stable fixation at the bone-implant interface would be regarded as one of the primary goals to achieve clinical efficacy, regardless of the surgical site. Although mechanical and physical properties of polyetheretherketone (PEEK) provide advantages for implant devices, the hydrophobic nature and the lack of direct bone contact remains a limitation. To examine the effects of a plasma-sprayed titanium coated PEEK on the mechanical and histologic properties at the bone-implant interface. A preclinical laboratory study. Polyetheretherketone and plasma-sprayed titanium coated PEEK implants (Ti-bond; Spinal Elements, Carlsbad, CA, USA) were placed in a line-to-line manner in cortical bone and in a press-fit manner in cancellous bone of adult sheep using an established ovine model. Shear strength was assessed in the cortical sites at 4 and 12 weeks, whereas histology was performed in cortical and cancellous sites at both time points. The titanium coating dramatically improved the shear strength at the bone-implant interface at 4 weeks and continued to improve with time compared with PEEK. Direct bone ongrowth in cancellous and cortical sites can be achieved using a plasma-sprayed titanium coating on PEEK. Direct bone to implant bonding can be achieved on PEEK in spite of its hydrophobic nature using a plasma-sprayed titanium coating. The plasma-sprayed titanium coating improved mechanical properties in the cortical sites and the histology in cortical and cancellous sites. Copyright © 2015 Elsevier Inc. All rights reserved.

Conductivity in insulators due to implantation of conducting species

International Nuclear Information System (INIS)

Prawer, S.; Kalish, R.

1993-01-01

Control of the surface conductivity of insulators can be accomplished by high dose ion implantation of conductive species. The use of C + as the implant species is particularly interesting because C can either form electrically insulating sp 3 bonds or electrically conducting sp 2 bonds. In the present work, fused quartz plates have been irradiated with 100 keV C + ions to doses up to 1 x 10 17 ions/cm 2 at room temperature and at 200 deg C. The ion beam induced conductivity was monitored in-situ and was found to increase by up to 8 orders to magnitude for the ion dose range studied. Xe implantations over a similar range did not induce any changes in the conductivity showing that the increase in conductivity is caused by the presence of the C in the fused quartz matrix and not by damage. The dependence of the conductivity on implantation temperature and on post implantation annealing sheds light on the clustering of the C implants. The temperature dependence of the conductivity for the highest doses employed (1 x 10 17 C + /cm 2 ) can be described very well by lnσ α T. This is considered to be a peculiar dependence which does not comply with any of the standard models for conduction. 9 refs., 1 tab., 6 figs

Bone-anchored hearing aids in conductive and mixed hearing losses: why do patients reject them?

Science.gov (United States)

Siau, Richard T K; Dhillon, Baljeet; Siau, Derrick; Green, Kevin M J

2016-10-01

This study aimed to report the bone-anchored hearing aid uptake rate and the reasons for their rejection by patients with conductive and mixed hearing losses. A retrospective review was performed of 113 consecutive patients with unilateral or bilateral conductive or mixed hearing loss referred to the Greater Manchester bone-anchored hearing aid (BAHA) programme between September 2008 and August 2011. 98 (86.7 %) patients were deemed audiologically suitable for BAHA implantation. Of these, 38 (38.8 %) had BAHA implanted; 60 (61.2 %) patients declined. Of those who declined, 27 (45 %) cited anxiety over surgery, 18 (30 %) cited cosmetic reasons, 16 (26.7 %) perceived limited benefit from the device and six (10 %) preferred conventional hearing aids. Our study highlights a 38.8 % BAHA uptake rate in audiologically suitable patients. The main reasons cited for rejection of BAHA were anxiety over surgery and cosmetic concerns. It is important that clinicians address these early during consultation with prospective BAHA recipients and avoid rushing to implant these patients with a bone-anchored hearing aid.

Early bone anchorage to micro- and nano-topographically complex implant surfaces in hyperglycemia.

Science.gov (United States)

Ajami, Elnaz; Bell, Spencer; Liddell, Robert S; Davies, John E

2016-07-15

The aim of this work was to investigate the effect of implant surface design on early bone anchorage in the presence of hyperglycemia. 108 Wistar rats were separated into euglycemic (EG) controls and STZ-treated hyperglycemic (HG) groups, and received bilateral femoral custom rectangular implants of two surface topographies: grit blasted (GB) and grit-blast with a superimposed calcium phosphate nanotopography (GB-DCD). The peri-implant bone was subjected to a tensile disruption test 5, 7, and 9days post-operatively (n=28/time point); the force was measured; and the residual peri-implant bone was observed by scanning electron microscopy (SEM). Disruption forces at 5days were not significantly different from zero for the GB implants (p=0.24) in either metabolic group; but were for GB+DCD implants in both metabolic groups (pmicro-surfaced implants showed significantly different disruption forces at all time points (e.g. >15N and implants, as all values were very low (implant bone showed compromised intra-fibrillar collagen mineralization in hyperglycemia, while inter-fibrillar and cement line mineralization remained unaffected. Enhanced bone anchorage to the implant surfaces was observed on the nanotopographically complex surface independent of metabolic group. The compromised intra-fibrillar mineralization observed provides a mechanism by which early bone mineralization is affected in hyperglycemia. It is generally accepted that the hyperglycemia associated with diabetes mellitus compromises bone quality, although the mechanism by which this occurs is unknown. Uncontrolled hyperglycemia is therefore a contra-indication for bone implant placement. It is also known that nano-topographically complex implant surfaces accelerate early peri-implant healing. In this report we show that, in our experimental model, nano-topographically complex surfaces can mitigate the compromised bone healing seen in hyperglycemia. Importantly, we also provide a mechanistic explanation for

Bone compaction enhances fixation of weightbearing titanium implants

DEFF Research Database (Denmark)

Kold, Søren; Rahbek, Ole; Vestermark, Marianne

2005-01-01

are weightbearing, the effects of compaction on weightbearing implants were examined. The hypothesis was that compaction would increase implant fixation compared with conventional drilling. Porous-coated titanium implants were inserted bilaterally into the weightbearing portion of the femoral condyles of dogs....... In each dog, one knee had the implant cavity prepared with drilling, and the other knee was prepared with compaction. Eight dogs were euthanized after 2 weeks, and eight dogs were euthanized after 4 weeks. Femoral condyles from an additional eight dogs represented Time 0. Compacted specimens had higher...... bone-implant contact and periimplant bone density at 0 and 2 weeks, but not at 4 weeks. A biphasic response of compaction was found with a pushout test, as compaction increased ultimate shear strength and energy absorption at 0 and 4 weeks, but not at 2 weeks. This biphasic response indicates...

Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants

DEFF Research Database (Denmark)

Babiker, Hassan; Ding, Ming; Overgaard, Søren

Best Poster 5Demineralized bone matrix and human cancellous bone enhance fixation of titanium implants AuthorsBabiker , H.; Ding M.; Overgaard S.InstitutionOrthopaedic Research Laboratory, Department of Orthopaedic Surgery, Odense University Hospital, Clinical Institute, University of Southern...... from human tissue were included (IsoTis OrthoBiologics, Inc. USA). Both materials are commercially available. Titanium alloy implants (Biomet Inc.) of 10 mm in length and 10 mm in diameter were inserted bilaterally into the femoral condyles of 8 skeletally mature sheep. Thus four implants...... with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: DBM; DBM/CB with ratio of 1/3; DBM/allograft with ratio of 1/3; or allograft (Gold standard), respectively. Standardised surgical procedure was used1. At sacrifice, 6 weeks after surgery, both distal femurs were harvested...

Characterization of drug-release kinetics in trabecular bone from titania nanotube implants

Directory of Open Access Journals (Sweden)

Aw MS

2012-09-01

Full Text Available Moom Sinn Aw,1 Kamarul A Khalid,2,3 Karan Gulati,1 Gerald J Atkins,2 Peter Pivonka,4 David M Findlay,2 Dusan Losic11School of Chemical Engineering, 2Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, SA, Australia; 3Department of Orthopaedics, Traumatology and Rehabilitation, Faculty of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; 4Engineering Computational Biology Group, School of Computer Science and Software Engineering, The University of Western Australia, Perth, WA, AustraliaPurpose: The aim of this study was to investigate the application of the three-dimensional bone bioreactor for studying drug-release kinetics and distribution of drugs in the ex vivo cancellous bone environment, and to demonstrate the application of nanoengineered titanium (Ti wires generated with titania nanotube (TNT arrays as drug-releasing implants for local drug deliveryMethods: Nanoengineered Ti wires covered with a layer of TNT arrays implanted in bone were used as a drug-releasing implant. Viable bovine trabecular bone was used as the ex vivo bone substrate embedded with the implants and placed in the bone reactor. A hydrophilic fluorescent dye (rhodamine B was used as the model drug, loaded inside the TNT–Ti implants, to monitor drug release and transport in trabecular bone. The distribution of released model drug in the bone was monitored throughout the bone structure, and concentration profiles at different vertical (0–5 mm and horizontal (0–10 mm distances from the implant surface were obtained at a range of release times from 1 hour to 5 days.Results: Scanning electron microscopy confirmed that well-ordered, vertically aligned nanotube arrays were formed on the surface of prepared TNT–Ti wires. Thermogravimetric analysis proved loading of the model drug and fluorescence spectroscopy was used to show drug-release characteristics in-vitro. The drug release from implants inserted into bone ex

Insufficient irrigation induces peri-implant bone resorption: an in vivo histologic analysis in sheep.

Science.gov (United States)

Trisi, Paolo; Berardini, Marco; Falco, Antonello; Podaliri Vulpiani, Michele; Perfetti, Giorgio

2014-06-01

To measure in vivo impact of dense bone overheating on implant osseointegration and peri-implant bone resorption comparing different bur irrigation methods vs. no irrigation. Twenty TI-bone implants were inserted in the inferior edge of mandibles of sheep. Different cooling procedures were used in each group: no irrigation (group A), only internal bur irrigation (group B), both internal and external irrigation (group C), and external irrigation (group D). The histomorphometric parameters calculated for each implant were as follows: %cortical bone-implant contact (%CBIC) and %cortical bone volume (%CBV). Friedman's test was applied to test the statistical differences. In group A, we found a huge resorption of cortical bone with %CBIC and %CBV values extremely low. Groups B and C showed mean %CBIC and %BV values higher than other groups The mean %CBV value was significantly different when comparing group B and group C vs. group A (P bone caused massive resorption of the cortical bone and implant failure. Drilling procedures on hard bone need an adequate cooling supply because the bone matrix overheating may induce complete resorption of dense bone around implants. Internal-external irrigation and only internal irrigation showed to be more efficient than other types of cooling methods in preventing bone resorption around implants. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging.

Science.gov (United States)

Wagner, A; Sachse, A; Keller, M; Aurich, M; Wetzel, W-D; Hortschansky, P; Schmuck, K; Lohmann, M; Reime, B; Metge, J; Arfelli, F; Menk, R; Rigon, L; Muehleman, C; Bravin, A; Coan, P; Mollenhauer, J

2006-03-07

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening.

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging

Energy Technology Data Exchange (ETDEWEB)

Wagner, A [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany); Sachse, A [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany); Keller, M [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany); Aurich, M [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany); Wetzel, W-D [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany); Hortschansky, P [Hans-Knoell-Institut fuer Naturstoffforschung, Jena (Germany); Schmuck, K [DePuy Biotech GmbH, Jena (Germany); Lohmann, M [Hasylab at DESY, Hamburg (Germany); Reime, B [Hasylab at DESY, Hamburg (Germany); Metge, J [CELLS-ALBA, Universitat Autonoma de Barcelona (Spain); Arfelli, F [Department of Physics, University of Trieste, Trieste (Italy); Menk, R [ELETTRA, Trieste (Italy); Rigon, L [ELETTRA, Trieste (Italy); Muehleman, C [Department of Biochemistry, Rush Medical College, Chicago, IL (United States); Bravin, A [European Synchrotron Radiation Facility, BP220 38043, Grenoble (France); Coan, P [European Synchrotron Radiation Facility, BP220 38043, Grenoble (France); Mollenhauer, J [Department of Orthopaedics of the University of Jena at the Waldkrankenhaus ' Rudolf Elle' , Jena (Germany)

2006-03-07

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening.

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging

International Nuclear Information System (INIS)

Wagner, A; Sachse, A; Keller, M; Aurich, M; Wetzel, W-D; Hortschansky, P; Schmuck, K; Lohmann, M; Reime, B; Metge, J; Arfelli, F; Menk, R; Rigon, L; Muehleman, C; Bravin, A; Coan, P; Mollenhauer, J

2006-01-01

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging

Science.gov (United States)

Wagner, A.; Sachse, A.; Keller, M.; Aurich, M.; Wetzel, W.-D.; Hortschansky, P.; Schmuck, K.; Lohmann, M.; Reime, B.; Metge, J.; Arfelli, F.; Menk, R.; Rigon, L.; Muehleman, C.; Bravin, A.; Coan, P.; Mollenhauer, J.

2006-03-01

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening.

Performance of laser sintered Ti-6Al-4V implants with bone-inspired porosity and micro/nanoscale surface roughness in the rabbit femur.

Science.gov (United States)

Cohen, David J; Cheng, Alice; Sahingur, Kaan; Clohessy, Ryan M; Hopkins, Louis B; Boyan, Barbara D; Schwartz, Zvi

2017-04-28

Long term success of bone-interfacing implants remains a challenge in compromised patients and in areas of low bone quality. While surface roughness at the micro/nanoscale can promote osteogenesis, macro-scale porosity is important for promoting mechanical stability of the implant over time. Currently, machining techniques permit pores to be placed throughout the implant, but the pores are generally uniform in dimension. The advent of laser sintering provides a way to design and manufacture implants with specific porosity and variable dimensions at high resolution. This approach enables production of metal implants that mimic complex geometries found in biology. In this study, we used a rabbit femur model to compare osseointegration of laser sintered solid and porous implants. Ti-6Al-4V implants were laser sintered in a clinically relevant size and shape. One set of implants had a novel porosity based on human trabecular bone; both sets had grit-blasted/acid-etched surfaces. After characterization, implants were inserted transaxially into rabbit femora; mechanical testing, micro-computed tomography (microCT) and histomorphometry were conducted 10 weeks post-operatively. There were no differences in pull-out strength or bone-to-implant contact. However, both microCT and histomorphometry showed significantly higher new bone volume for porous compared to solid implants. Bone growth was observed into porous implant pores, especially near apical portions of the implant interfacing with cortical bone. These results show that laser sintered Ti-6Al-4V implants with micro/nanoscale surface roughness and trabecular bone-inspired porosity promote bone growth and may be used as a superior alternative to solid implants for bone-interfacing implants.

The effect of implant design and bone quality on insertion torque, resonance frequency analysis, and insertion energy during implant placement in low or low- to medium-density bone.

Science.gov (United States)

Wang, Tong-Mei; Lee, Ming-Shu; Wang, Juo-Song; Lin, Li-Deh

2015-01-01

This study investigated the effect of implant design and bone quality on insertion torque (IT), implant stability quotient (ISQ), and insertion energy (IE) by monitoring the continuous change in IT and ISQ while implants were inserted in artificial bone blocks that simulate bone of poor or poor-to-medium quality. Polyurethane foam blocks (Sawbones) of 0.16 g/cm³ and 0.32 g/cm³ were respectively used to simulate low density and low- to medium-density cancellous bone. In addition, some test blocks were laminated with a 1-mm 0.80 g/cm³ polyurethane layer to simulate cancellous bone with a thin cortical layer. Four different implants (Nobel Biocare Mk III-3.75, Mk III-4.0, Mk IV-4.0, and NobelActive-4.3) were placed into the different test blocks in accordance with the manufacturer's instructions. The IT and ISQ were recorded at every 0.5-mm of inserted length during implant insertion, and IE was calculated from the torque curve. The peak IT (PIT), final IT (FIT), IE, and final ISQ values were statistically analyzed. All implants showed increasing ISQ values when the implant was inserted more deeply. In contrast to the ISQ, implants with different designs showed dissimilar IT curve patterns during the insertion. All implants showed a significant increase in the PIT, FIT, IE, and ISQ when the test-block density increased or when the 1-mm laminated layer was present. Tapered implants showed FIT or PIT values of more than 40 Ncm for all of the laminated test blocks and for the nonlaminated test blocks of low to medium density. Parallel-wall implants did not exhibit PIT or FIT values of more than 40 Ncm for all of the test blocks. NobelActive-4.3 showed a significantly higher FIT, but a significantly lower IE, than Mk IV-4.0. While the existence of cortical bone or implant designs significantly affects the dynamic IT profiles during implant insertion, it does not affect the ISQ to a similar extent. Certain implant designs are more suitable than others if high IT is

Marginal bone loss around non-submerged implants is associated with salivary microbiome during bone healing.

Science.gov (United States)

Duan, Xiao-Bo; Wu, Ting-Xi; Guo, Yu-Chen; Zhou, Xue-Dong; Lei, Yi-Ling; Xu, Xin; Mo, An-Chun; Wang, Yong-Yue; Yuan, Quan

2017-06-01

Marginal bone loss during bone healing exists around non-submerged dental implants. The aim of this study was to identify the relationship between different degrees of marginal bone loss during bone healing and the salivary microbiome. One hundred patients were recruited, and marginal bone loss around their implants was measured using cone beam computed tomography during a 3-month healing period. The patients were divided into three groups according to the severity of marginal bone loss. Saliva samples were collected from all subjected and were analysed using 16S MiSeq sequencing. Although the overall structure of the microbial community was not dramatically altered, the relative abundance of several taxonomic groups noticeably changed. The abundance of species in the phyla Spirochaeta and Synergistetes increased significantly as the bone loss became more severe. Species within the genus Treponema also exhibited increased abundance, whereas Veillonella, Haemophilus and Leptotrichia exhibited reduced abundances, in groups with more bone loss. Porphyromonasgingivalis, Treponemadenticola and Streptococcus intermedius were significantly more abundant in the moderate group and/or severe group. The severity of marginal bone loss around the non-submerged implant was associated with dissimilar taxonomic compositions. An increased severity of marginal bone loss was related to increased proportions of periodontal pathogenic species. These data suggest a potential role of microbes in the progression of marginal bone loss during bone healing.

The quantitative assessment of peri-implant bone responses using histomorphometry and micro-computed tomography.

Science.gov (United States)

Schouten, Corinne; Meijer, Gert J; van den Beucken, Jeroen J J P; Spauwen, Paul H M; Jansen, John A

2009-09-01

In the present study, the effects of implant design and surface properties on peri-implant bone response were evaluated with both conventional histomorphometry and micro-computed tomography (micro-CT), using two geometrically different dental implants (Screw type, St; Push-in, Pi) either or not surface-modified (non-coated, CaP-coated, or CaP-coated+TGF-beta1). After 12 weeks of implantation in a goat femoral condyle model, peri-implant bone response was evaluated in three different zones (inner: 0-500 microm; middle: 500-1000 microm; and outer: 1000-1500 microm) around the implant. Results indicated superiority of conventional histomorphometry over micro-CT, as the latter is hampered by deficits in the discrimination at the implant/tissue interface. Beyond this interface, both analysis techniques can be regarded as complementary. Histomorphometrical analysis showed an overall higher bone volume around St compared to Pi implants, but no effects of surface modification were observed. St implants showed lowest bone volumes in the outer zone, whereas inner zones were lowest for Pi implants. These results implicate that for Pi implants bone formation started from two different directions (contact- and distance osteogenesis). For St implants it was concluded that undersized implantation technique and loosening of bone fragments compress the zones for contact and distant osteogenesis, thereby improving bone volume at the interface significantly.

Abnormal bone formation induced by implantation of osteosarcoma-derived bone-inducing substance in the X-linked hypophosphatemic mouse

International Nuclear Information System (INIS)

Yoshikawa, H.; Masuhara, K.; Takaoka, K.; Ono, K.; Tanaka, H.; Seino, Y.

1985-01-01

The X-linked hypophosphatemic mouse (Hyp) has been proposed as a model for the human familial hypophosphatemia (the most common form of vitamin D-resistant rickets). An osteosarcoma-derived bone-inducing substance was subcutaneously implanted into the Hyp mouse. The implant was consistently replaced by cartilage tissue at 2 weeks after implantation. The cartilage matrix seemed to be normal, according to the histological examination, and 35sulphur ( 35 S) uptake was also normal. Up to 4 weeks after implantation the cartilage matrix was completely replaced by unmineralized bone matrix and hematopoietic bone marrow. Osteoid tissue arising from the implantation of bone inducing substance in the Hyp mouse showed no radiologic or histologic sign of calcification. These findings suggest that the abnormalities of endochondral ossification in the Hyp mouse might be characterized by the failure of mineralization in cartilage and bone matrix. Analysis of the effects of bone-inducing substance on the Hyp mouse may help to give greater insight into the mechanism and treatment of human familial hypophosphatemia

Partially Biodegradable Distraction Implant to Replace Conventional Implants in Alveolar Bone of Insufficient Height: A Preliminary Study in Dogs.

Science.gov (United States)

Li, Tao; Zhang, Yongqiang; Shao, Bo; Gao, Yuan; Zhang, Chen; Cao, Qiang; Kong, Liang

2015-12-01

Dental implants have been widely used in the last few decades. However, patients with insufficient bone height need reconstructive surgeries before implant insertion. The distraction implant (DI) has been invented to simplify the treatment procedure, but the shortcomings of DIs have limited their clinical use. We incorporated biodegradable polyester into a novel DI called the partially biodegradable distraction implant (PBDI). The purpose of this study was to assess the radiological, histological, and biomechanical properties of the PBDI in animal models. PBDIs were manufactured and inserted into the atrophied mandibles of nine dogs. Box-shaped alveolar bones were segmented and distracted. The dogs were randomly divided into three groups that were sacrificed 1, 2, and 3 months after the implant insertion. Actual augmentation height (AAH) of the bone segments was measured to evaluate the effect of distraction. X-ray examination and micro-CT reconstruction and analysis were used to evaluate the regenerated bone in the distraction gap and bone around the functional element. Histological sections were used to evaluate the osseointegration and absorption of the PBDI. Fatigue tests were used to evaluate the biomechanical properties of the PBDI. Little change was found in AAH among the three groups. X-ray examination and micro-CT reconstruction showed good growth of regenerated bone in the distraction gap. Alveolar bone volume around the functional element increased steadily. No obvious bone absorption occurred in the alveolar crest around PBDI. Three months after distraction, the functional element achieved osseointegration, and the support element began to be absorbed. All PBDIs survived the fatigue test. The PBDI is a novel and reliable dental implant. It becomes a conventional implant after the absorption of the support element and the removal of the distraction screw. It is a promising replacement for conventional implants in patients with insufficient alveolar bone

Novel hybrid drilling protocol: evaluation for the implant healing--thermal changes, crestal bone loss, and bone-to-implant contact.

Science.gov (United States)

Calvo-Guirado, José Luis; Delgado-Peña, Jorge; Maté-Sánchez, Jose E; Mareque Bueno, Javier; Delgado-Ruiz, Rafael Arcesio; Romanos, Georgios E

2015-07-01

To evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo. Temperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10 mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P2, P3, P4, and first molar M1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75 mm diameter and 10 mm length were inserted. The dogs were euthanized at 30 and 90 days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated. The control group showed maximum temperatures of 35.3 °C ± 1.8 °C, ΔT of 10.4 °C, and a mean time of 100 s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 °C ± 1.2 °C, ΔT of 8.1 °C, and a mean time of 240 s/procedure. After 30 days, CBL values for both groups (test: 1.168 ± 0.194 mm; control: 1.181 ± 0.113 mm) and BIC values (test: 43 ± 2.8%; control: 45 ± 1.3%) were similar, without significant differences (P > 0.05). After 90 days, CBL (test: 1.173 ± 0.187 mm; control: 1.205 ± 0.122 mm) and BIC (test: 64 ± 3.3%; control: 64 ± 2.4%) values were similar, without significant differences (P > 0.05). The BIC values were increased at 90 days in both groups compared with the 30-day period (P drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Results of bone regenerate study after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants in experimental femoral neck fractures (experimental study

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K. S. Kazanin

2015-01-01

Full Text Available Objective - to analyze the results of X-ray, cytomorphometric and immunohistochemistry experimental studies of bone regenerates after osteosynthesis with bioinert and calcium phosphate-coated bioactive implants. Material and methods. The study was conducted on experimental femoral neck fractures in rabbit males. Reparative osteogenesis processes were studied in groups of bioinert titanium implant osteosynthesis and calcium phosphate-coated bioactive titanium implant osteosynthesis. The animals were clinically followed-up during the postoperative period. X-ray, cytomorphometric and immunohistochemistry studies of samples extracted from femoral bones were conducted over time on days 1, 7, 14, 30 and 60. The animal experiments were kept and treated according to recommendations of international standards, Helsinki Declaration on animal welfare and approved by the local ethics committee. All surgeries were performed under anesthesia, and all efforts were made to minimize the suffering of the animals. Results. In the animal group without femoral neck fracture osteosynthesis, femoral neck pseudoarthrosis was observed at the end of the experiment. The results of cytomorphometric and immunohistochemistry studies conducted on day 60 of the experiment confirmed that the cellular composition of the bone regenerate in the group of calcium phosphate-coated bioactive titanium implants corresponded to a more mature bone tissue than in the group of bioinert titanium implants. Conclusion. The results of the statistical analysis of cytomorphometric and immunohistochemistry data show that the use of calcium phosphate-coated bioactive titanium implants allows to achieve significantly earlier bone tissue regeneration.

Stability of dental implants in grafted bone in the anterior maxilla: longitudinal study.

LENUS (Irish Health Repository)

Al-Khaldi, Nasser

2010-06-06

We aimed to assess the stability over time of dental implants placed in grafted bone in the maxilla using resonance frequency analysis, and to compare the stability of implants placed in grafted and non-grafted bone. Data were collected from 23 patients (15 test and 8 controls) in whom 64 implants (Brånemark system, Nobel Biocare, Göteborg, Sweden) were placed in accordance with the two-stage surgical protocol. In the test group 36 fixtures were placed in grafted bone, and in the control group 28 fixtures were placed in non-grafted bone. Resonance frequency analysis was used to assess the test sites at implant placement and abutment connection. The mean (SD) implant stability quotient (ISQ) for test sites at the time of implant placement was 61.91 (6.68), indicating excellent primary stability, and was 63.53 (5.76) at abutment connection. ISQ values at abutment connection were similar for test and control sites. Implants placed in grafted bone compared favourably with those in non-grafted bone, and showed excellent stability.

Evaluation of interference fit and bone damage of an uncemented femoral knee implant.

Science.gov (United States)

Berahmani, Sanaz; Hendriks, Maartje; de Jong, Joost J A; van den Bergh, Joop P W; Maal, Thomas; Janssen, Dennis; Verdonschot, Nico

2018-01-01

During implantation of an uncemented femoral knee implant, press-fit interference fit provides the primary stability. It is assumed that during implantation a combination of elastic and plastic deformation and abrasion of the bone will occur, but little is known about what happens at the bone-implant interface and how much press-fit interference fit is eventually achieved. Five cadaveric femora were prepared and implantation was performed by an experienced surgeon. Micro-CT- and conventional CT-scans were obtained pre- and post-implantation for geometrical measurements and to measure bone mineral density. Additionally, the position of the implant with respect to the bone was determined by optical scanning of the reconstructions. By measuring the differences in surface geometry, assessments were made of the cutting error, the actual interference fit, the amount of bone damage, and the effective interference fit. Our analysis showed an average cutting error of 0.67mm (SD 0.17mm), which pointed mostly towards bone under-resections. We found an average actual AP interference fit of 1.48mm (SD 0.27mm), which was close to the nominal value of 1.5mm. We observed combinations of bone damage and elastic deformation in all bone specimens, which showed a trend to be related with bone density. Higher bone density tended to lead to lower bone damage and higher elastic deformation. The results of the current study indicate different factors that interact while implanting an uncemented femoral knee component. This knowledge can be used to fine-tune design criteria of femoral components to achieve adequate primary stability for all patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of trehalose coating on basic fibroblast growth factor release from tailor-made bone implants.

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Choi, Sungjin; Lee, Jongil; Igawa, Kazuyo; Suzuki, Shigeki; Mochizuki, Manabu; Nishimura, Ryohei; Chung, Ung-il; Sasaki, Nobuo

2011-12-01

Artificial bone implants are often incorporated with osteoinductive factors to facilitate early bone regeneration. Calcium phosphate, the main component in artificial bone implants, strongly binds these factors, and in a few cases, the incorporated proteins are not released from the implant under conditions of physiological pH, thereby leading to reduction in their osteoinductivity. In this study, we coated tailor-made bone implants with trehalose to facilitate the release of basic fibroblast growth factor (bFGF). In an in vitro study, mouse osteoblastic cells were separately cultured for 48 hr in a medium with a untreated implant (T-), trehalose-coated implant (T+), bFGF-incorporated implant (FT-), and bFGF-incorporated implant with trehalose coating (FT+). In the FT+ group, cell viability was significantly higher than that in the other groups (Pbone implant without affecting the crystallinity or the mechanical strength of the artificial bone implant. These results suggest that coating artificial bone implants with trehalose could limit the binding of bFGF to calcium phosphate.

Heat generation during implant placement in low-density bone: effect of surgical technique, insertion torque and implant macro design.

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Marković, Aleksa; Mišić, Tijana; Miličić, Biljana; Calvo-Guirado, Jose Luis; Aleksić, Zoran; Ðinić, Ana

2013-07-01

The study aimed to investigate the effect of surgical technique, implant macrodesign and insertion torque on bone temperature changes during implant placement. In the in vitro study, 144 self-tapping (blueSKY(®) 4 × 10 mm; Bredent) and 144 non-self-tapping (Standard implant(®) 4.1 × 10 mm; Straumann) were placed in osteotomies prepared in pig ribs by lateral bone condensing or bone drilling techniques. The maximum insertion torque values of 30, 35 and 40 Ncm were used. Real-time bone temperature measurement during implant placement was performed by three thermocouples positioned vertically, in tripod configuration around every osteotomy, at a distance of 5 mm from it and at depths of 1, 5 and 10 mm. Data were analysed using Kruskal-Wallis, Mann-Whitney U-tests and Regression analysis. Significant predictor of bone temperature at the osteotomy depth of 1 mm was insertion torque (P = 0.003) and at the depth of 10-mm implant macrodesign (P = 0.029), while no significant predictor at depth of 5 mm was identified (P > 0.05). Higher insertion torque values as well as non-self-tapping implant macrodesign were related to higher temperatures. Implant placement in sites prepared by bone drilling induced significantly higher temperature increase (P = 0.021) compared with bone condensing sites at the depth of 5 mm, while no significant difference was recorded at other depths. Compared with 30 Ncm, insertion torque values of 35 and 40 Ncm produced significantly higher temperature increase (P = 0.005; P = 0.003, respectively) at the depth of 1 mm. There was no significant difference in temperature change induced by 35 and 40 Ncm, neither by implant macrodesign at all investigated depths (P > 0.05). Placement of self-tapping implants with low insertion torque into sites prepared by lateral bone condensing technique might be advantageous in terms of thermal effect on bone. © 2012 John Wiley & Sons A/S.

Effects of mechanical repetitive load on bone quality around implants in rat maxillae.

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Yusuke Uto

Full Text Available Greater understanding and acceptance of the new concept "bone quality", which was proposed by the National Institutes of Health and is based on bone cells and collagen fibers, are required. The novel protein Semaphorin3A (Sema3A is associated with osteoprotection by regulating bone cells. The aims of this study were to investigate the effects of mechanical loads on Sema3A production and bone quality based on bone cells and collagen fibers around implants in rat maxillae. Grade IV-titanium threaded implants were placed at 4 weeks post-extraction in maxillary first molars. Implants received mechanical loads (10 N, 3 Hz for 1800 cycles, 2 days/week for 5 weeks from 3 weeks post-implant placement to minimize the effects of wound healing processes by implant placement. Bone structures, bone mineral density (BMD, Sema3A production and bone quality based on bone cells and collagen fibers were analyzed using microcomputed tomography, histomorphometry, immunohistomorphometry, polarized light microscopy and birefringence measurement system inside of the first and second thread (designated as thread A and B, respectively, as mechanical stresses are concentrated and differently distributed on the first two threads from the implant neck. Mechanical load significantly increased BMD, but not bone volume around implants. Inside thread B, but not thread A, mechanical load significantly accelerated Sema3A production with increased number of osteoblasts and osteocytes, and enhanced production of both type I and III collagen. Moreover, mechanical load also significantly induced preferential alignment of collagen fibers in the lower flank of thread B. These data demonstrate that mechanical load has different effects on Sema3A production and bone quality based on bone cells and collagen fibers between the inside threads of A and B. Mechanical load-induced Sema3A production may be differentially regulated by the type of bone structure or distinct stress distribution

Clinical and Radiologic Outcomes of Submerged and Nonsubmerged Bone-Level Implants with Internal Hexagonal Connections in Immediate Implantation: A 5-Year Retrospective Study.

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Wu, Shiyu; Wu, Xiayi; Shrestha, Rachana; Lin, Jinying; Feng, Zhicai; Liu, Yudong; Shi, Yunlin; Huang, Baoxin; Li, Zhipeng; Liu, Quan; Zhang, Xiaocong; Hu, Mingxuan; Chen, Zhuofan

2018-02-01

To evaluate the 5-year clinical and radiologic outcome of immediate implantation using submerged and nonsubmerged techniques with bone-level implants and internal hexagonal connections and the effects of potential influencing factors. A total of 114 bone-level implants (XiVE S plus) with internal hexagonal connections inserted into 72 patients were included. Patients were followed up for 5 years. A t-test was used to statistically evaluate the marginal bone loss between the submerged and nonsubmerged groups. The cumulative survival rate (CSR) was calculated according to the life table method and illustrated with Kaplan-Meier survival curves. Comparisons of the CSR between healing protocols, guided bone regeneration, implants with different sites, lengths, and diameters were performed using log-rank tests. The 5-year cumulative implant survival rates with submerged and nonsubmerged healing were 94% and 96%, respectively. No statistically significant differences in terms of marginal bone loss, healing protocol, application of guided bone regeneration, implant site, or length were observed. High CSRs and good marginal bone levels were achieved 5 years after immediate implantation of bone-level implants with internal hexagonal connections using both the submerged and nonsubmerged techniques. Factors such as implant length, site, and application of guided bone regeneration did not have an impact on the long-term success of the implants. © 2017 by the American College of Prosthodontists.

Influence of Loudness Compression on Hearing with Bone Anchored Hearing Implants

OpenAIRE

Kurz, Anja; Caversaccio, Marco; Kompis, Martin; Flynn, Marc

2014-01-01

Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect ...

Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis

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Strietzel, Frank Peter; Neumann, Konrad; Hertel, Moritz

2015-01-01

Objective To address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching (PM) implant-abutment configurations? Material and methods A systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS-, compared with PM-implant-abutment connections, published between 2005 and June 2013. Results Twenty-two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS- compared to PM-implant-abutment connections, indicating a clear tendency favoring the PS technique. A meta-analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm [CI95% 0.38; 0.60]) at PS implants, compared with PM implants (1.01 mm [CI95% 0.62; 1.40] (P marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation. PMID:24438506

Immediate provisionalization of immediate implants in the esthetic zone: a prospective case series evaluating implant survival, esthetics, and bone maintenance.

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Levin, Barry P; Wilk, Brian L

2013-05-01

This prospective study evaluates immediately placed and immediately provisionalized implants in the esthetic zone. All implants were TiO2-blasted, fluoride-modified, grade 4 titanium, with a coronal microthread design. Bone grafting and guided bone regeneration (GBR) was performed at all sites, and screw-retained temporary restorations were delivered on the day of surgery. All of the provisional crown(s) were out of occlusal function and remained in place for at least 8 weeks prior to initiation of definitive restorative therapy. Bone maintenance (BM) was considered successful if radiographs demonstrated proximal bone levels even or coronal to the implant platform. Of the 29 implants placed, 25 (86 percent) achieved bone maintenance at least 12 months post-loading with the final restorations. This study was considered successful, with 100 percent implant survival after at least 1 year loading of the final restoration, and 100 percent of patients were satisfied with the esthetics of their implant treatment.

Bone-anchored hearing devices in children with unilateral conductive hearing loss: a patient-carer perspective.

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Banga, Rupan; Doshi, Jayesh; Child, Anne; Pendleton, Elizabeth; Reid, Andrew; McDermott, Ann-Louise

2013-09-01

We sought to determine the outcome of implantation of a bone-anchored hearing device in children with unilateral conductive hearing loss. A retrospective case note analysis was used in a tertiary referral pediatric hospital to study 17 consecutive cases of pediatric patients with unilateral conductive hearing loss who were fitted with a bone-anchored hearing device between 2005 and 2010. The average age of the patients at the time of bone-anchored hearing device fitting was 10 years 6 months (range, 6 years 3 months to 16 years). Qualitative subjective outcome measures demonstrated benefit. The vast majority of patients reported improved social and physical functioning and improved quality of life. All 17 patients are currently using their bone-anchored hearing device on a daily basis after a follow-up of 6 months. This study has shown improved quality of life in children with unilateral hearing loss after implantation of their bone-anchored hearing device. There was a high degree of patient satisfaction and improvement in health status reported by children and/or carers. Bone-anchored hearing devices have an important role in the management of children with symptomatic unilateral hearing loss. Perhaps earlier consideration of a bone-anchored hearing device would be appropriate in selected cases.

Revascularization of diaphyseal bone segments by vascular bundle implantation.

Science.gov (United States)

Nagi, O N

2005-11-01

Vascularized bone transfer is an effective, established treatment for avascular necrosis and atrophic or infected nonunions. However, limited donor sites and technical difficulty limit its application. Vascular bundle transplantation may provide an alternative. However, even if vascular ingrowth is presumed to occur in such situations, its extent in aiding revascularization for ultimate graft incorporation is not well understood. A rabbit tibia model was used to study and compare vascularized, segmental, diaphyseal, nonvascularized conventional, and vascular bundle-implanted grafts with a combination of angiographic, radiographic, histopathologic, and bone scanning techniques. Complete graft incorporation in conventional grafts was observed at 6 months, whereas it was 8 to 12 weeks with either of the vascularized grafts. The pattern of radionuclide uptake and the duration of graft incorporation between vascular segmental bone grafts (with intact endosteal blood supply) and vascular bundle-implanted segmental grafts were similar. A vascular bundle implanted in the recipient bone was found to anastomose extensively with the intraosseous circulation at 6 weeks. Effective revascularization of bone could be seen when a simple vascular bundle was introduced into a segment of bone deprived of its normal blood supply. This simple technique offers promise for improvement of bone graft survival in clinical circumstances.

Binaural Hearing Ability With Bilateral Bone Conduction Stimulation in Subjects With Normal Hearing: Implications for Bone Conduction Hearing Aids.

Science.gov (United States)

Zeitooni, Mehrnaz; Mäki-Torkko, Elina; Stenfelt, Stefan

The purpose of this study is to evaluate binaural hearing ability in adults with normal hearing when bone conduction (BC) stimulation is bilaterally applied at the bone conduction hearing aid (BCHA) implant position as well as at the audiometric position on the mastoid. The results with BC stimulation are compared with bilateral air conduction (AC) stimulation through earphones. Binaural hearing ability is investigated with tests of spatial release from masking and binaural intelligibility level difference using sentence material, binaural masking level difference with tonal chirp stimulation, and precedence effect using noise stimulus. In all tests, results with bilateral BC stimulation at the BCHA position illustrate an ability to extract binaural cues similar to BC stimulation at the mastoid position. The binaural benefit is overall greater with AC stimulation than BC stimulation at both positions. The binaural benefit for BC stimulation at the mastoid and BCHA position is approximately half in terms of decibels compared with AC stimulation in the speech based tests (spatial release from masking and binaural intelligibility level difference). For binaural masking level difference, the binaural benefit for the two BC positions with chirp signal phase inversion is approximately twice the benefit with inverted phase of the noise. The precedence effect results with BC stimulation at the mastoid and BCHA position are similar for low frequency noise stimulation but differ with high-frequency noise stimulation. The results confirm that binaural hearing processing with bilateral BC stimulation at the mastoid position is also present at the BCHA implant position. This indicates the ability for binaural hearing in patients with good cochlear function when using bilateral BCHAs.

Animal Models for Evaluation of Bone Implants and Devices: Comparative Bone Structure and Common Model Uses.

Science.gov (United States)

Wancket, L M

2015-09-01

Bone implants and devices are a rapidly growing field within biomedical research, and implants have the potential to significantly improve human and animal health. Animal models play a key role in initial product development and are important components of nonclinical data included in applications for regulatory approval. Pathologists are increasingly being asked to evaluate these models at the initial developmental and nonclinical biocompatibility testing stages, and it is important to understand the relative merits and deficiencies of various species when evaluating a new material or device. This article summarizes characteristics of the most commonly used species in studies of bone implant materials, including detailed information about the relevance of a particular model to human bone physiology and pathology. Species reviewed include mice, rats, rabbits, guinea pigs, dogs, sheep, goats, and nonhuman primates. Ultimately, a comprehensive understanding of the benefits and limitations of different model species will aid in rigorously evaluating a novel bone implant material or device. © The Author(s) 2015.

Buccal bone loss after immediate implantation can be reduced by the flapless approach

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ARTHUR BELÉM NOVAES JR

2011-10-01

Full Text Available Aim: The aim of this study was to evaluate the buccal bone remodeling after immediate implantation with flap or flapless approach. Material and Methods: The mandibular bilateral premolars of 3 dogs were extracted and immediately three implants were placed in both hemi-arches of each dog. Randomly, one hemi-arch was treated with the flapless approach, while in the contra lateral hemi-arch tooth extractions and implant placement were done after mucoperiosteal flap elevation. Non-submerged healing of 12 weeks was provided for both groups. Histomorphometric analysis was done to compare buccal and lingual bone height loss, bone density and bone-to-implant contact in the groups. Fluorescence analysis was performed to investigate the dynamic of bone remodeling in the different groups. Results: There was a significant association between the surgical flap and the extent of bone resorption around immediate implants. The loss of buccal bone height was significantly lower in the flapless group when compared to the flap group (0.98 mm x 2.14 mm, respectively, p<0.05. The coronal and apical buccal bone densities of the flap group were significantly higher when compared to the lingual components, showing anatomical differences between the bone plates. Fluorescence analysis showed no major differences in bone healing between the flap and flapless groups, supporting that the higher loss of buccal bone height is linked to the anatomic characteristics of this plate and to the negative influence of the detachment of the periosteum in immediate implant therapy. Conclusion: The flapless approach for immediate post-extraction implants reduces the buccal bone height loss.

2D FEA of evaluation of micromovements and stresses at bone-implant interface in immediately loaded tapered implants in the posterior maxilla

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Shrikar R Desai

2013-01-01

Full Text Available Aim: The aim of the study is to evaluate the influence implant length on stress distribution at bone implant interface in single immediately loaded implants when placed in D4 bone quality. Materials and Methods: A 2-dimensional finite element models were developed to simulate two types of implant designs, standard 3.75 mm-diameter tapered body implants of 6 and 10 mm lengths. The implants were placed in D4 bone quality with a cortical bone thickness of 0.5 mm. The implant design incorporated microthreads at the crestal part and the rest of the implant body incorporated Acme threads. The Acme thread form has a 29° thread angle with a thread height half of the pitch; the apex and valley are flat. A 100 N of force was applied vertically and in the oblique direction (at an angle of 45° to the long axis of the implants. The respective material properties were assigned. Micro-movements and stresses at the bone implant interface were evaluated. Results: The results of total deformation (micro-movement and Von mises stress were found to be lower for tapered long implant (10 mm than short implant (6 mm while using both vertical as well as oblique loading. Conclusion: Short implants can be successfully placed in poor bone quality under immediate loading protocol. The novel approach of the combination of microthreads at the crestal portion and acme threads for body portion of implant fixture gave promising results.

2D FEA of evaluation of micromovements and stresses at bone-implant interface in immediately loaded tapered implants in the posterior maxilla.

Science.gov (United States)

Desai, Shrikar R; Singh, Rika; Karthikeyan, I

2013-09-01

The aim of the study is to evaluate the influence implant length on stress distribution at bone implant interface in single immediately loaded implants when placed in D4 bone quality. A 2-dimensional finite element models were developed to simulate two types of implant designs, standard 3.75 mm-diameter tapered body implants of 6 and 10 mm lengths. The implants were placed in D4 bone quality with a cortical bone thickness of 0.5 mm. The implant design incorporated microthreads at the crestal part and the rest of the implant body incorporated Acme threads. The Acme thread form has a 29° thread angle with a thread height half of the pitch; the apex and valley are flat. A 100 N of force was applied vertically and in the oblique direction (at an angle of 45°) to the long axis of the implants. The respective material properties were assigned. Micro-movements and stresses at the bone implant interface were evaluated. The results of total deformation (micro-movement) and Von mises stress were found to be lower for tapered long implant (10 mm) than short implant (6 mm) while using both vertical as well as oblique loading. Short implants can be successfully placed in poor bone quality under immediate loading protocol. The novel approach of the combination of microthreads at the crestal portion and acme threads for body portion of implant fixture gave promising results.

Synergistic effects of bisphosphonate and calcium phosphate nanoparticles on peri-implant bone responses in osteoporotic rats.

Science.gov (United States)

Alghamdi, Hamdan S; Bosco, Ruggero; Both, Sanne K; Iafisco, Michele; Leeuwenburgh, Sander C G; Jansen, John A; van den Beucken, Jeroen J J P

2014-07-01

The prevalence of osteoporosis will increase within the next decades due to the aging world population, which can affect the bone healing response to dental and orthopedic implants. Consequently, local drug targeting of peri-implant bone has been proposed as a strategy for the enhancement of bone-implant integration in osteoporotic conditions. In the present study, an established in-vivo femoral condyle implantation model in osteoporotic and healthy bone is used to analyze the osteogenic capacity of titanium implants coated with bisphosphonate (BP)-loaded calcium phosphate nanoparticles (nCaP) under compromised medical conditions. After 4 weeks of implantation, peri-implant bone volume (%BV; by μCT) and bone area (%BA; by histomorphometry) were significantly increased within a distance of 500 μm from implant surfaces functionalized with BP compared to control implants in osteoporotic and healthy conditions. Interestingly, the deposition of nCaP/BP coatings onto implant surfaces increased both peri-implant bone contact (%BIC) and volume (%BV) compared to the deposition of nCaP or BP coatings individually, in osteoporotic and healthy conditions. The results of real-time PCR revealed similar osteogenic gene expression levels to all implant surfaces at 4-weeks post-implantation. In conclusion, simultaneous targeting of bone formation (by nCaP) and bone resorption (by BP) using nCaP/BP surface coatings represents an effective strategy for synergistically improvement of bone-implant integration, especially in osteoporotic conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bone density around the fixture after function of implant molar prosthesis using CBCT

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Jung, Jae Hyun; Hwang, In Taik; Jung, Byung Hyun; Kim, Jae Duk; Kang, Dong Wan [School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju (Korea, Republic of)

2010-03-15

The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0TM, and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.

Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

Science.gov (United States)

Coutinho, M B; Marques, C; Mendes, G J; Gonçalves, C

2015-11-01

To report a case of successful bone-anchored hearing aid implantation in an adult patient with type III osteogenesis imperfecta, which is commonly regarded as a contraindication to this procedure. A 45-year-old man with type III osteogenesis imperfecta presented with mixed hearing loss. There was a mild sensorineural component in both ears, with an air-bone gap between 45 and 50 dB HL. He was implanted with a bone-anchored hearing aid. The audiological outcome was good, with no complications and good implant stability (as measured by resonance frequency analysis). To our knowledge, this is the first recorded case of bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

Friction coefficient and effective interference at the implant-bone interface.

Science.gov (United States)

Damm, Niklas B; Morlock, Michael M; Bishop, Nicholas E

2015-09-18

Although the contact pressure increases during implantation of a wedge-shaped implant, friction coefficients tend to be measured under constant contact pressure, as endorsed in standard procedures. Abrasion and plastic deformation of the bone during implantation are rarely reported, although they define the effective interference, by reducing the nominal interference between implant and bone cavity. In this study radial forces were analysed during simulated implantation and explantation of angled porous and polished implant surfaces against trabecular bone specimens, to determine the corresponding friction coefficients. Permanent deformation was also analysed to determine the effective interference after implantation. For the most porous surface tested, the friction coefficient initially increased with increasing normal contact stress during implantation and then decreased at higher contact stresses. For a less porous surface, the friction coefficient increased continually with normal contact stress during implantation but did not reach the peak magnitude measured for the rougher surface. Friction coefficients for the polished surface were independent of normal contact stress and much lower than for the porous surfaces. Friction coefficients were slightly lower for pull-out than for push-in for the porous surfaces but not for the polished surface. The effective interference was as little as 30% of the nominal interference for the porous surfaces. The determined variation in friction coefficient with radial contact force, as well as the loss of interference during implantation will enable a more accurate representation of implant press-fitting for simulations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Finite element analysis of the stress distributions in peri-implant bone in modified and standard-threaded dental implants

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Serkan Dundar

2016-01-01

Full Text Available The aim of this study was to examine the stress distributions with three different loads in two different geometric and threaded types of dental implants by finite element analysis. For this purpose, two different implant models, Nobel Replace and Nobel Active (Nobel Biocare, Zurich, Switzerland, which are currently used in clinical cases, were constructed by using ANSYS Workbench 12.1. The stress distributions on components of the implant system under three different static loadings were analysed for the two models. The maximum stress values that occurred in all components were observed in FIII (300 N. The maximum stress values occurred in FIII (300 N when the Nobel Replace implant is used, whereas the lowest ones, in the case of FI (150 N loading in the Nobel Active implant. In all models, the maximum tensions were observed to be in the neck region of the implants. Increasing the connection between the implant and the bone surface may allow more uniform distribution of the forces of the dental implant and may protect the bone around the implant. Thus, the implant could remain in the mouth for longer periods. Variable-thread tapered implants can increase the implant and bone contact.

Prevalence of Dental Implants and Evaluation of Peri-implant Bone Levels in Patients Presenting to a Dental School: A Radiographic Cross-Sectional 2-Year Study.

Science.gov (United States)

Alkan, Eylem Ayhan; Mau, Lian Ping; Schoolfield, John; Guest, Gary F; Cochran, David L

To evaluate the number of patients with dental implants who present to a dental school clinic for screening and to report the prevalence of peri-implant bone level change detected on digital panoramic radiographs of those subjects. Patient screening files for 9,422 patients over a 2-year period were examined to see how many patients presented with dental implants. Those patients with at least one implant were further evaluated by measuring the bone level on the mesial and distal sides of the implant using the screening radiograph. A total of 187 patients (2%) had at least one implant. In regard to implants, 423 were examined and 146 (33%) had no detectable bone loss defined as bone level below the top of the implant. When thresholds of bone loss were evaluated, 109 implants (25%) had ≥ 2 mm of bone loss on either the mesial or distal sides or both. The median bone loss was 1.74 mm for the 277 implants with detectable bone loss and 2.97 mm for the 109 implants that had ≥ 2 mm bone loss. Interestingly, patients who were ≥ 70 years of age had significantly (P = .03) more bone loss in the mandible compared with the maxilla, while patients who were 60 to 69 years of age had significantly greater loss in the maxilla. These data reveal that for patients presenting to the dental school for a screening over a 2-year period, 1.98% had one or more dental implants. Furthermore, those patients with implants had a minimum amount of bone loss as measured from the top of the implant.

Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan; Ding, Ming; Overgaard, Søren

2016-01-01

matrix (DBM), alone or in combination with allograft or commercially available human cancellous bone (CB), may replace allografts, as they have the capability of inducing new bone and improving implant fixation through enhancing bone ongrowth. The purpose of this study was to investigate the effect...... of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10...... mm diameter, were inserted bilaterally into the femoral condyles of eight skeletally mature sheep. Thus, four implants with a concentric gap of 2 mm were implanted in each sheep. The gap was filled with: (a) DBM; (b) DBM:CB at a ratio of 1:3; (c) DBM:allograft at a ratio of 1:3; or (d) allograft...

Implant-bone boundary, management with coordinative of zinc and vanadium compounds

International Nuclear Information System (INIS)

Granciuc, Victoria; Manascurta, Ghenadie; Granciuc, Gheorge

2013-01-01

Theoretical concept about description of the implant integration into the bone on a microscopic view remains to be a wide studied subject. The study of the morphological samples with sections on the border implant-bone had been done on different depths and sides of the implant using hematoxylin-eosin stain. Remarkable result had been observed on comparative analysis of studied groups on administrating TS-2Z and TS-1Z,TS-9V that did stimulate bone regeneration. Histological studies confirm the results of improvement of biochemical and blood indexes after implant surgery at the laboratory animals that had received coordinative compounds of Zn(L-H)2; Zn(L-H)etazol; [Vo(L- H)etazol]2SO4. (authors)

Bone morphology changes around two types of bone-level implants installed in fresh extraction sockets - a histomorphometric study in Beagle dogs

NARCIS (Netherlands)

Alharbi, H.M.; Babay, N.; Alzoman, H.; Basudan, S.; Anil, S.; Jansen, J.A.

2015-01-01

BACKGROUND: Minimizing crestal bone loss following immediate implant placement is considered the most challenging aspect in implant therapy. Implant surface topography and chemical modifications have been shown to influence the success of Osseointegration. The Straumann((R)) Bone Level implant,

Regular and platform switching: bone stress analysis varying implant type.

Science.gov (United States)

Gurgel-Juarez, Nália Cecília; de Almeida, Erika Oliveira; Rocha, Eduardo Passos; Freitas, Amílcar Chagas; Anchieta, Rodolfo Bruniera; de Vargas, Luis Carlos Merçon; Kina, Sidney; França, Fabiana Mantovani Gomes

2012-04-01

This study aimed to evaluate stress distribution on peri-implant bone simulating the influence of platform switching in external and internal hexagon implants using three-dimensional finite element analysis. Four mathematical models of a central incisor supported by an implant were created: External Regular model (ER) with 5.0 mm × 11.5 mm external hexagon implant and 5.0 mm abutment (0% abutment shifting), Internal Regular model (IR) with 4.5 mm × 11.5 mm internal hexagon implant and 4.5 mm abutment (0% abutment shifting), External Switching model (ES) with 5.0 mm × 11.5 mm external hexagon implant and 4.1 mm abutment (18% abutment shifting), and Internal Switching model (IS) with 4.5 mm × 11.5 mm internal hexagon implant and 3.8 mm abutment (15% abutment shifting). The models were created by SolidWorks software. The numerical analysis was performed using ANSYS Workbench. Oblique forces (100 N) were applied to the palatal surface of the central incisor. The maximum (σ(max)) and minimum (σ(min)) principal stress, equivalent von Mises stress (σ(vM)), and maximum principal elastic strain (ε(max)) values were evaluated for the cortical and trabecular bone. For cortical bone, the highest stress values (σ(max) and σ(vm) ) (MPa) were observed in IR (87.4 and 82.3), followed by IS (83.3 and 72.4), ER (82 and 65.1), and ES (56.7 and 51.6). For ε(max), IR showed the highest stress (5.46e-003), followed by IS (5.23e-003), ER (5.22e-003), and ES (3.67e-003). For the trabecular bone, the highest stress values (σ(max)) (MPa) were observed in ER (12.5), followed by IS (12), ES (11.9), and IR (4.95). For σ(vM), the highest stress values (MPa) were observed in IS (9.65), followed by ER (9.3), ES (8.61), and IR (5.62). For ε(max) , ER showed the highest stress (5.5e-003), followed by ES (5.43e-003), IS (3.75e-003), and IR (3.15e-003). The influence of platform switching was more evident for cortical bone than for trabecular bone, mainly for the external hexagon

Evaluation of bone loss in antibacterial coated dental implants: An experimental study in dogs

International Nuclear Information System (INIS)

Godoy-Gallardo, Maria; Manzanares-Céspedes, Maria Cristina; Sevilla, Pablo; Nart, José; Manzanares, Norberto; Manero, José M.; Gil, Francisco Javier; Boyd, Steven K.; Rodríguez, Daniel

2016-01-01

The aim of this study was to evaluate the in vivo effect of antibacterial modified dental implants in the first stages of peri-implantitis. Thirty dental implants were inserted in the mandibular premolar sites of 5 beagle dogs. Sites were randomly assigned to Ti (untreated implants, 10 units), Ti-Ag (silver electrodeposition treatment, 10 units), and Ti-TSP (silanization treatment, 10 units). Coated implants were characterized by scanning electron microscopy, interferometry and X-ray photoelectron spectroscopy. Two months after implant insertion, experimental peri-implantitis was initiated by ligature placement. Ligatures were removed 2 months later, and plaque formation was allowed for 2 additional months. Clinical and radiographic analyses were performed during the study. Implant-tissue samples were prepared for micro computed tomography, backscattered scanning electron microscopy, histomorphometric and histological analyses and ion release measurements. X-ray, SEM and histology images showed that vertical bone resorption in treated implants was lower than in the control group (P < 0.05). This effect is likely due to the capacity of the treatments to reduce bacteria colonization on the implant surface. Histological analysis suggested an increase of peri-implant bone formation on silanized implants. However, the short post-ligature period was not enough to detect differences in clinical parameters among implant groups. Within the limits of this study, antibacterial surface treatments have a positive effect against bone resorption induced by peri-implantitis. - Highlights: • Dental implants were modified with two antibacterial treatments, silver and TESPSA silanization. • Performance of the modified dental implants was studied in vivo. • Treated implants showed less peri-implant bone resorption. • Decrease in bone resorption was attributed to the antibacterial surface treatments. • Silane treatment enhanced bone regeneration around dental implants.

Evaluation of bone loss in antibacterial coated dental implants: An experimental study in dogs

Energy Technology Data Exchange (ETDEWEB)

Godoy-Gallardo, Maria [Department of Micro- and Nanotechnology, Technical University of Denmark, Kongens Lyngby (Denmark); Manzanares-Céspedes, Maria Cristina [Unidad de Anatomía y Embriología Humana, Faculty of Dentistry, University of Barcelona, Barcelona (Spain); Sevilla, Pablo [Department of Mechanics, Escola Universitària Salesiana de Sarrià (EUSS), Barcelona (Spain); Nart, José [Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Sant Cugat (Spain); Manzanares, Norberto [Unidad de Anatomía y Embriología Humana, Faculty of Dentistry, University of Barcelona, Barcelona (Spain); Manero, José M. [Biomaterials, Biomechanics and Tissue Engineering Group, Dept. Materials Science and Metallurgical Engineering, Technical University of Catalonia (UPC-BarcelonaTECH), Barcelona (Spain); Centre for Research in NanoEngineering (CRNE), UPC-BarcelonaTECH, Barcelona (Spain); Gil, Francisco Javier [Universitat Internacional de Catalunya, Sant Cugat (Spain); Boyd, Steven K. [McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta (Canada); Rodríguez, Daniel, E-mail: daniel.rodriguez.rius@upc.edu [Biomaterials, Biomechanics and Tissue Engineering Group, Dept. Materials Science and Metallurgical Engineering, Technical University of Catalonia (UPC-BarcelonaTECH), Barcelona (Spain); Centre for Research in NanoEngineering (CRNE), UPC-BarcelonaTECH, Barcelona (Spain)

2016-12-01

The aim of this study was to evaluate the in vivo effect of antibacterial modified dental implants in the first stages of peri-implantitis. Thirty dental implants were inserted in the mandibular premolar sites of 5 beagle dogs. Sites were randomly assigned to Ti (untreated implants, 10 units), Ti-Ag (silver electrodeposition treatment, 10 units), and Ti-TSP (silanization treatment, 10 units). Coated implants were characterized by scanning electron microscopy, interferometry and X-ray photoelectron spectroscopy. Two months after implant insertion, experimental peri-implantitis was initiated by ligature placement. Ligatures were removed 2 months later, and plaque formation was allowed for 2 additional months. Clinical and radiographic analyses were performed during the study. Implant-tissue samples were prepared for micro computed tomography, backscattered scanning electron microscopy, histomorphometric and histological analyses and ion release measurements. X-ray, SEM and histology images showed that vertical bone resorption in treated implants was lower than in the control group (P < 0.05). This effect is likely due to the capacity of the treatments to reduce bacteria colonization on the implant surface. Histological analysis suggested an increase of peri-implant bone formation on silanized implants. However, the short post-ligature period was not enough to detect differences in clinical parameters among implant groups. Within the limits of this study, antibacterial surface treatments have a positive effect against bone resorption induced by peri-implantitis. - Highlights: • Dental implants were modified with two antibacterial treatments, silver and TESPSA silanization. • Performance of the modified dental implants was studied in vivo. • Treated implants showed less peri-implant bone resorption. • Decrease in bone resorption was attributed to the antibacterial surface treatments. • Silane treatment enhanced bone regeneration around dental implants.

The combined use of rhBMP-2/ACS, autogenous bone graft, a bovine bone mineral biomaterial, platelet-rich plasma, and guided bone regeneration at nonsubmerged implant placement for supracrestal bone augmentation. A case report.

Science.gov (United States)

Sclar, Anthony G; Best, Steven P

2013-01-01

This case report presents the clinical application and outcomes of the use of a combined approach to treat a patient with a severe alveolar defect. Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier, along with autogenous bone graft, bovine bone mineral, platelet-rich plasma, and guided bone regeneration, were used simultaneous with nonsubmerged implant placement. At 1 year postsurgery, healthy peri-implant soft tissues and radiographically stable peri-implant crestal bone levels were observed along with locally increased radiographic bone density. In addition, a cone beam computed tomography (CBCT) scan demonstrated apparent supracrestal peri-implant bone augmentation with the appearance of normal alveolar ridge contours, including the facial bone wall.

The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

Directory of Open Access Journals (Sweden)

Khalid A. Arafa

2016-01-01

Full Text Available Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods. Results: Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p>0.05. There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Conclusion: Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts.

The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth.

Science.gov (United States)

Arafa, Khalid A

2016-01-01

To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods.  Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p more than 0.05). There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts.

Demineralized bone matrix fibers formable as general and custom 3D printed mold-based implants for promoting bone regeneration.

Science.gov (United States)

Rodriguez, Rudy U; Kemper, Nathan; Breathwaite, Erick; Dutta, Sucharita M; Hsu, Erin L; Hsu, Wellington K; Francis, Michael P

2016-07-26

Bone repair frequently requires time-consuming implant construction, particularly when using un-formed implants with poor handling properties. We therefore developed osteoinductive, micro-fibrous surface patterned demineralized bone matrix (DBM) fibers for engineering both defect-matched and general three-dimensional implants. Implant molds were filled with demineralized human cortical bone fibers there were compressed and lyophilized, forming mechanically strong shaped DBM scaffolds. Enzyme linked immunosorbent assays and mass spectrometry confirmed that DBM fibers contained abundant osteogenic growth factors (bone morphogenetic proteins, insulin-like growth factor-I) and extracellular matrix proteins. Mercury porosimetry and mechanical testing showed interconnected pores within the mechanically stable, custom DBM fiber scaffolds. Mesenchymal stem cells readily attached to the DBM and showed increasing metabolic activity over time. DBM fibers further increased alkaline phosphatase activity in C2C12 cells. In vivo, DBM implants elicited osteoinductive potential in a mouse muscle pouch, and also promoted spine fusion in a rat arthrodesis model. DBM fibers can be engineered into custom-shaped, osteoinductive and osteoconductive implants with potential for repairing osseous defects with precise fitment, potentially reducing operating time. By providing pre-formed and custom implants, this regenerative allograft may improve patient outcomes following surgical bone repair, while further advancing personalized orthopedic and craniomaxillofacial medicine using three-dimensional-printed tissue molds.

Nanosized Hydroxyapatite Coating on PEEK Implants Enhances Early Bone Formation: A Histological and Three-Dimensional Investigation in Rabbit Bone

Directory of Open Access Journals (Sweden)

Pär Johansson

2015-06-01

Full Text Available Polyether ether ketone (PEEK has been frequently used in spinal surgery with good clinical results. The material has a low elastic modulus and is radiolucent. However, in oral implantology PEEK has displayed inferior ability to osseointegrate compared to titanium materials. One idea to reinforce PEEK would be to coat it with hydroxyapatite (HA, a ceramic material of good biocompatibility. In the present study we analyzed HA-coated PEEK tibial implants via histology and radiography when following up at 3 and 12 weeks. Of the 48 implants, 24 were HA-coated PEEK screws (test and another 24 implants served as uncoated PEEK controls. HA-coated PEEK implants were always osseointegrated. The total bone area (BA was higher for test compared to control implants at 3 (p < 0.05 and 12 weeks (p < 0.05. Mean bone implant contact (BIC percentage was significantly higher (p = 0.024 for the test compared to control implants at 3 weeks and higher without statistical significance at 12 weeks. The effect of HA-coating was concluded to be significant with respect to early bone formation, and HA-coated PEEK implants may represent a good material to serve as bone anchored clinical devices.

Bone response to a titanium aluminium nitride coating on metallic implants.

Science.gov (United States)

Freeman, C O; Brook, I M

2006-05-01

The design, surface characteristics and strength of metallic implants are dependant on their intended use and clinical application. Surface modifications of materials may enable reduction of the time taken for osseointegration and improve the biological response of bio-mechanically favourable metals and alloys. The influence of a titanium aluminium nitride (TAN) coating on the response of bone to commercially pure titanium and austenitic 18/8 stainless steel wire is reported. TAN coated and plain rods of stainless steel and commercially pure titanium were implanted into the mid-shaft of the femur of Wistar rats. The femurs were harvested at four weeks and processed for scanning electron and light microscopy. All implants exhibited a favourable response in bone with no evidence of fibrous encapsulation. There was no significant difference in the amount of new bone formed around the different rods (osseoconduction), however, there was a greater degree of shrinkage separation of bone from the coated rods than from the plain rods (p = 0.017 stainless steel and p = 0.0085 titanium). TAN coating may result in reduced osseointegration between bone and implant.

Comparison of marginal bone loss between internal- and external-connection dental implants in posterior areas without periodontal or peri-implant disease.

Science.gov (United States)

Kim, Dae-Hyun; Kim, Hyun Ju; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

2018-04-01

The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference ( P <0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P =0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P =0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.

[Atraumatic bone expansion: Interest of piezo-surgery, conicals expanders and immediate implantation combination].

Science.gov (United States)

Iraqui, O; Lakhssassi, N; Berrada, S; Merzouk, N

2016-06-01

The durability of dental implants depends on the presence of a 1mm coating bone sheath all around the fixture. Therefore, bone resorption represents a challenge for the practitioner. Bone expansion is a surgical technique that allows the management of horizontal bone atrophy. Cortical bone splitting allows for an enlargement of the residual crest by displacement of the vestibular bone flap. The immediate placement of implants secures the widening and allows for a 97% survival rate. However, bone expansion is hard to undertake in sites with high bone density. Furthermore, the use of traditional instruments increases patient's stress and the risk for an interruptive fracture during bone displacement. Non-traumatic bone expansion is one solution to this problem. The combination of piezo-surgery and conical expanders allows for a secured displacement of the selected bone flap as well as an immediate implant placement, avoiding the risk of slipping, overheating, or fracture, all within an undeniable operative comfort. Non-traumatic bone expansion is a reliable, reproducible, conservative, and economical in time and cost procedure. We describe our atraumatic bone expension and immediate implant placement technique in high bone density sites and illustrate it by a clinical case. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Processing of microCT implant-bone systems images using Fuzzy Mathematical Morphology

International Nuclear Information System (INIS)

Bouchet, A; Pastore, J; Colabella, L; Omar, S; Ballarre, J

2016-01-01

The relationship between a metallic implant and the existing bone in a surgical permanent prosthesis is of great importance since the fixation and osseointegration of the system leads to the failure or success of the surgery. Micro Computed Tomography is a technique that helps to visualize the structure of the bone. In this study, the microCT is used to analyze implant-bone systems images. However, one of the problems presented in the reconstruction of these images is the effect of the iron based implants, with a halo or fluorescence scattering distorting the micro CT image and leading to bad 3D reconstructions. In this work we introduce an automatic method for eliminate the effect of AISI 316L iron materials in the implant-bone system based on the application of Compensatory Fuzzy Mathematical Morphology for future investigate about the structural and mechanical properties of bone and cancellous materials. (paper)

Endochondral vs. intramembranous demineralized bone matrices as implants for osseous defects.

Science.gov (United States)

Nidoli, M C; Nielsen, F F; Melsen, B

1999-05-01

This study focuses on the difference in regenerative capacity between endochondral and intramembranous demineralized bone matrices (DBMs) when implanted into bony defects. It also focuses on the possible influence of the type of skeletal recipient site (orthotopic or heterotopic). Of 34 Wistar rats, 10 served as a source of DBM, and 24 were divided into two groups of 12 animals. In group A identical defects were produced in the parietal bones, whereas in group B the defects were produced in each radius. The right defects were implanted with endochondral DBM and the left defects were implanted with intramembranous DBM. Descriptive and/or histomorphometric analyses were performed by means of light and polarized microscopy, and radiography (group B). Right and left data were compared to disclose differences in bone-healing capacity. The quantitative results demonstrated that endochondral DBM displays a greater regenerative capacity than intramembranous DBM when implanted heterotopically. The different clinical performances of endochondral and intramembranous bone grafts might be explained on the basis of the mechanical rather than the osteoinductive principle. The qualitative results suggest that the type of bone deposition induced by the DBMs is not related to the type of implanted DBM. Recipient site characteristics and/or environmental factors seem decisive in the occurrence of either types of ossification.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement.

Science.gov (United States)

Yunus, Barunawaty

2011-06-01

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

Energy Technology Data Exchange (ETDEWEB)

Yunus, Barunawaty [Faculty of Dentistry, Hasanuddin University, Makassar (Malaysia)

2011-06-15

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

International Nuclear Information System (INIS)

Yunus, Barunawaty

2011-01-01

This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

Locally delivered ethyl-2,5-dihydroxybenzoate using 3D printed bone implant for promotion of bone regeneration in a osteoporotic animal model

Directory of Open Access Journals (Sweden)

B-J Kwon

2018-01-01

Full Text Available Osteoporosis is a disease characterized by low bone mass, most commonly caused by an increase in bone resorption that is not matched by sufficient bone formation. The most common complications of postmenopausal osteoporosis are bone-related defects and fractures. Fracture healing is a multifactorial bone regeneration process, influenced by both biological and mechanical factors related to age, osteoporosis and stability of the osteosynthesis. During the treatment of bone defects in osteoporotic conditions, imbalanced bone remodeling is the leading cause for implant failure. To overcome these problems, ethyl-2,5-dihydroxybenzoate (E-2,5-DHB, a drug that promotes bone formation and inhibits bone resorption, was used. E-2,5-DHB-incorporating titanium (Ti implants using poly(lactic-co-glycolic acid (PLGA coating for local delivery of E-2,5-DHB were developed and the effects on bone healing of femoral defects were evaluated in an osteoporotic model. The release of E-2,5-DHB resulted in decreased bone resorption and increased bone formation around the implant. Thus, it was confirmed that, in the osteoporotic model, bone healing was increased and implant fixation was enhanced. These results suggested that E-2,5-DHB-coated Ti implants have great potential as an ultimate local drug delivery system for bone tissue scaffolds.

Effect on Bone Architecture of Marginal Grooves in Dental Implants Under Occlusal Loaded Conditions in Beagle Dogs.

Science.gov (United States)

Kato, Hatsumi; Kuroshima, Shinichiro; Inaba, Nao; Uto, Yusuke; Sawase, Takashi

2018-02-01

The aim of this study was to clarify whether marginal grooves on dental implants affect osseointegration, bone structure, and the alignment of collagen fibers to determine bone quality under loaded conditions. Anodized Ti-6Al-4V alloy dental implants, with and without marginal grooves (test and control implants, respectively), were used (3.7 × 8.0 mm). Fourth premolars and first molars of 6 beagle mandibles were extracted. Two control and test implants were placed in randomly selected healed sites at 12 weeks after tooth extraction. Screw-retained single crowns for first molars were fabricated. Euthanasia was performed at 8 weeks after the application of occlusal forces. Implant marginal bone level, bone to implant contact (BIC), bone structure around dental implants, and the alignment of collagen fibers determining bone quality were analyzed. The marginal bone level in test implants was significantly higher than that in control implants. Occlusal forces significantly increased BIC in test implants ( P = .007), whereas BIC did not change in control implants, irrespective of occlusal forces ( P = .303). Moreover, occlusal forces significantly increased BIC in test implants compared with control implants ( P = .032). Additionally, occlusal forces preferentially aligned collagen fibers in test implants, but not control implants. Hence, marginal grooves on dental implants have positive effects on increased osseointegration and adapted bone quality based on the preferential alignment of collagen fibers around dental implants under loaded conditions.

Correlation Between Resonance Frequency Analysis and Bone Quality Assessments at Dental Implant Recipient Sites.

Science.gov (United States)

Fu, Min-Wen; Fu, Earl; Lin, Fu-Gong; Chang, Wei-Jeng; Hsieh, Yao-Dung; Shen, E-Chin

To evaluate whether primary implant stability could be used to predict bone quality, the association between the implant stability quotient (ISQ) value and the bone type at the implant site was evaluated. Ninety-five implant sites in 50 patients were included. Bone type (categorized by Lekholm and Zarb) at the implant site was initially assessed using presurgical dental radiography. During the preparation of the implant site, a bone core specimen was carefully obtained. The bone type was assessed by tactile sensation during the drilling operation, according to the Misch criteria. The primary stability of the inserted implant was evaluated by resonance frequency analysis (RFA). The ISQ value was recorded. The bone core specimen was then examined by stereomicroscopy or microcomputed tomography (micro-CT), and the bone type was determined by the surface characteristics of the specimen, based on Lekholm and Zarb classification. Agreement between the bone quality assessed by the four methods (ie, presurgical radiography, tactile sensation, stereomicroscopy, and micro-CT) was tested by Cohen's kappa statistics, whereas the association between the ISQ value and the bone type was evaluated by the generalized linear regression model. The mean ISQ score was 72.6, and the score was significantly influenced by the maxillary or mandibular arch (P = .001). The bone type at the implant sites varied according to the assessment method. However, a significant influence of the arch was repeatedly noted when using radiography or tactile sensation. Among the four bone-quality assessment methods, a weak agreement existed only between stereomicroscopy and micro-CT, especially in the maxilla (κ = 0.469). A negative association between the ISQ value and the bone type assessed by stereomicroscopy or by micro-CT was significant in the maxilla, but not in the mandible, after adjustments for sex, age, and right/left side (P = .013 and P = .027 for stereomicroscopy and micro-CT, respectively

Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems.

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Hadzik, Jakub; Botzenhart, Ute; Krawiec, Maciej; Gedrange, Tomasz; Heinemann, Friedhelm; Vegh, Andras; Dominiak, Marzena

2017-09-01

Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration. The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study. Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive ® , Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks. The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively). Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication. Copyright © 2017 Elsevier GmbH. All rights reserved.

Chronological Age as Factor Influencing the Dental Implant Osseointegration in the Jaw Bone

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Jan Papež

2018-04-01

Full Text Available The objectives of this study were to evaluate osseointegration of dental implant in the jaw bone in the young and elderly population and comparing the results to assess indicators and risk factors as age for the success or failure of dental implants. A retrospective study of 107 implants (Impladent, LASAK, Czech Republic was prepared. The patients at implants surgery were divided in three groups. The patients were followed-up for a 7-year period. We evaluated osseointegration from long term point of view as a change of marginal bone levels close to dental implant. Marginal bone levels were recorded and analysed with regard to different patient- and implant-related factors. An influence of chronological age on change of marginal bone levels during 6-year retrospective study vas evaluated. The study examined 47 patient charts and 107 implants from the Second Faculty of Medicine, Charles University and University Hospital Motol. We proved that young healthy patients with long bridges or Branemarks have the same progression of marginal bone levels changes. The chronological age hasn’t therefore direct influence on the osseointegration from long term point of view. But we found that the length of dental suprastrucure-prosthetic construction negatively influences marginal bone changes, though these results weren’t statistically significant. More extensive dental implant suprastrucure undergoes smaller osseointegration. On the other hand the length of dental suprastrucure (prosthetic construction negatively influences dental osseointegration in both groups of patient.

Formation of blood clot on biomaterial implants influences bone healing.

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Shiu, Hoi Ting; Goss, Ben; Lutton, Cameron; Crawford, Ross; Xiao, Yin

2014-12-01

The first step in bone healing is forming a blood clot at injured bones. During bone implantation, biomaterials unavoidably come into direct contact with blood, leading to a blood clot formation on its surface prior to bone regeneration. Despite both situations being similar in forming a blood clot at the defect site, most research in bone tissue engineering virtually ignores the important role of a blood clot in supporting healing. Dental implantology has long demonstrated that the fibrin structure and cellular content of a peri-implant clot can greatly affect osteoconduction and de novo bone formation on implant surfaces. This article reviews the formation of a blood clot during bone healing in relation to the use of platelet-rich plasma (PRP) gels. It is implicated that PRP gels are dramatically altered from a normal clot in healing, resulting in conflicting effect on bone regeneration. These results indicate that the effect of clots on bone regeneration depends on how the clots are formed. Factors that influence blood clot structure and properties in relation to bone healing are also highlighted. Such knowledge is essential for developing strategies to optimally control blood clot formation, which ultimately alter the healing microenvironment of bone. Of particular interest are modification of surface chemistry of biomaterials, which displays functional groups at varied composition for the purpose of tailoring blood coagulation activation, resultant clot fibrin architecture, rigidity, susceptibility to lysis, and growth factor release. This opens new scope of in situ blood clot modification as a promising approach in accelerating and controlling bone regeneration.

Cannabis sativa smoke inhalation decreases bone filling around titanium implants: a histomorphometric study in rats.

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Nogueira-Filho, Getulio da R; Cadide, Tiago; Rosa, Bruno T; Neiva, Tiago G; Tunes, Roberto; Peruzzo, Daiane; Nociti, Francisco Humberto; César-Neto, João B

2008-12-01

Although the harmful effect of tobacco smoking on titanium implants has been documented, no studies have investigated the effects of cannabis sativa (marijuana) smoking. Thus, this study investigated whether marijuana smoke influences bone healing around titanium implants. Thirty Wistar rats were used. After anesthesia, the tibiae surface was exposed and 1 screw-shaped titanium implant was placed bilaterally. The animals were randomly assigned to one of the following groups: control (n = 15) and marijuana smoke inhalation (MSI) 8 min/d (n = 15). Urine samples were obtained to detect the presence of tetra-hidro-cannabinoid. After 60 days, the animals were killed. The degree of bone-to-implant contact and the bone area within the limits of the threads of the implant were measured in the cortical (zone A) and cancellous bone (zone B). Tetra-hidro-cannabinoid in urine was positive only for the rats of MSI group. Intergroup analysis did not indicate differences in zone A-cortical bone (P > 0.01), however, a negative effect of marijuana smoke (MSI group) was observed in zone B-cancellous bone for bone-to-implant contact and bone area (Student's t test, P smoke on bone healing may represent a new concern for implant success/failure.

The development of a composite bone model for training on placement of dental implants.

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Alkhodary, Mohamed Ahmed; Abdelraheim, Abdelraheim Emad Eldin; Elsantawy, Abd Elaleem Hassan; Al Dahman, Yousef Hamad; Al-Mershed, Mohammed

2015-04-01

It takes a lot of training on patients for both undergraduate to develop clinical sense as regards to the placement of dental implants in the jaw bones, also, the models provided by the dental implant companies for training are usually made of strengthened synthetic foams, which are far from the composition, and tactile sense provided by natural bone during drilling for clinical placement of dental implants. This is an in-vitro experimental study which utilized bovine femur bone, where the shaft of the femur provided the surface compact layer, and the head provided the cancellous bone layer, to provide a training model similar to jaw bones macroscopic anatomy. Both the compact and cancellous bone samples were characterized using mechanical compressive testing. The elastic moduli of the cancellous and cortical femur bone were comparable to those of the human mandible, and the prepared training model provided a more lifelike condition during the drilling and placement of dental implants. The composite bone model developed simulated the macroscopic anatomy of the jaw bones having a surface layer of compact bone, and a core of cancellous bone, and provided a better and a more natural hands-on experience for placement of dental implants as compared to plastic models made of polyurethane.

Protocol for Bone Augmentation with Simultaneous Early Implant Placement: A Retrospective Multicenter Clinical Study

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Peter Fairbairn

2015-01-01

Full Text Available Purpose. To present a novel protocol for alveolar bone regeneration in parallel to early implant placement. Methods. 497 patients in need of extraction and early implant placement with simultaneous bone augmentation were treated in a period of 10 years. In all patients the same specific method was followed and grafting was performed utilizing in situ hardening fully resorbable alloplastic grafting materials consisting of β-tricalcium phosphate and calcium sulfate. The protocol involved atraumatic extraction, implant placement after 4 weeks with simultaneous bone augmentation, and loading of the implant 12 weeks after placement and grafting. Follow-up periods ranged from 6 months to 10 years (mean of 4 years. Results. A total of 601 postextraction sites were rehabilitated in 497 patients utilizing the novel protocol. Three implants failed before loading and three implants failed one year after loading, leaving an overall survival rate of 99.0%. Conclusions. This standardized protocol allows successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation. The concept of placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable, alloplastic materials, and loading the implant at 12 weeks seems to offer advantages when compared with traditional treatment modalities.

Minimal guided bone regeneration procedure for immediate implant placement in the esthetic zone

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Nettemu Sunil Kumar

2013-01-01

Full Text Available The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.

Bone integration capability of nanopolymorphic crystalline hydroxyapatite coated on titanium implants

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Suzuki T

2012-02-01

Full Text Available Masahiro Yamada*, Takeshi Ueno*, Naoki Tsukimura, Takayuki Ikeda, Kaori Nakagawa, Norio Hori, Takeo Suzuki, Takahiro OgawaLaboratory of Bone and Implant Sciences, The Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA *These authors contributed equally to this workAbstract: The mechanism by which hydroxyapatite (HA-coated titanium promotes bone–implant integration is largely unknown. Furthermore, refining the fabrication of nanostructured HA to the level applicable to the mass production process for titanium implants is challenging. This study reports successful creation of nanopolymorphic crystalline HA on microroughened titanium surfaces using a combination of flame spray and low-temperature calcination and tests its biological capability to enhance bone–implant integration. Sandblasted microroughened titanium implants and sandblasted + HA-coated titanium implants were subjected to biomechanical and histomorphometric analyses in a rat model. The HA was 55% crystallized and consisted of nanoscale needle-like architectures developed in various diameters, lengths, and orientations, which resulted in a 70% increase in surface area compared to noncoated microroughened surfaces. The HA was free from impurity contaminants, with a calcium/phosphorus ratio of 1.66 being equivalent to that of stoichiometric HA. As compared to microroughened implants, HA-coated implants increased the strength of bone–implant integration consistently at both early and late stages of healing. HA-coated implants showed an increased percentage of bone–implant contact and bone volume within 50 µm proximity of the implant surface, as well as a remarkably reduced percentage of soft tissue intervention between bone and the implant surface. In contrast, bone volume outside the 50 µm border was lower around HA-coated implants. Thus, this study

Effects of the implant design on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis of original computer-aided design models.

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Yamanishi, Yasufumi; Yamaguchi, Satoshi; Imazato, Satoshi; Nakano, Tamaki; Yatani, Hirofumi

2014-09-01

Occlusal overloading causes peri-implant bone resorption. Previous studies examined stress distribution in alveolar bone around commercial implants using three-dimensional (3D) finite element analysis. However, the commercial implants contained some different designs. The purpose of this study is to reveal the effect of the target design on peri-implant bone stress and abutment micromovement. Six 3D implant models were created for different implant-abutment joints: 1) internal joint model (IM); 2) external joint model (EM); 3) straight abutment (SA) shape; 4) tapered abutment (TA) shapes; 5) platform switching (PS) in the IM; and 6) modified TA neck design (reverse conical neck [RN]). A static load of 100 N was applied to the basal ridge surface of the abutment at a 45-degree oblique angle to the long axis of the implant. Both stress distribution in peri-implant bone and abutment micromovement in the SA and TA models were analyzed. Compressive stress concentrated on labial cortical bone and tensile stress on the palatal side in the EM and on the labial side in the IM. There was no difference in maximum principal stress distribution for SA and TA models. Tensile stress concentration was not apparent on labial cortical bone in the PS model (versus IM). Maximum principal stress concentrated more on peri-implant bone in the RN than in the TA model. The TA model exhibited less abutment micromovement than the SA model. This study reveals the effects of the design of specific components on peri-implant bone stress and abutment displacement after implant-supported single restoration in the anterior maxilla.

Impaired bone formation in ovariectomized mice reduces implant integration as indicated by longitudinal in vivo micro-computed tomography.

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Li, Zihui; Kuhn, Gisela; Schirmer, Michael; Müller, Ralph; Ruffoni, Davide

2017-01-01

Although osteoporotic bone, with low bone mass and deteriorated bone architecture, provides a less favorable mechanical environment than healthy bone for implant fixation, there is no general agreement on the impact of osteoporosis on peri-implant bone (re)modeling, which is ultimately responsible for the long term stability of the bone-implant system. Here, we inserted an implant in a mouse model mimicking estrogen deficiency-induced bone loss and we monitored with longitudinal in vivo micro-computed tomography the spatio-temporal changes in bone (re)modeling and architecture, considering the separate contributions of trabecular, endocortical and periosteal surfaces. Specifically, 12 week-old C57BL/6J mice underwent OVX/SHM surgery; 9 weeks after we inserted special metal-ceramics implants into the 6th caudal vertebra and we measured bone response with in vivo micro-CT weekly for the following 6 weeks. Our results indicated that ovariectomized mice showed a reduced ability to increase the thickness of the cortical shell close to the implant because of impaired peri-implant bone formation, especially at the periosteal surface. Moreover, we observed that healthy mice had a significantly higher loss of trabecular bone far from the implant than estrogen depleted animals. Such behavior suggests that, in healthy mice, the substantial increase in peri-implant bone formation which rapidly thickened the cortex to secure the implant may raise bone resorption elsewhere and, specifically, in the trabecular network of the same bone but far from the implant. Considering the already deteriorated bone structure of estrogen depleted mice, further bone loss seemed to be hindered. The obtained knowledge on the dynamic response of diseased bone following implant insertion should provide useful guidelines to develop advanced treatments for osteoporotic fracture fixation based on local and selective manipulation of bone turnover in the peri-implant region.

Impaired bone formation in ovariectomized mice reduces implant integration as indicated by longitudinal in vivo micro-computed tomography.

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Zihui Li

Full Text Available Although osteoporotic bone, with low bone mass and deteriorated bone architecture, provides a less favorable mechanical environment than healthy bone for implant fixation, there is no general agreement on the impact of osteoporosis on peri-implant bone (remodeling, which is ultimately responsible for the long term stability of the bone-implant system. Here, we inserted an implant in a mouse model mimicking estrogen deficiency-induced bone loss and we monitored with longitudinal in vivo micro-computed tomography the spatio-temporal changes in bone (remodeling and architecture, considering the separate contributions of trabecular, endocortical and periosteal surfaces. Specifically, 12 week-old C57BL/6J mice underwent OVX/SHM surgery; 9 weeks after we inserted special metal-ceramics implants into the 6th caudal vertebra and we measured bone response with in vivo micro-CT weekly for the following 6 weeks. Our results indicated that ovariectomized mice showed a reduced ability to increase the thickness of the cortical shell close to the implant because of impaired peri-implant bone formation, especially at the periosteal surface. Moreover, we observed that healthy mice had a significantly higher loss of trabecular bone far from the implant than estrogen depleted animals. Such behavior suggests that, in healthy mice, the substantial increase in peri-implant bone formation which rapidly thickened the cortex to secure the implant may raise bone resorption elsewhere and, specifically, in the trabecular network of the same bone but far from the implant. Considering the already deteriorated bone structure of estrogen depleted mice, further bone loss seemed to be hindered. The obtained knowledge on the dynamic response of diseased bone following implant insertion should provide useful guidelines to develop advanced treatments for osteoporotic fracture fixation based on local and selective manipulation of bone turnover in the peri-implant region.

Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone.

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Johansson, Pär; Jimbo, Ryo; Naito, Yoshihito; Kjellin, Per; Currie, Fredrik; Wennerberg, Ann

2016-01-01

Polyether ether ketone (PEEK) possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA) minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test), and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone-implant contact was higher for test compared to control (P<0.05). The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points (P<0.01). With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential.

Do dual-thread orthodontic mini-implants improve bone/tissue mechanical retention?

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Lin, Yang-Sung; Chang, Yau-Zen; Yu, Jian-Hong; Lin, Chun-Li

2014-12-01

The aim of this study was to understand whether the pitch relationship between micro and macro thread designs with a parametrical relationship in a dual-thread mini-implant can improve primary stability. Three types of mini-implants consisting of single-thread (ST) (0.75 mm pitch in whole length), dual-thread A (DTA) with double-start 0.375 mm pitch, and dual-thread B (DTB) with single-start 0.2 mm pitch in upper 2-mm micro thread region for performing insertion and pull-out testing. Histomorphometric analysis was performed in these specimens in evaluating peri-implant bone defects using a non-contact vision measuring system. The maximum inserted torque (Tmax) in type DTA was found to be the smallest significantly, but corresponding values found no significant difference between ST and DTB. The largest pull-out strength (Fmax) in the DTA mini-implant was found significantly greater than that for the ST mini-implant regardless of implant insertion orientation. Mini-implant engaged the cortical bone well as observed in ST and DTA types. Dual-thread mini-implant with correct micro thread pitch (parametrical relationship with macro thread pitch) in the cortical bone region can improve primary stability and enhanced mechanical retention.

The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography

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2016-01-01

Purpose The objective of this study was to investigate the relationships between primary implant stability as measured by impact response frequency and the structural parameters of trabecular bone using cone-beam computed tomography(CBCT), excluding the effect of cortical bone thickness. Methods We measured the impact response of a dental implant placed into swine bone specimens composed of only trabecular bone without the cortical bone layer using an inductive sensor. The peak frequency of the impact response spectrum was determined as an implant stability criterion (SPF). The 3D microstructural parameters were calculated from CT images of the bone specimens obtained using both micro-CT and CBCT. Results SPF had significant positive correlations with trabecular bone structural parameters (BV/TV, BV, BS, BSD, Tb.Th, Tb.N, FD, and BS/BV) (Pmicro-CT and CBCT (Pimplant stability prediction by combining BV/TV and SMI in the stepwise forward regression analysis. Bone with high volume density and low surface density shows high implant stability. Well-connected thick bone with small marrow spaces also shows high implant stability. The combination of bone density and architectural parameters measured using CBCT can predict the implant stability more accurately than the density alone in clinical diagnoses. PMID:27127692

A study on the resistance at bone-implant interface during implant insertion in a cadaver goat jaw model

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Goutam Das

2016-01-01

Full Text Available Background: The aim of the study is to determine the resistance at bone-implant interface during insertion of dental implant. Materials and Methods: Freshly procured cadaver goat mandibles were collected from slaughterhouses. Four dental implants of two different diameters were inserted into osteotomized sites of the goat mandibles. The gradual changes in resonance frequency (RF were recorded in RF analyzer for the five consecutive turns of implant insertion. Results and Observations: RF was found to be positively correlated with diameter of dental implants. Conclusion: RF analysis can be used to determine the type of resistance the implant faces during insertion and the kind of bone density through which it passes. It gives a forecast of expected initial stability.

Minimum Abutment Height to Eliminate Bone Loss: Influence of Implant Neck Design and Platform Switching.

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Spinato, Sergio; Galindo-Moreno, Pablo; Bernardello, Fabio; Zaffe, Davide

This retrospective study quantitatively analyzed the minimum prosthetic abutment height to eliminate bone loss after 4.7-mm-diameter implant placement in maxillary bone and how grafting techniques can affect the marginal bone loss in implants placed in maxillary areas. Two different implant types with a similar neck design were singularly placed in two groups of patients: the test group, with platform-switched implants, and the control group, with conventional (non-platform-switched) implants. Patients requiring bone augmentation underwent unilateral sinus augmentation using a transcrestal technique with mineralized xenograft. Radiographs were taken immediately after implant placement, after delivery of the prosthetic restoration, and after 12 months of loading. The average mesial and distal marginal bone loss of the control group (25 patients) was significantly more than twice that of the test group (26 patients), while their average abutment height was similar. Linear regression analysis highlighted a statistically significant inverse relationship between marginal bone loss and abutment height in both groups; however, the intercept of the regression line, both mesially and distally, was 50% lower for the test group than for the control group. The marginal bone loss was annulled with an abutment height of 2.5 mm for the test group and 3.0 mm for the control group. No statistically significant differences were found regarding marginal bone loss of implants placed in native maxillary bone compared with those placed in the grafted areas. The results suggest that the shorter the abutment height, the greater the marginal bone loss in cement-retained prostheses. Abutment height showed a greater influence in platform-switched than in non-platform-switched implants on the limitation of marginal bone loss.

Evaluation of marginal bone loss of dental implants with internal or external connections and its association with other variables: A systematic review.

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de Medeiros, Rodrigo Antonio; Pellizzer, Eduardo Piza; Vechiato Filho, Aljomar José; Dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas; Goiato, Marcelo Coelho

2016-10-01

Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear. The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections. A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection. From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants. Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry

Primary stability and self-tapping blades: biomechanical assessment of dental implants in medium-density bone.

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Kim, Yung-Soo; Lim, Young-Jun

2011-10-01

The aim of this biomechanical study was to assess the influence of self-tapping blades in terms of primary implant stability between implants with self-tapping blades and implants without self-tapping blades using five different analytic methods, especially in medium-density bone. Two different types of dental implants (4 × 10 mm) were tested: self-tapping and non-self-tapping. The fixture design including thread profiles was exactly the same between the two groups; the only difference was the presence of cutting blades on one half of the apical portion of the implant body. Solid rigid polyurethane blocks with corresponding densities were selected to simulate medium-density bone. Five mechanical assessments (insertion torque, resonance frequency analysis [RFA], reverse torque, pull-out and push in test) were performed for primary stability. Implants without self-tapping blades showed significantly higher values (P0.05). The outcomes of the present study indicate that the implant body design without self-tapping blades has a good primary stability compared with that with self-tapping blades in medium-density bone. Considering the RFA, a distinct layer of cortical bone on marginal bone will yield implant stability quotient values similar to those in medium-bone density when implants have the same diameter. © 2011 John Wiley & Sons A/S.

Development of a Novel Bone Conduction Verification Tool Using a Surface Microphone: Validation With Percutaneous Bone Conduction Users.

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Hodgetts, William; Scott, Dylan; Maas, Patrick; Westover, Lindsey

2018-03-23

. There were 90 planned comparisons of interest, three at each frequency (3 × 10) for the three input levels (30 × 3). Therefore, to minimize a type 1 error associated with multiple comparisons, we adjusted alpha using the Holm-Bonferroni method. There were five comparisons that yielded significant differences between the skull simulator and surface microphone (test and retest) in the estimation of audibility. However, the mean difference in these effects was small at 3.3 dB. Both sensors yielded equivalent results for the majority of comparisons. Models of bone conduction devices that have intact skin cannot be measured with the skull simulator. This study is the first to present and evaluate a new tool for bone conduction verification. The surface microphone is capable of yielding equivalent audibility measurements as the skull simulator for percutaneous bone conduction users at multiple input levels. This device holds potential for measuring other bone conduction devices (Sentio, BoneBridge, Attract, Soft headband devices) that do not have a percutaneous implant.

Morphological and chemical evaluation of bone with apatite-coated Al2O3 implants as scaffolds for bone repair

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A. L. M. Maia F.

2013-12-01

Full Text Available The clinical challenge in the reconstruction of bone defects has stimulated several studies in search of alternatives to repair these defects. The ceramics are considered as synthetic scaffolds and are used in dentistry and orthopedics. This study aimed to evaluate by micro energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS, the influence of uncoated and apatite-coated Al2O3 implants on bone regeneration. Twelve samples of Al2O3 implants were prepared and half of this samples (n = 6 were apatite-coated by the modified biomimetic method and then the ceramic material were implanted in the tibia of rabbits. Three experimental groups were tested: Group C - control, surgery procedure without ceramic implant, Group Ce - uncoated Al2O3 implants (n = 6 and Group CeHA - apatite-coated Al2O3 implants (n = 6. The deposition of bone tissue was determined by measuring the weight content of Ca and P through surface mapping of bone-implant interface by µ-EDXRF and through point analysis by EDS. It was observed after thirty days of treatment a greater deposition of Ca and P in the group treated with CeHA (p <0.001 compared to group C. The results suggest that ceramic coated with hydroxyapatite (CeHA can be an auxiliary to bone deposition in tibia defect model in rabbits.

Bone changes in ridge split with immediate implant placement: A systematic review

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Mohamed M. Dohiem

2015-12-01

Conclusion: Alveolar ridge splitting might be considered a predictable approach that demonstrates a high implant survival rate, adequate horizontal bone gain and minimal postoperative complications. Weak evidence showed the effect of flap design and immediate implantation on marginal bone loss and survival rate.

Implants delivering bisphosphonate locally increase periprosthetic bone density in an osteoporotic sheep model. A pilot study

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GVA Stadelmann

2008-07-01

Full Text Available It is a clinical challenge to obtain a sufficient orthopaedic implant fixation in weak osteoporotic bone. When the primary implant fixation is poor, micromotions occur at the bone-implant interface, activating osteoclasts, which leads to implant loosening. Bisphosphonate can be used to prevent the osteoclastic response, but when administered systemically its bioavailability is low and the time it takes for the drug to reach the periprosthetic bone may be a limiting factor. Recent data has shown that delivering bisphosphonate locally from the implant surface could be an interesting solution. Local bisphosphonate delivery increased periprosthetic bone density, which leads to a stronger implant fixation, as demonstrated in rats by the increased implant pullout force. The aim of the present study was to verify the positive effect on periprosthetic bone remodelling of local bisphosphonate delivery in an osteoporotic sheep model. Four implants coated with zoledronate and two control implants were inserted in the femoral condyle of ovariectomized sheep for 4 weeks. The bone at the implant surface was 50% higher in the zoledronate-group compared to control group. This effect was significant up to a distance of 400µm from the implant surface. The presented results are similar to what was observed in the osteoporotic rat model, which suggest that the concept of releasing zoledronate locally from the implant to increase the implant fixation is not species specific. The results of this trial study support the claim that local zoledronate could increase the fixation of an implant in weak bone.

Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

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Langhoff, J D; Mayer, J; Faber, L; Kaestner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

2008-01-01

Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. The new surfaces were referenced to a stainless steel implant and a standard titanium implant surface (TiMAX). In a sheep limb model, healing period was 3 months. Bone-implant bonding was evaluated either biomechanically or histologically. The new surface anodized screws demonstrated similar or slightly higher bone-implant-contact (BIC) and torque release forces than the titanium reference. The BIC of the stainless steel implants was significant lower than two of the anodized surfaces (p = 0.04), but differences between stainless steel and all titanium implants in torque release forces were not significant (p = 0.06). The new anodized titanium surfaces showed good bone-implant bonding despite a smooth surface and increased nanohardness. However, they failed to facilitate implant removal at 3 months.

Alkaline biodegradable implants for osteoporotic bone defects--importance of microenvironment pH.

Science.gov (United States)

Liu, W; Wang, T; Yang, C; Darvell, B W; Wu, J; Lin, K; Chang, J; Pan, H; Lu, W W

2016-01-01

Change of microenvironment pH by biodegradable implants may ameliorate unbalanced osteoporotic bone remodeling. The present work demonstrated that a weak alkaline condition stimulated osteoblasts differentiation while suppressed osteoclast generation. In vivo, implants with an alkaline microenvironment pH (monitored by a pH microelectrode) exhibited a promising healing effect for the repair of osteoporotic bone defects. Under osteoporotic conditions, the response of the bone microenvironment to an endosseous implant is significantly impaired, and this substantially increases the risk of fracture, non-union and aseptic implant loosening. Acid-base equilibrium is an important factor influencing bone cell behaviour. The present purpose was to study the effect of a series of alkaline biodegradable implant materials on regeneration of osteoporotic bone defect, monitoring the microenvironment pH (μe-pH) over time. The proliferation and differentiation potential of osteoporotic rat bone marrow stromal cells and RAW 264.7 cells were examined under various pH conditions. Ovariectomized rat bone defects were filled with specific biodegradable materials, and μe-pH was measured by pH microelectrode. New osteoid and tartrate-resistant acid phosphatase-positive osteoclast-like cells were examined by Goldner's trichrome and TRAP staining, respectively. The intermediate layer between implants and new bone were studied using energy-dispersive X-ray spectroscopy (EDX) linear scanning. In vitro, weak alkaline conditions stimulated osteoporotic rat bone marrow stromal cells (oBMSC) differentiation, while inhibiting the formation of osteoclasts. In vivo, μe-pH differs from that of the homogeneous peripheral blood and exhibits variations over time particular to each material. Higher initial μe-pH was associated with more new bone formation, late response of TRAP-positive osteoclast-like cells and the development of an intermediate 'apatitic' layer in vivo. EDX suggested that

Improved Bone Micro Architecture Healing Time after Implant Surgery in an Ovariectomized Rat.

Science.gov (United States)

Takahashi, Takahiro; Watanabe, Takehiro; Nakada, Hiroshi; Sato, Hiroki; Tanimoto, Yasuhiro; Sakae, Toshiro; Kimoto, Suguru; Mijares, Dindo; Zhang, Yu; Kawai, Yasuhiko

2016-01-01

The present animal study investigated whether oral intake of synthetic bone mineral (SBM) improves peri-implant bone formation and bone micro architecture (BMA). SBM was used as an intervention experimental diet and AIN-93M was used as a control. The SBM was prepared by mixing dicalcium phosphate dihydrate (CaHPO 4 ·2H 2 O) and magnesium and zinc chlorides (MgCl 2 and ZnCl 2 , respectively), and hydrolyzed in double-distilled water containing dissolved potassium carbonate and sodium fluoride. All rats were randomly allocated into one of two groups: a control group was fed without SBM (n = 18) or an experimental group was fed with SBM (n = 18), at seven weeks old. At 9 weeks old, all rats underwent implant surgery on their femurs under general anesthesia. The implant was inserted into the insertion socket prepared at rats' femur to a depth of 2.5 mm by using a drill at 500 rpm. Nine rats in each group were randomly selected and euthanized at 2 weeks after implantation. The remaining nine rats in each group continued their diets, and were euthanized in the same manner at 4 weeks after implantation. The femur, including the implant, was removed from the body and implant was pulled out by an Instron universal testing machine. After the implant removal, BMA was evaluated by bone surface ratio (BS/BV), bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular number (TbN), trabecular star volume (Vtr), and micro-CT images. BS/BV, BV/TV, TbTh and Vtr were significantly greater in the rats were fed with SBM than those were fed without SBM at 2 and 4 weeks after implantation (P implant formation and BMA, prominent with trabecular bone structure. The effect of SBM to improve secondary stability of the implant, and shortening the treatment period should be investigated in the future study.

Evaluation of the Survival Rate and Bone Loss of Implants with Various Lengths

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AR. Rokn

2006-12-01

Full Text Available Statement of Problem: The replacement of missing teeth with implant-associated restorations has become a widely used treatment modality in recent years. The length of dental implants may be a critical factor in achieving and maintaining osseointegration.Purpose: The aim of this study was to evaluate the survival rate and bone loss of dental implants with different lengthsMaterials and Methods: A retrospective cohort study was performed on 60 ITI-system implants, evenly distributed into three groups including 8, 10 and 12 mm high implants in the posterior segments of both jaws. Demographic information, oral hygiene,cigarette smoking, implant length, duration of implant placement (at least 24 months,bleeding on probing index and pocket probing depth were recorded for all participants.Bone loss was calculated using pre- and post-operative panoramic radiographs.Results: The mean rate of bone loss was different among the three groups and were found to be 0.21 (0.45, 0.3 (0.41 and 0.43 (0.55 mm in the 8, 10, and 12 mm high implants, respectively. Neither mean bone loss nor bleeding on probing index showed significant differences with implant length. A significant correlation was found between implant length and pocket probing depth (P<0.0001.Conclusion: The results of this study suggest that both short (8 mm high and long (10 or 12 mm high implants may be used with nearly equal success rates in the posterior segments of the jaws.

Gentamicin coating of nanotubular anodized titanium implant reduces implant-related osteomyelitis and enhances bone biocompatibility in rabbits

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Liu D

2017-07-01

Full Text Available Denghui Liu,1,* Chongru He,2,* Zhongtang Liu,2 Weidong Xu2 1Department of Orthopedics, the 113 Military Hospital, Ningbo, 2Department of Orthopedics, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Titanium and titanium alloy are widely used as orthopedic implants for their favorable mechanical properties and satisfactory biocompatibility. The aim of the present study was to investigate the antibacterial effect and bone cell biocompatibility of a novel implant made with nanotubular anodized titanium coated with gentamicin (NTATi-G through in vivo study in ­rabbits. The animals were divided into four groups, each receiving different kinds of implants, that is, NTATi-G, titanium coated with gentamicin (Ti-G, nanotubular anodized titanium uncoated with gentamicin (NTATi and titanium uncoated with gentamicin (Ti. The results showed that NTATi-G implant prevented implant-related osteomyelitis and enhanced bone biocompatibility in vivo. Moreover, the body temperature of rabbits in NTATi-G and Ti-G groups was lower than those in Ti groups, while the weight of rabbits in NTATi-G and Ti-G groups was heavier than those in NTATi and Ti groups, respectively. White blood cell counts in NTATi-G group were lower than NTATi and Ti groups. Features of myelitis were observed by X-ray films in the NTATi and Ti groups, but not in the NTATi-G and Ti-G groups. The radiographic scores, which assessed pathology and histopathology in bone tissues, were significantly lower in the NTATi-G and Ti-G groups than those in the NTATi and Ti groups, respectively (P<0.05. Meanwhile, explants and bone tissue culture demonstrated significantly less bacterial growth in the NTATi-G and Ti-G groups than in the NTATi and Ti groups, respectively (P<0.01. The bone volume in NTATi-G group was greater than Ti-G group, and little bone formation was seen in NTATi and Ti

Biodegradable magnesium-based implants in bone studied by synchrotron radiation microtomography

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Moosmann, Julian; Zeller-Plumhoff, Berit; Wieland, D. C. Florian; Galli, Silvia; Krüger, Diana; Dose, Thomas; Burmester, Hilmar; Wilde, Fabian; Bech, Martin; Peruzzi, Niccolò; Wiese, Björn; Hipp, Alexander; Beckmann, Felix; Hammel, Jörg; Willumeit-Römer, Regine

2017-09-01

Permanent implants made of titanium or its alloys are the gold standard in many orthopedic and traumatological applications due to their good biocompatibility and mechanical properties. However, a second surgical intervention is required for this kind of implants as they have to be removed in the case of children that are still growing or on patient's demand. Therefore, magnesium-based implants are considered for medical applications as they are degraded under physiological conditions. The major challenge is tailoring the degradation in a manner that is suitable for a biological environment and such that stabilization of the bone is provided for a controlled period. In order to understand failure mechanisms of magnesium-based implants in orthopedic applications and, further, to better understand the osseointegration, screw implants in bone are studied under mechanical load by means of a push-out device installed at the imaging beamline P05 of PETRA III at DESY. Conventional absorption contrast microtomography and phasecontrast techniques are applied in order to monitor the bone-to-implant interface under increasing load conditions. In this proof-of-concept study, first results from an in situ push-out experiment are presented.

Converted marine coral hydroxyapatite implants with growth factors: In vivo bone regeneration

Energy Technology Data Exchange (ETDEWEB)

Nandi, Samit K., E-mail: samitnandi1967@gmail.com [Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata (India); Kundu, Biswanath, E-mail: biswa_kundu@rediffmail.com [Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata (India); Mukherjee, Jayanta [Institute of Animal Health and Veterinary Biologicals, Kolkata (India); Mahato, Arnab; Datta, Someswar; Balla, Vamsi Krishna [Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata (India)

2015-04-01

Herein we report rabbit model in vivo bone regeneration of hydrothermally converted coralline hydroxyapatite (HCCHAp) scaffolds without (group I) and with growth factors namely insulin like growth factor-1 (IGF-1) (group II) and bone morphogenetic protein-2 (BMP-2) (group III). All HCCHAp scaffolds have been characterized for phase purity and morphology before implantation. Calcined marine coral was hydrothermally converted using a mineralizer/catalyst to phase pure HAp retaining original pore structure and geometry. After sintering at 1250 °C, the HCCHAp found to have ~ 87% crystallinity, 70–75% porosity and 2 ± 0.5 MPa compressive strength. In vitro growth factor release study at day 28 revealed 77 and 98% release for IGF-1 and BMP-2, respectively. The IGF-1 release was more sustained than BMP-2. In vivo bone healing of different groups was compared using chronological radiology, histological evaluations, scanning electron microscopy and fluorochrome labeling up to 90 days of implantation. In vivo studies showed substantial reduction in radiolucent zone and decreased radiodensity of implants in group II followed by group III and group I. These observations clearly suggest in-growth of osseous tissue, initiation of bone healing and complete union between implants and natural bone in group II implants. A statistical score sheet based on histological observations showed an excellent osseous tissue formation in group II and group III scaffolds and moderate bone regeneration in group I scaffolds. - Highlights: • In vivo bone regeneration of hydrothermally converted coralline hydroxyapatite • Scaffolds with and without growth factors (IGF-1 and BMP-2) • In vitro drug release was more sustained for IGF-1 than BMP-2. • Growth factor significantly improved osseous tissue formation of implanted scaffold. • Established through detailed statistical score sheet from histological observations.

Converted marine coral hydroxyapatite implants with growth factors: In vivo bone regeneration

International Nuclear Information System (INIS)

Nandi, Samit K.; Kundu, Biswanath; Mukherjee, Jayanta; Mahato, Arnab; Datta, Someswar; Balla, Vamsi Krishna

2015-01-01

Herein we report rabbit model in vivo bone regeneration of hydrothermally converted coralline hydroxyapatite (HCCHAp) scaffolds without (group I) and with growth factors namely insulin like growth factor-1 (IGF-1) (group II) and bone morphogenetic protein-2 (BMP-2) (group III). All HCCHAp scaffolds have been characterized for phase purity and morphology before implantation. Calcined marine coral was hydrothermally converted using a mineralizer/catalyst to phase pure HAp retaining original pore structure and geometry. After sintering at 1250 °C, the HCCHAp found to have ~ 87% crystallinity, 70–75% porosity and 2 ± 0.5 MPa compressive strength. In vitro growth factor release study at day 28 revealed 77 and 98% release for IGF-1 and BMP-2, respectively. The IGF-1 release was more sustained than BMP-2. In vivo bone healing of different groups was compared using chronological radiology, histological evaluations, scanning electron microscopy and fluorochrome labeling up to 90 days of implantation. In vivo studies showed substantial reduction in radiolucent zone and decreased radiodensity of implants in group II followed by group III and group I. These observations clearly suggest in-growth of osseous tissue, initiation of bone healing and complete union between implants and natural bone in group II implants. A statistical score sheet based on histological observations showed an excellent osseous tissue formation in group II and group III scaffolds and moderate bone regeneration in group I scaffolds. - Highlights: • In vivo bone regeneration of hydrothermally converted coralline hydroxyapatite • Scaffolds with and without growth factors (IGF-1 and BMP-2) • In vitro drug release was more sustained for IGF-1 than BMP-2. • Growth factor significantly improved osseous tissue formation of implanted scaffold. • Established through detailed statistical score sheet from histological observations

Development of implants composed of bioactive materials for bone repair

Science.gov (United States)

Xiao, Wei

The purpose of this Ph.D. research was to address the clinical need for synthetic bioactive materials to heal defects in non-loaded and loaded bone. Hollow hydroxyapatite (HA) microspheres created in a previous study were evaluated as a carrier for controlled release of bone morphogenetic protein-2 (BMP2) in bone regeneration. New bone formation in rat calvarial defects implanted with BMP2-loaded microspheres (43%) was significantly higher than microspheres without BMP2 (17%) at 6 weeks postimplantation. Then hollow HA microspheres with a carbonate-substituted composition were prepared to improve their resorption rate. Hollow HA microspheres with 12 wt. % of carbonate showed significantly higher new bone formation (73 +/- 8%) and lower residual HA (7 +/- 2%) than stoichiometric HA microspheres (59 +/- 2% new bone formation; 21 +/- 3% residual HA). The combination of carbonate-substituted hollow HA microspheres and clinically-safe doses of BMP2 could provide promising implants for healing non-loaded bone defects. Strong porous scaffolds of bioactive silicate (13-93) glass were designed with the aid of finite-element modeling, created by robocasting and evaluated for loaded bone repair. Scaffolds with a porosity gradient to mimic human cortical bone showed a compressive strength of 88 +/- 20 MPa, a flexural strength of 34 +/- 5 MPa and the ability to support bone infiltration in vivo. The addition of a biodegradable polylactic acid (PLA) layer to the external surface of these scaffolds increased their load-bearing capacity in four-point bending by 50% and dramatically enhanced their work of fracture, resulting in a "ductile" mechanical response. These bioactive glass-PLA composites, combining bioactivity, high strength, high work of fracture and an internal architecture conducive to bone infiltration, could provide optimal implants for structural bone repair.

Placement of fin type dental implant in three different surgical situations of alveolar bone

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Coen Pramono D

2007-03-01

Full Text Available Three different dental implant placements according to surgical implant bed situations were observed in its bone integration 3 months after dental implant insertion. This observation was done on implant system which has plateau or fin system. Elf implants were placed in the upper jaw in two patients. In case one, two implants were inserted immediately after tooth extraction, and the other six implants were placed in the alveolar crest regions in delayed implantation or in which the teeth had been extracted over 6 months of period. In case two, three implants were inserted in the post trauma region in the anterior maxilla, which the labial plate had been lost and reconstructed with bone grafting procedure using a mixture of alloplastic and autogenous bones. The alveolar reconstruction was needed to be performed due to only thin alveolar crest width was left intact. All of those implants observed showed in good integration.

The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

OpenAIRE

Khalid A. Arafa

2016-01-01

Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group receive...

Assessment of trabecular bone changes around endosseous implants using image analysis techniques: A preliminary study

International Nuclear Information System (INIS)

Zuki, Mervet El; Omami, Galal; Horner, Keith

2014-01-01

The objective of this study was to assess the trabecular bone changes that occurred around functional endosseous dental implants by means of radiographic image analysis techniques. Immediate preoperative and postoperative periapical radiographs of de-identified implant patients at the University Dental Hospital of Manchester were retrieved, screened for specific inclusion criteria, digitized, and quantified for structural elements of the trabecular bone around the endosseous implants, by using image analysis techniques. Data were analyzed using SPSS version 11.5. P values of less than 0.05 were considered statistically significant. A total of 12 implants from 11 patients were selected for the study, and 26 regions of interest were obtained. There was a significant increase in the bone area in terms of the mean distance between nodes (p=0.006) and a significant decrease in the marrow area in terms of the bone area (p=0.006) and the length of marrow spaces (p=0.032). It appeared that the bone around the implant underwent remodeling that resulted in a net increase in bone after implant placement.

Assessment of trabecular bone changes around endosseous implants using image analysis techniques: A preliminary study

Energy Technology Data Exchange (ETDEWEB)

Zuki, Mervet El [Dept. of Oral Medicine and Radiology, Benghazi University College of Dentistry, Benghazi (Libya); Omami, Galal [Oral Diagnosis and Polyclinics, Faculty of Dentistry, The University of Hong Kong (Hong Kong); Horner, Keith [Dept. of Oral Radiology, University Dental Hospital of Manchester, Manchester (United Kingdom)

2014-06-15

The objective of this study was to assess the trabecular bone changes that occurred around functional endosseous dental implants by means of radiographic image analysis techniques. Immediate preoperative and postoperative periapical radiographs of de-identified implant patients at the University Dental Hospital of Manchester were retrieved, screened for specific inclusion criteria, digitized, and quantified for structural elements of the trabecular bone around the endosseous implants, by using image analysis techniques. Data were analyzed using SPSS version 11.5. P values of less than 0.05 were considered statistically significant. A total of 12 implants from 11 patients were selected for the study, and 26 regions of interest were obtained. There was a significant increase in the bone area in terms of the mean distance between nodes (p=0.006) and a significant decrease in the marrow area in terms of the bone area (p=0.006) and the length of marrow spaces (p=0.032). It appeared that the bone around the implant underwent remodeling that resulted in a net increase in bone after implant placement.

Experimental and numerical study of cemented bone-implant interface behaviour

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P. Zlamal

2011-01-01

Full Text Available Although the total hip replacement (THR is a long-proven method of surgical treatment of diseases and disorders of the human hip, the surgery brings some risk of long-term instability of the joint. The aim of the research was to investigate the cemented bone-implant interface behavior. The main problems (cement layer degradation and bone-cement interface debonding during physiological loading conditions have been investigated using a custom hip simulator. The experimental setup was designed to allow cyclic loading of the sample of pelvic bone with implanted cemented acetabular component. The hip contact force of required direction and magnitude was applied to the implant using a spherical femoral component head. The most unfavorable activity (downstairs walking was simulated. The process of damage accumulation in the fixation was monitored by repeated scanning using high resolution micro Computed Tomography (µCT. Use of micro-focus source and large high-resolution flat panel detector allows investigation of structural changes and crack propagation both in the cement layer and the trabecular bone.

Bone graft materials in fixation of orthopaedic implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

2013-01-01

Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

Influence of peri-implant artifacts on bone morphometric analysis with micro-computed tomography.

Science.gov (United States)

Song, Jin Wook; Cha, Jung Yul; Bechtold, Till Edward; Park, Young Chel

2013-01-01

To determine the optimal dilation pixel size distance from the mini-implant interface needed to compensate for the metal artifact on micro-computed tomography (micro-CT) for bone morphometric analysis. A total of 72 self-drilling mini-implants were placed into the buccal alveolar bone of six male beagle dogs. After 12 weeks of orthodontic loading, specimens were harvested and scanned with micro-CT (Skyscan 1076) at a resolution of 9 μm. Using the reload plug-in and dilation procedure of CTAn, the percentage of bone-implant contact (BIC) and bone volume density (BV/TV, bone volume/total volume), respectively, were measured from one to seven pixels from the metal implant surface. Each pixel size of dilation (PSD) were compared with that of a ground histologic section, and the optimal PSD for bone morphometric analysis using micro-CT was determined. BIC values from micro-CT analysis decreased when the PSD increased (P micro-CT showed the highest correlation coefficient with BIC from histologic slides when the PSD was 5 to 7 (P micro-CT showed a very high correlation with BV/TV from histologic slides in all ranges (P micro-CT, at least 5 PSD from the metal implant surface is needed.

Comparing the influence of crestal cortical bone and sinus floor cortical bone in posterior maxilla bi-cortical dental implantation: a three-dimensional finite element analysis.

Science.gov (United States)

Yan, Xu; Zhang, Xinwen; Chi, Weichao; Ai, Hongjun; Wu, Lin

2015-05-01

This study aimed to compare the influence of alveolar ridge cortical bone and sinus floor cortical bone in sinus areabi-cortical dental implantation by means of 3D finite element analysis. Three-dimensional finite element (FE) models in a posterior maxillary region with sinus membrane and the same height of alveolar ridge of 10 mm were generated according to the anatomical data of the sinus area. They were either with fixed thickness of crestal cortical bone and variable thickness of sinus floor cortical bone or vice versa. Ten models were assumed to be under immediate loading or conventional loading. The standard implant model based on the Nobel Biocare implant system was created via computer-aided design software. All materials were assumed to be isotropic and linearly elastic. An inclined force of 129 N was applied. Von Mises stress mainly concentrated on the surface of crestal cortical bone around the implant neck. For all the models, both the axial and buccolingual resonance frequencies of conventional loading were higher than those of immediate loading; however, the difference is less than 5%. The results showed that bi-cortical implant in sinus area increased the stability of the implant, especially for immediately loading implantation. The thickness of both crestal cortical bone and sinus floor cortical bone influenced implant micromotion and stress distribution; however, crestal cortical bone may be more important than sinus floor cortical bone.

Dental Implants in an Aged Population: Evaluation of Periodontal Health, Bone Loss, Implant Survival, and Quality of Life.

Science.gov (United States)

Becker, William; Hujoel, Philippe; Becker, Burton E; Wohrle, Peter

2016-06-01

To evaluate aged partially and fully edentulous patients who received dental implants and were maintained over time. Further, to determine how the partially and edentulous ageing populations (65 and above) with dental implants maintain bone levels, proper oral hygiene, and perceive benefits of dental implants. Since 1995, patients receiving dental implants have been prospectively entered into an Access-based computerized program (Triton Tacking System). Patient demographics (age, sex), bone quality, quantity, implant location, and type of surgery have been continuously entered into the database. The database was queried for patients receiving implants (first stage) between 66 and 93 years of age. Thirty-one patients were within this age group. Twenty-five patients returned to the clinic for periodontal and dental implant evaluation. The Periodontal Index was used to evaluate selected teeth in terms of probing depth, bleeding on probing, plaque accumulation, and mobility. Using NIH Image J, radiographs taken at second stage and last examination were measured for changes in interproximal bone levels. Once identified, each patient anomalously filled out an abbreviated quality of health life form. Due to small sample size, descriptive statistics were used to compare clinical findings. Fifteen males ranging from 78 to 84 (mean age 84 years) years and 16 females from 66 to 93 (mean age 83 years) (age range 66-93) were contacted by phone or mail and asked to return to our office for a re-examination. For this group, the first dental implants were placed in 1996 (n = initial two implants) and continuously recorded through 2013 (n = last seven implants). Thirty-one patients received a total of 84 implants. Two patients were edentulous, and the remaining were partially edentulous. Four implants were lost. Between implant placement and 6- to 7-year interval, 13 patients with 40 implants had a cumulative survival rate of 94.6%. Of the original group (n = 33), three

[Principles of bone tissue structures interaction with full removable dentures fixed on intraosseous implantates modelling].

Science.gov (United States)

Shashmurina, V R; Chumachenko, E N; Olesova, V N; Volozhin, A I

2008-01-01

Math modelling "removable dentures-implantate-bone" with size and density of bone tissue as variables was created. It allowed to study biomechanical bases of mandibular bone tissue structures interaction with full removable dentures of different constructions and fixed on intraosseous implantates. Analysis of the received data showed that in the majority of cases it was expedient to recommend 3 bearing (abutments) system of denture making. Rest on 4 and more implantates was appropriate for patients with reduced density of spongy bone and significant mandibular bone atrophy. 2 abutment system can be used in patients with high density of spongy bone and absence of mandibular bone atrophy.

Bone reactions adjacent to titanium implants subjected to static load. A study in the dog (I)

DEFF Research Database (Denmark)

Gotfredsen, K; Berglundh, T; Lindhe, J

2001-01-01

The aim of the study was to evaluate the effect of lateral static load induced by an expansion force on the bone/implant interface and adjacent peri-implant bone. In 3 beagle dogs, the 2nd, 3rd and 4th mandibular premolars were extracted bilaterally. Twelve weeks later 8 implants of the ITI Dental...... Implant System were placed in each dog. Crowns connected in pairs were screwed on the implants 12 weeks after implant installation. The connected crowns contained an orthodontic expansion screw yielding 4 loading units in each dog. Clinical registrations, standardized radiographs and fluorochrome labeling...... were carried out during the 24-week loading period. Biopsies were harvested and processed for ground sectioning. The sections were subjected to histological examination. No evident marginal bone loss was observed at either test or control sites. The bone density and the mineralized bone-to-implant...

Bone healing response in cyclically loaded implants: Comparing zero, one, and two loading sessions per day.

Science.gov (United States)

de Barros E Lima Bueno, Renan; Dias, Ana Paula; Ponce, Katia J; Wazen, Rima; Brunski, John B; Nanci, Antonio

2018-05-31

When bone implants are loaded, they are inevitably subjected to displacement relative to bone. Such micromotion generates stress/strain states at the interface that can cause beneficial or detrimental sequels. The objective of this study is to better understand the mechanobiology of bone healing at the tissue-implant interface during repeated loading. Machined screw shaped Ti implants were placed in rat tibiae in a hole slightly bigger than the implant diameter. Implants were held stable by a specially-designed bone plate that permits controlled loading. Three loading regimens were applied, (a) zero loading, (b) one daily loading session of 60 cycles with an axial force of 1.5 N/cycle for 7 days, and (c) two such daily sessions with the same axial force also for 7 days. Finite element analysis was used to characterize the mechanobiological conditions produced by the loading sessions. After 7 days, the implants with surrounding interfacial tissue were harvested and processed for histological, histomorphometric and DNA microarray analyses. Histomorphometric analyses revealed that the group subjected to repeated loading sessions exhibited a significant decrease in bone-implant contact and increase in bone-implant distance, as compared to unloaded implants and those subjected to only one loading session. Gene expression profiles differed during osseointegration between all groups mainly with respect to inflammatory and unidentified gene categories. The results indicate that increasing the daily cyclic loading of implants induces deleterious changes in the bone healing response, most likely due to the accumulation of tissue damage and associated inflammatory reaction at the bone-implant interface. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Nanomechanical properties of bone around cement-retained abutment implants. A minipig study

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R.R.M. de Barros

2016-06-01

Full Text Available Aim The nanomechanical evaluation can provide additional information about the dental implants osseointegration process. The aim of this study was to quantify elastic modulus and hardness of bone around cemented-retained abutment implants positioned at two different crestal bone levels. Materials and methods The mandibular premolars of 7 minipigs were extracted. After 8 weeks, 8 implants were inserted in each animal: crestally on one side of the mandible and subcrestally on the other (crestal and subcrestal groups. Functional loading were immediately provided with abutments cementation and prostheses installation. Eight weeks later, the animals euthanasia was performed and nanoindentation analyses were made at the most coronal newly formed bone region (coronal group, and below in the threaded region (threaded group of histologic sections. Results The comparisons between subcrestal and crestal groups did not achieve statistical relevance; however the elastic modulus and hardness levels were statistically different in the two regions of evaluation (coronal and threaded. Conclusions The crestal and subcrestal placement of cement-retained abutment implants did not affect differently the nanomechanical properties of the surrounding bone. However the different regions of newly formed bone (coronal and threaded groups were extremely different in both elastic modulus and hardness, probably reflecting their differences in bone composition and structure.

Bone Healing Around Dental Implants: Simplified vs Conventional Drilling Protocols at Speed of 400 rpm.

Science.gov (United States)

Gil, Luiz Fernando; Sarendranath, Alvin; Neiva, Rodrigo; Marão, Heloisa F; Tovar, Nick; Bonfante, Estevam A; Janal, Malvin N; Castellano, Arthur; Coelho, Paulo G

This study evaluated whether simplified drilling protocols would provide comparable histologic and histomorphometric results to conventional drilling protocols at a low rotational speed. A total of 48 alumina-blasted and acid-etched Ti-6Al-4V implants with two diameters (3.75 and 4.2 mm, n = 24 per group) were bilaterally placed in the tibiae of 12 dogs, under a low-speed protocol (400 rpm). Within the same diameter group, half of the implants were inserted after a simplified drilling procedure (pilot drill + final diameter drill), and the other half were placed using the conventional drilling procedure. After 3 and 5 weeks, the animals were euthanized, and the retrieved bone-implant samples were subjected to nondecalcified histologic sectioning. Histomorphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) analysis were performed. Histology showed that new bone was formed around implants, and inflammation or bone resorption was not evident for both groups. Histomorphometrically, when all independent variables were collapsed over drilling technique, no differences were detected for BIC and BAFO; when drilling technique was analyzed as a function of time, the conventional groups reached statistically higher BIC and BAFO at 3 weeks, but comparable values between techniques were observed at 5 weeks; 4.2-mm implants obtained statistically higher BAFO relative to 3.75-mm implants. Based on the present methodology, the conventional technique improved bone formation at 3 weeks, and narrower implants were associated with less bone formation.

Middle ear implant in conductive and mixed congenital hearing loss in children.

Science.gov (United States)

Roman, Stéphane; Denoyelle, Françoise; Farinetti, Anne; Garabedian, Erea-Noel; Triglia, Jean-Michel

2012-12-01

Active middle ear implant can be used in children and adolescents with congenital hearing loss. The authors report their experience with the semi implantable Medel Vibrant Soundbridge(®) (VSB) in the audiologic rehabilitation of such patients. In this retrospective study, audiological and surgical data of 10 children (10.5±4 years) implanted with 12 VSB in 2 tertiary cares ENT Departments were analysed. Two children with bilateral external auditory canal (EAC) atresia and mixed hearing loss (mean air conduction (AC) thresholds=65dB HL) were bilaterally implanted. Eight children presented with microtia associated with EAC atresia bilaterally (n=3) and unilaterally (n=5). All of them had a conductive hearing loss in the implanted ear (mean (AC) thresholds were 58.75dB HL preoperatively). The Floating Mass Transducer was crimped on the long process of the incus (n=8) or on the suprastructure of the stapes (n=4). There were no intra- or postoperative surgical complications. All the children wore their implants after 5 weeks. Postoperative mean bone conduction (BC) thresholds were unchanged. The mean aided thresholds with VSB (four frequencies warble tones at 0.5, 1, 2 and 4 kHz) were 28dB HL (± 10). Word discrimination threshold in quiet conditions in free field with the VSB unilaterally activated was 50% at 38dB SPL (± 9). The results indicate that satisfaction of the children and their parents is very encouraging but surgeons should be cautious with this new approach in relation to the pinna reconstruction and to possible risks to inner ear and facial nerve. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Meta-Analysis of Correlations Between Marginal Bone Resorption and High Insertion Torque of Dental Implants.

Science.gov (United States)

Li, Haoyan; Liang, Yongqiang; Zheng, Qiang

2015-01-01

To evaluate correlations between marginal bone resorption and high insertion torque value (> 50 Ncm) of dental implants and to assess the significance of immediate and early/conventional loading of implants under a certain range torque value. Specific inclusion and exclusion criteria were used to retrieve eligible articles from Ovid, PubMed, and EBSCO up to December 2013. Screening of eligible studies, quality assessment, and data extraction were conducted in duplicate. The results were expressed as random/fixed-effects models using weighted mean differences for continuous outcomes with 95% confidence intervals. Initially, 154 articles were selected (11 from Ovid, 112 from PubMed, and 31 from EBSCO). After exclusion of duplicate articles and articles that did not meet the inclusion criteria, six clinical studies were selected. Assessment of P values revealed that correlations between marginal bone resorption and high insertion torque were not statistically significant and that there was no difference between immediately versus early/conventionally loaded implants under a certain range of torque. None of the meta-analyses revealed any statistically significant differences between high insertion torque and conventional insertion torque in terms of effects on marginal bone resorption.

Bone implant sockets made using three different procedures: a stability study in dogs

Science.gov (United States)

Campo, Julián

2012-01-01

Objective: This study compared the effects of three different methods of preparing bone implant sockets (drilling, osteotomes, and piezoelectric device) on osseointegration using resonance frequency analysis (RFA). Study Design: An experimental prospective study was designed. Material and Methods: Ten adult beagle dogs were studied. After 5 weeks, 23 out of 28 initially placed implants in the iliac crest were evaluated, comparing these three different procedures of bone implant socket. Student’s t-test (paired, two-tailed) was used to reveal differences among the three groups at each time point (SPSS 16.0, IL, USA). Results: After a 5-week healing period, the implants placed in sockets that were made using an osteotome or piezoelectric device were slightly more stable than those made by drilling. Reduced mechanical and heat injury to the bone is beneficial for maintaining and improving stability during the critical early healing period. Conclusion: Using RFA, there was evidence of a slight increase in implant stability in the iliac crest after 5 weeks of healing when the implant socket was made using a piezoelectric device or expansion procedure as compare with the drilling method. Key words:Bone implant sockets, drilling, osteotomes, piezoelectric, resonance frequency analysis, stability. PMID:24558558

Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

Directory of Open Access Journals (Sweden)

Mondelli, Maria Fernanda Capoani Garcia

2015-10-01

Full Text Available Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.

Nanostructured implant surface effect on osteoblast gene expression and bone-to-implant contact in vivo

Energy Technology Data Exchange (ETDEWEB)

Mendonca, Gustavo, E-mail: gustavo_mendonca@dentistry.unc.edu [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil); Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States); Universidade Catolica de Brasilia, Curso de Odontologia, Taguatinga/DF (Brazil); Baccelli Silveira Mendonca, Daniela [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil) and Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States); Pagotto Simoes, Luis Gustavo; Araujo, Andre Luis; Leite, Edson Roberto [Departmento de Quimica, Universidade Federal de Sao Carlos-UFSCAR, Rod. Washington Luiz, 13565-905 Sao Carlos, SP (Brazil); Golin, Alexsander Luiz [Departmento de Engenharia Mecanica, Faculdade de Engenharia Mecanica, Pontificia Universidade Catolica de Curitiba, Curitiba, PR (Brazil); Aragao, Francisco J.L. [Universidade Catolica de Brasilia, Pos-Graduacao em Ciencias Genomicas e Biotecnologia, SGAN Quadra 916, Modulo B, Av. W5 Norte 70.790-160-Asa Norte Brasilia/DF (Brazil); Embrapa Recursos Geneticos e Biotecnologia, Laboratorio de Introducao e Expressao de Genes, PqEB W5 Norte, 70770-900, Brasilia, DF (Brazil); Cooper, Lyndon F., E-mail: lyndon_cooper@dentistry.unc.edu [Bone Biology and Implant Therapy Laboratory, Department of Prosthodontics, University of North Carolina at Chapel Hill, 404 Brauer Hall, CB 7450, Chapel Hill, NC 27511 (United States)

2011-12-01

The aim of this study was to investigate the response of nanostructured implant surfaces at the level of osteoblast differentiation and its effects in bone-to-implant contact (BIC) and removal-torque values (RTV). CpTi grade IV implants (1.6 x 4.0 mm) were machined or machined and subsequently coated with an oxide solution. The surfaces were divided into: machined (M), titania-anatase (An), titania-rutile (Ru), and zirconia (Zr). Surfaces were examined by scanning electron microscopy, atomic force microscopy, and by X-ray microanalysis. Implants were inserted in rat tibia and harvested from 0 to 21 days for measurement of Alkaline Phosphatase, Bone Sialoprotein, Osteocalcin, Osteopontin, and RUNX-2 mRNA levels by real time PCR; from 0 to 56 days for RTV; and from 0 to 56 days for BIC. The roughness parameter (Sa) was compared by one-way ANOVA followed by Tukey Test. Comparison of Torque removal values and histomorphometric measurements on implants in vivo was performed by Kruskal-Wallis test and the significance level for all statistical analyses was set at p {<=} 0.05. mRNA levels on all nanostructured surfaces were increased compared to M. At 56 days, the mean RTV in Ncm was 11.6 {+-} 2.5, 11.3 {+-} 2.4, 11.1 {+-} 3.5, 9.7 {+-} 1.4 for An, Ru, Zr, and M, respectively. Higher BIC (%) was measured for all the nanostructured surfaces versus M at 21 and 56 days (p < 0.05). Nanostructured topographic features composed of TiO{sub 2} or ZrO{sub 2} applied to machined cpTi implant promoted greater mesenchymal stem cell commitment to the osteoblast phenotype and associated increased BIC and physical association with bone. Highlights: {yields} Nanostructured surfaces using a sol-gel technique coated cpTi with TiO{sub 2} or ZrO{sub 2}. {yields} Evaluated molecular and mechanical effect of nanofeatures in vivo in rat tibiae. {yields} Nanofeatures improved the differentiation of rat MSCs into osteoblasts. {yields} Nanofeatures improved increased bone-to-implant contact and

Nanostructured implant surface effect on osteoblast gene expression and bone-to-implant contact in vivo

International Nuclear Information System (INIS)

Mendonca, Gustavo; Baccelli Silveira Mendonca, Daniela; Pagotto Simoes, Luis Gustavo; Araujo, Andre Luis; Leite, Edson Roberto; Golin, Alexsander Luiz; Aragao, Francisco J.L.; Cooper, Lyndon F.

2011-01-01

The aim of this study was to investigate the response of nanostructured implant surfaces at the level of osteoblast differentiation and its effects in bone-to-implant contact (BIC) and removal-torque values (RTV). CpTi grade IV implants (1.6 x 4.0 mm) were machined or machined and subsequently coated with an oxide solution. The surfaces were divided into: machined (M), titania-anatase (An), titania-rutile (Ru), and zirconia (Zr). Surfaces were examined by scanning electron microscopy, atomic force microscopy, and by X-ray microanalysis. Implants were inserted in rat tibia and harvested from 0 to 21 days for measurement of Alkaline Phosphatase, Bone Sialoprotein, Osteocalcin, Osteopontin, and RUNX-2 mRNA levels by real time PCR; from 0 to 56 days for RTV; and from 0 to 56 days for BIC. The roughness parameter (Sa) was compared by one-way ANOVA followed by Tukey Test. Comparison of Torque removal values and histomorphometric measurements on implants in vivo was performed by Kruskal-Wallis test and the significance level for all statistical analyses was set at p ≤ 0.05. mRNA levels on all nanostructured surfaces were increased compared to M. At 56 days, the mean RTV in Ncm was 11.6 ± 2.5, 11.3 ± 2.4, 11.1 ± 3.5, 9.7 ± 1.4 for An, Ru, Zr, and M, respectively. Higher BIC (%) was measured for all the nanostructured surfaces versus M at 21 and 56 days (p 2 or ZrO 2 applied to machined cpTi implant promoted greater mesenchymal stem cell commitment to the osteoblast phenotype and associated increased BIC and physical association with bone. Highlights: → Nanostructured surfaces using a sol-gel technique coated cpTi with TiO 2 or ZrO 2 . → Evaluated molecular and mechanical effect of nanofeatures in vivo in rat tibiae. → Nanofeatures improved the differentiation of rat MSCs into osteoblasts. → Nanofeatures improved increased bone-to-implant contact and removal torque values. → TiO 2 or ZrO 2 nanofeatures improved the biological response of machined titanium.

Methods to Improve Osseointegration of Dental Implants in Low Quality (Type-IV Bone: An Overview

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Hamdan S. Alghamdi

2018-01-01

Full Text Available Nowadays, dental implants have become more common treatment for replacing missing teeth and aim to improve chewing efficiency, physical health, and esthetics. The favorable clinical performance of dental implants has been attributed to their firm osseointegration, as introduced by Brånemark in 1965. Although the survival rate of dental implants over a 10-year observation has been reported to be higher than 90% in totally edentulous jaws, the clinical outcome of implant treatment is challenged in compromised (bone conditions, as are frequently present in elderly people. The biomechanical characteristics of bone in aged patients do not offer proper stability to implants, being similar to type-IV bone (Lekholm & Zarb classification, in which a decreased clinical fixation of implants has been clearly demonstrated. However, the search for improved osseointegration has continued forward for the new evolution of modern dental implants. This represents a continuum of developments spanning more than 20 years of research on implant related-factors including surgical techniques, implant design, and surface properties. The methods to enhance osseointegration of dental implants in low quality (type-IV bone are described in a general manner in this review.

Methods to Improve Osseointegration of Dental Implants in Low Quality (Type-IV) Bone: An Overview.

Science.gov (United States)

Alghamdi, Hamdan S

2018-01-13

Nowadays, dental implants have become more common treatment for replacing missing teeth and aim to improve chewing efficiency, physical health, and esthetics. The favorable clinical performance of dental implants has been attributed to their firm osseointegration, as introduced by Brånemark in 1965. Although the survival rate of dental implants over a 10-year observation has been reported to be higher than 90% in totally edentulous jaws, the clinical outcome of implant treatment is challenged in compromised (bone) conditions, as are frequently present in elderly people. The biomechanical characteristics of bone in aged patients do not offer proper stability to implants, being similar to type-IV bone (Lekholm & Zarb classification), in which a decreased clinical fixation of implants has been clearly demonstrated. However, the search for improved osseointegration has continued forward for the new evolution of modern dental implants. This represents a continuum of developments spanning more than 20 years of research on implant related-factors including surgical techniques, implant design, and surface properties. The methods to enhance osseointegration of dental implants in low quality (type-IV) bone are described in a general manner in this review.

Translocation of autogenous bone particles to improve peri-implant osteogenesis.

NARCIS (Netherlands)

Tabassum, A.; Walboomers, X.F.; Meijer, G.J.; Jansen, J.B.M.J.

2012-01-01

During the placement of titanium implants into bone, particles are loosened and translocated as a result of the inherent roughness of the surface. Such bone particles have been shown to play a significant role in new bone formation. Therefore, the aim of the present study was to establish a new

Comparison of marginal bone loss and implant success between axial and tilted implants in maxillary All-on-4 treatment concept rehabilitations after 5 years of follow-up.

Science.gov (United States)

Hopp, Milena; de Araújo Nobre, Miguel; Maló, Paulo

2017-10-01

There is need for more scientific and clinical information on longer-term outcomes of tilted implants compared to implants inserted in an axial position. Comparison of marginal bone loss and implant success after a 5-year follow-up between axial and tilted implants inserted for full-arch maxillary rehabilitation. The retrospective clinical study included 891 patients with 3564 maxillary implants rehabilitated according to the All-on-4 treatment concept. The follow-up time was 5 years. Linear mixed-effect models were performed to analyze the influence of implant orientation (axial/tilted) on marginal bone loss and binary logistic regression to assess the effect of patient characteristics on occurrence of marginal bone loss >2.8 mm. Only those patients with measurements of at least one axial and one tilted implant available were analyzed. This resulted in a data set of 2379 implants (1201 axial, 1178 tilted) in 626 patients (=reduced data set). Axial and tilted implants showed comparable mean marginal bone losses of 1.14 ± 0.71 and 1.19 ± 0.82 mm, respectively. Mixed model analysis indicated that marginal bone loss levels at 5 years follow up was not significantly affected by the orientation (axial/tilted) of the implants in the maxillary bone. Smoking and female gender were associated with marginal bone loss >2.8 mm in a logistic regression analysis. Five-year implant success rates were 96%. The occurrence of implant failure showed to be statistically independent from orientation. Within the limitations of this study and considering a follow-up time of 5 years, it can be concluded that tilted implants behave similarly with regards to marginal bone loss and implant success in comparison to axial implants in full-arch rehabilitation of the maxilla. Longer-term outcomes (10 years +) are needed to verify this result. © 2017 Wiley Periodicals, Inc.

Osteogenic protein-1 increases the fixation of implants grafted with morcellised bone allograft and ProOsteon bone substitute: an experimental study in dogs

DEFF Research Database (Denmark)

Jensen, T B; Overgaard, S; Lind, M

2007-01-01

Impacted bone allograft is often used in revision joint replacement. Hydroxyapatite granules have been suggested as a substitute or to enhance morcellised bone allograft. We hypothesised that adding osteogenic protein-1 to a composite of bone allograft and non-resorbable hydroxyapatite granules...... (ProOsteon) would improve the incorporation of bone and implant fixation. We also compared the response to using ProOsteon alone against bone allograft used in isolation. We implanted two non-weight-bearing hydroxyapatite-coated implants into each proximal humerus of six dogs, with each implant...... surrounded by a concentric 3 mm gap. These gaps were randomly allocated to four different procedures in each dog: 1) bone allograft used on its own; 2) ProOsteon used on its own; 3) allograft and ProOsteon used together; or 4) allograft and ProOsteon with the addition of osteogenic protein-1. After three...

Estimating the benefit of a second bone anchored hearing implant in unilaterally implanted users with a testband.

OpenAIRE

Kompis, Martin; Kurz, Anja; Flynn, Mark; Caversaccio, Marco

2016-01-01

Conclusion Using a second bone anchored hearing implant (BAHI) mounted on a testband in unilaterally implanted BAHI users to test its potential advantage pre-operatively under-estimates the advantage of two BAHIs placed on two implants. Objectives To investigate how well speech understanding with a second BAHI mounted on a testband approaches the benefit of bilaterally implanted BAHIs. Method Prospective study with 16 BAHI users. Eight were implanted unilaterally (group A) and eight were impl...

Influence of bioactive material coating of Ti dental implant surfaces on early healing and osseointegration of bone

International Nuclear Information System (INIS)

Yeo, In-Sung; Min, Seung-Ki; An, Young-Bai

2010-01-01

The dental implant surface type is one of many factors that determine the long-term clinical success of implant restoration. The implant surface consists of bioinert titanium oxide, but recently coatings with bioactive calcium phosphate ceramics have often been used on Ti implant surfaces. Bio-active surfaces are known to significantly improve the healing time of the human bone around the inserted dental implant. In this study, we characterized two types of coated implant surfaces by scanning electron microscopy, energy dispersive spectrometry, and surface roughness testing. The effect of surface modification on early bone healing was then tested by using the rabbit tibia model to measure bone-to-implant contact ratios and removal torque values. These modified surfaces showed different characteristics in terms of surface topography, chemical composition, and surface roughness. However, no significant differences were found in the bone-to-implant contact and the resistance to removal torque between these surfaces. Both the coated implants may induce similar favorable early bone responses in terms of the early functioning and healing of dental implants even though they differed in their surface characteristics.

Preliminary audiologic and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device: A systematic review.

Science.gov (United States)

Bezdjian, Aren; Bruijnzeel, Hanneke; Daniel, Sam J; Grolman, Wilko; Thomeer, Hans G X M

2017-10-01

To delineate the auditory functional improvement and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device. Eligible articles presenting patients implanted with the Sophono™ were identified through a comprehensive search of PubMed and Embase electronic databases. All relevant articles were reviewed to justify inclusion independently by 2 authors. Studies that successfully passed critical appraisal for directness of evidence and risk of bias were included. From a total of 125 articles, 8 studies encompassing 86 patients using 99 implants were selected. Most patients (79.1%) were children. Ear atresia (67.5%) was the most frequently reported indication for Sophono™ implantation. Overall pure tone average auditory improvement was 31.10 (±8.29) decibel. During a mean follow-up time of 12.48 months, 25 patients (29%) presented with post-operative complications from which 3 were deemed as serious implant-related adverse events (3.5%). The Sophono™ transcutaneous bone conduction device shows promising functional improvement, no intra-operative complications and minor post-operative skin related complications. If suitable, the device could be a proposed solution for the rehabilitation of hearing in children meeting eligibility criteria. A wearing schedule must be implemented in order to reduce magnet-related skin complications. Copyright © 2017 Elsevier B.V. All rights reserved.

Peri-Implant Bone Loss and Peri-Implantitis: A Report of Three Cases and Review of the Literature

Directory of Open Access Journals (Sweden)

Vanchit John

2016-01-01

Full Text Available Dental implant supported restorations have been added substantially to the clinical treatment options presented to patients. However, complications with these treatment options also arise due to improper patient selection and inadequate treatment planning combined with poor follow-up care. The complications related to the presence of inflammation include perimucositis, peri-implant bone loss, and peri-implantitis. Prevalence rates of these complications have been reported to be as high as 56%. Treatment options that have been reported include nonsurgical therapy, the use of locally delivered and systemically delivered antibiotics, and surgical protocols aimed at regenerating the lost bone and soft tissue around the implants. The aim of this article is to report on three cases and review some of the treatment options used in their management.

Volumetric quantification of bone-implant contact using micro-computed tomography analysis based on region-based segmentation.

Science.gov (United States)

Kang, Sung-Won; Lee, Woo-Jin; Choi, Soon-Chul; Lee, Sam-Sun; Heo, Min-Suk; Huh, Kyung-Hoe; Kim, Tae-Il; Yi, Won-Jin

2015-03-01

We have developed a new method of segmenting the areas of absorbable implants and bone using region-based segmentation of micro-computed tomography (micro-CT) images, which allowed us to quantify volumetric bone-implant contact (VBIC) and volumetric absorption (VA). The simple threshold technique generally used in micro-CT analysis cannot be used to segment the areas of absorbable implants and bone. Instead, a region-based segmentation method, a region-labeling method, and subsequent morphological operations were successively applied to micro-CT images. The three-dimensional VBIC and VA of the absorbable implant were then calculated over the entire volume of the implant. Two-dimensional (2D) bone-implant contact (BIC) and bone area (BA) were also measured based on the conventional histomorphometric method. VA and VBIC increased significantly with as the healing period increased (pimplants using micro-CT analysis using a region-based segmentation method.

Finite Element Analysis of Bone Stress for Miniscrew Implant Proximal to Root Under Occlusal Force and Implant Loading.

Science.gov (United States)

Shan, Li-Hua; Guo, Na; Zhou, Guan-jun; Qie, Hui; Li, Chen-Xi; Lu, Lin

2015-10-01

Because of the narrow interradicular spaces and varying oral anatomies of individual patients, there is a very high risk of root proximity during the mini implants inserting. The authors hypothesized that normal occlusal loading and implant loading affected the stability of miniscrew implants placed in proximity or contact with the adjacent root. The authors implemented finite element analysis (FEA) to examine the effectiveness of root proximity and root contact. Stress distribution in the bone was assessed at different degrees of root proximity by generating 4 finite element models: the implant touches the root surface, the implant was embedded in the periodontal membrane, the implant touches the periodontal surface, and the implant touches nothing. Finite element analysis was then carried out with simulations of 2 loading conditions for each model: condition A, involving only tooth loading and condition B, involving both tooth and implant loading. Under loading condition A, the maximum stress on the bone for the implant touching the root was the distinctly higher than that for the other models. For loading condition B, peak stress areas for the implant touching the root were the area around the neck of the mini implant and the point of the mini implant touches the root. The results of this study suggest that normal occlusal loading and implant loading contribute to the instability of the mini implant when the mini implant touches the root.

Clinical Parameters and Crestal Bone Loss in Internal Versus External Hex Implants at One Year after Loading

Directory of Open Access Journals (Sweden)

HamidReza Arab

2015-09-01

Full Text Available Introduction: The survival of an implant system is affected by the choice of antirotational design, which can include an external or internal hex. Implant success also is affected by the maintenance of the crestal bone around implants. The aim of present study was to evaluate the crestal bone loss and clinical parameters related to bone loss in patients loaded with an external or internal hex 3i implant (3i Implant Innovation, Palm Beach Gardens, FL, USA. The evaluations were performed one year after loading. Materials and Methods: A total of 39 implants (23 external hex, 16 internal hex were placed randomly in 23 patients (10 male, 13 female by a submerged approach. None of patients had compromised conditions or parafunctional habits. At placement and at one year after loading, periapical radiographs were taken via the parallel method from the implant sites. Results: Crestal bone loss was -0.712±0.831 mm in implants with an internal hex connection and -0.139±0.505 mm in implants with an external hex connection (P≤0.05. No correlation was found between crestal bone loss and parameters such as age, gender, jaw, implant location (anterior, premolar, or molar, implant diameter, or implant length. Conclusions: Crestal bone loss was greater in patients with internal hex 3i implants than in those with external implants. Similar results in other clinical factors were found between the groups.

Abutment height influences the effect of platform switching on peri-implant marginal bone loss.

Science.gov (United States)

Galindo-Moreno, Pablo; León-Cano, Ana; Monje, Alberto; Ortega-Oller, Inmaculada; O'Valle, Francisco; Catena, Andrés

2016-02-01

The purpose was to radiographically analyze and compare the marginal bone loss (MBL) between implants with different mismatching distance and to study the influence of the prosthetic abutment height on the MBL in association with the related mismatching distances. This retrospective study included 108 patients in whom 228 implants were placed, 180 with diameter of 4.5 mm and 48 with diameter of 5 mm. All patients received OsseoSpeed™ implants with internal tapered conical connection (Denstply Implants). Different mismatching distances were obtained, given that all implants were loaded with the same uni-abutment type (Lilac; Denstply Implants). Data were gathered on age, gender, bone substratum, smoking habits, previous history of periodontitis, and prosthetic features. MBL was analyzed radiographically at 6 and 18 months post-loading. Mixed linear analysis of mesial and distal MBL values yielded significant effects of abutment, implant diameter, follow-up period, bone substratum, smoking, and abutment × time interaction. MBL was greater at 18 vs. 6 months, for short vs. long abutments, for grafted vs. pristine bone, for a heavier smoking habit, and for implants with a diameter of 5.0 vs. 4.5 mm. Greater mismatching does not minimize the MBL; abutment height, smoking habit, and bone substratum may play a role in the MBL over the short- and medium term. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Laser-Modified Surface Enhances Osseointegration and Biomechanical Anchorage of Commercially Pure Titanium Implants for Bone-Anchored Hearing Systems

Science.gov (United States)

Omar, Omar; Simonsson, Hanna; Palmquist, Anders; Thomsen, Peter

2016-01-01

Osseointegrated implants inserted in the temporal bone are a vital component of bone-anchored hearing systems (BAHS). Despite low implant failure levels, early loading protocols and simplified procedures necessitate the application of implants which promote bone formation, bone bonding and biomechanical stability. Here, screw-shaped, commercially pure titanium implants were selectively laser ablated within the thread valley using an Nd:YAG laser to produce a microtopography with a superimposed nanotexture and a thickened surface oxide layer. State-of-the-art machined implants served as controls. After eight weeks’ implantation in rabbit tibiae, resonance frequency analysis (RFA) values increased from insertion to retrieval for both implant types, while removal torque (RTQ) measurements showed 153% higher biomechanical anchorage of the laser-modified implants. Comparably high bone area (BA) and bone-implant contact (BIC) were recorded for both implant types but with distinctly different failure patterns following biomechanical testing. Fracture lines appeared within the bone ~30–50 μm from the laser-modified surface, while separation occurred at the bone-implant interface for the machined surface. Strong correlations were found between RTQ and BIC and between RFA at retrieval and BA. In the endosteal threads, where all the bone had formed de novo, the extracellular matrix composition, the mineralised bone area and osteocyte densities were comparable for the two types of implant. Using resin cast etching, osteocyte canaliculi were observed directly approaching the laser-modified implant surface. Transmission electron microscopy showed canaliculi in close proximity to the laser-modified surface, in addition to a highly ordered arrangement of collagen fibrils aligned parallel to the implant surface contour. It is concluded that the physico-chemical surface properties of laser-modified surfaces (thicker oxide, micro- and nanoscale texture) promote bone bonding

High resolution X-ray imaging of bone-implant interface by large area flat-panel detector

International Nuclear Information System (INIS)

Kytyr, D; Jirousek, O; Dammer, J

2011-01-01

The aim of the research was to investigate the cemented bone-implant interface behavior (cement layer degradation and bone-cement interface debonding) with emphasis on imaging techniques suitable to detect the early defects in the cement layer. To simulate in vivo conditions a human pelvic bone was implanted with polyurethane acetabular cup using commercial acrylic bone cement. The implanted cup was then loaded in a custom hip simulator to initiate fatigue crack propagation in the bone cement. The pelvic bone was then repetitively scanned in a micro-tomography device. Reconstructed tomography images showed failure processes that occurred in the cement layer during the first 250,000 cycles. A failure in cemented acetabular implant - debonding, crumbling and smeared cracks - has been found to be at the bone-cement interface. Use of micro-focus source and high resolution flat panel detector of large physical dimensions allowed to reconstruct the micro-structural models suitable for investigation of migration, micro-motions and consecutive loosening of the implant. The large area flat panel detector with physical dimensions 120 x 120mm with 50μm pixel size provided a superior image quality compared to clinical CT systems with 300-150μm pixel size.

Radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthreaded implants using digitized panoramic radiographs.

Science.gov (United States)

Nickenig, Hans-Joachim; Wichmann, Manfred; Schlegel, Karl Andreas; Nkenke, Emeka; Eitner, Stephan

2009-06-01

The purpose of this split-mouth study was to compare macro- and microstructure implant surfaces at the marginal bone level during a stress-free healing period and under functional loading. From January to February 2006, 133 implants (70 rough-surfaced microthreaded implants and 63 machined-neck implants) were inserted in the mandible of 34 patients with Kennedy Class I residual dentitions and followed until February 2008. The marginal bone level was radiographically determined, using digitized panoramic radiographs, at four time points: at implant placement (baseline level), after the healing period, after 6 months of functional loading, and at the end of follow-up. The median follow-up time was 1.9 (range: 1.9-2.1) years. The machined-neck group had a mean crestal bone loss of 0.5 mm (range: 0-2.3) after the healing period, 0.8 mm after 6 months (range: 0-2.4), and 1.1 mm (range: 0-3) at the end of follow-up. The rough-surfaced microthreaded implant group had a mean bone loss of 0.1 mm (range: -0.4-2) after the healing period, 0.4 mm (range: 0-2.1) after 6 months, and 0.5 mm (range: 0-2.1) at the end of follow-up. The two implant types showed significant differences in marginal bone levels (healing period: P=0.01; end of follow-up: Pimplants showed that implants with the microthreaded design caused minimal changes in crestal bone levels during healing (stress-free) and under functional loading.

Healing of extraction sockets filled with BoneCeramic® prior to implant placement: preliminary histological findings.

Science.gov (United States)

De Coster, Peter; Browaeys, Hilde; De Bruyn, Hugo

2011-03-01

Various grafting materials have been designed to minimize edentulous ridge volume loss following tooth extraction by encouraging new bone formation in healing sockets. BoneCeramic® is a composite of hydroxyapatite and bèta-tricalcium phosphate with pores of 100-500 microns. The aim of this study was to evaluate bone regeneration in healing sockets substituted with BoneCeramic® prior to implant procedures. Fifteen extraction sockets were substituted with BoneCeramic® and 14 sockets were left to heal naturally in 10 patients (mean age 59.6 years). Biopsies were collected only from the implant recipient sites during surgery after healing periods ranging from 6-74 weeks (mean 22). In total, 24 biopsies were available; 10 from substituted and 14 from naturally healed sites. In one site, the implant was not placed intentionally and, in four substituted sites, implant placement had to be postponed due to inappropriate healing, hence from five sites biopsies were not available. Histological sections were examined by transmitted light microscope. At the time of implant surgery, bone at substituted sites was softer than in controls, compromising initial implant stability. New bone formation at substituted sites was consistently poorer than in controls, presenting predominantly loose connective tissue and less woven bone. The use of BoneCeramic® as a grafting material in fresh extraction sockets appears to interfere with normal healing processes of the alveolar bone. On the basis of the present preliminary findings, its indication as a material for bone augmentation, when implant placement is considered within 6-38 weeks after extraction, should be revised. © 2009, Copyright the Authors. Journal Compilation © 2011, Wiley Periodicals, Inc.

Volumetric quantification of bone-implant contact using micro-computed tomography analysis based on region-based segmentation

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Kang, Sung Won; Lee, Woo Jin; Choi, Soon Chul; Lee, Sam Sun; Heo, Min Suk; Huh, Kyung Hoe; Kim, Tae Il; Yi, Won Ji [Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

2015-03-15

We have developed a new method of segmenting the areas of absorbable implants and bone using region-based segmentation of micro-computed tomography (micro-CT) images, which allowed us to quantify volumetric bone-implant contact (VBIC) and volumetric absorption (VA). The simple threshold technique generally used in micro-CT analysis cannot be used to segment the areas of absorbable implants and bone. Instead, a region-based segmentation method, a region-labeling method, and subsequent morphological operations were successively applied to micro-CT images. The three-dimensional VBIC and VA of the absorbable implant were then calculated over the entire volume of the implant. Two-dimensional (2D) bone-implant contact (BIC) and bone area (BA) were also measured based on the conventional histomorphometric method. VA and VBIC increased significantly with as the healing period increased (p<0.05). VBIC values were significantly correlated with VA values (p<0.05) and with 2D BIC values (p<0.05). It is possible to quantify VBIC and VA for absorbable implants using micro-CT analysis using a region-based segmentation method.

Volumetric quantification of bone-implant contact using micro-computed tomography analysis based on region-based segmentation

International Nuclear Information System (INIS)

Kang, Sung Won; Lee, Woo Jin; Choi, Soon Chul; Lee, Sam Sun; Heo, Min Suk; Huh, Kyung Hoe; Kim, Tae Il; Yi, Won Ji

2015-01-01

We have developed a new method of segmenting the areas of absorbable implants and bone using region-based segmentation of micro-computed tomography (micro-CT) images, which allowed us to quantify volumetric bone-implant contact (VBIC) and volumetric absorption (VA). The simple threshold technique generally used in micro-CT analysis cannot be used to segment the areas of absorbable implants and bone. Instead, a region-based segmentation method, a region-labeling method, and subsequent morphological operations were successively applied to micro-CT images. The three-dimensional VBIC and VA of the absorbable implant were then calculated over the entire volume of the implant. Two-dimensional (2D) bone-implant contact (BIC) and bone area (BA) were also measured based on the conventional histomorphometric method. VA and VBIC increased significantly with as the healing period increased (p<0.05). VBIC values were significantly correlated with VA values (p<0.05) and with 2D BIC values (p<0.05). It is possible to quantify VBIC and VA for absorbable implants using micro-CT analysis using a region-based segmentation method.

Metals for bone implants. Part 1. Powder metallurgy and implant rendering.

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Andani, Mohsen Taheri; Shayesteh Moghaddam, Narges; Haberland, Christoph; Dean, David; Miller, Michael J; Elahinia, Mohammad

2014-10-01

New metal alloys and metal fabrication strategies are likely to benefit future skeletal implant strategies. These metals and fabrication strategies were looked at from the point of view of standard-of-care implants for the mandible. These implants are used as part of the treatment for segmental resection due to oropharyngeal cancer, injury or correction of deformity due to pathology or congenital defect. The focus of this two-part review is the issues associated with the failure of existing mandibular implants that are due to mismatched material properties. Potential directions for future research are also studied. To mitigate these issues, the use of low-stiffness metallic alloys has been highlighted. To this end, the development, processing and biocompatibility of superelastic NiTi as well as resorbable magnesium-based alloys are discussed. Additionally, engineered porosity is reviewed as it can be an effective way of matching the stiffness of an implant with the surrounding tissue. These porosities and the overall geometry of the implant can be optimized for strain transduction and with a tailored stiffness profile. Rendering patient-specific, site-specific, morphology-specific and function-specific implants can now be achieved using these and other metals with bone-like material properties by additive manufacturing. The biocompatibility of implants prepared from superelastic and resorbable alloys is also reviewed. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Electropolished Titanium Implants with a Mirror-Like Surface Support Osseointegration and Bone Remodelling

Directory of Open Access Journals (Sweden)

Cecilia Larsson Wexell

2016-01-01

Full Text Available This work characterises the ultrastructural composition of the interfacial tissue adjacent to electropolished, commercially pure titanium implants with and without subsequent anodisation, and it investigates whether a smooth electropolished surface can support bone formation in a manner similar to surfaces with a considerably thicker surface oxide layer. Screw-shaped implants were electropolished to remove all topographical remnants of the machining process, resulting in a thin spontaneously formed surface oxide layer and a smooth surface. Half of the implants were subsequently anodically oxidised to develop a thickened surface oxide layer and increased surface roughness. Despite substantial differences in the surface physicochemical properties, the microarchitecture and the composition of the newly formed bone were similar for both implant surfaces after 12 weeks of healing in rabbit tibia. A close spatial relationship was observed between osteocyte canaliculi and both implant surfaces. On the ultrastructural level, the merely electropolished surface showed the various stages of bone formation, for example, matrix deposition and mineralisation, entrapment of osteoblasts within the mineralised matrix, and their morphological transformation into osteocytes. The results demonstrate that titanium implants with a mirror-like surface and a thin, spontaneously formed oxide layer are able to support bone formation and remodelling.

Retrospective analysis of survival rates and marginal bone loss on short implants in the mandible.

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Draenert, Florian G; Sagheb, Keyvan; Baumgardt, Katharina; Kämmerer, Peer W

2012-09-01

Short implants have become an interesting alternative to bone augmentation in dental implantology. Design of shorter implants and longer surveillance times are a current research issue. The goal of this study was to show the survival rates of short implants below 9 mm in the partly edentulous mandibular premolar and molar regions with fixed prosthetics. Marginal vertical and 2D bone loss was evaluated additionally. Different implant designs are orientationally evaluated. A total of 247 dental implants with fixed prosthetics (crowns and bridges) in the premolar and molar region of the mandible were evaluated; 47 implants were 9 mm or shorter. Patient data were evaluated to acquire implant survival rates, implant diameter, gender and age. Panoramic X-rays were analysed for marginal bone loss. Average surveillance time was 1327 days. Cumulative survival rate (CSR) of short implants was 98% (1 implants lost) compared to 94% in the longer implants group without significance. Thirty-five of the short implants were Astratech (0 losses) and 12 were Camlog Screw Line Promote Plus (1 loss). Early vertical and two-dimensional marginal bone loss was not significantly different in short and regular length implant group with an average of 0.6 mm and 0.7 mm(2) in short implants over the observation period. Within the limitations of this study, we conclude that short implants with a length of 9 mm or less have equal survival rates compared with longer implants over the observation period of 1-3 years. © 2011 John Wiley & Sons A/S.

Vitamin E Phosphate Coating Stimulates Bone Deposition in Implant-related Infections in a Rat Model.

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Lovati, Arianna B; Bottagisio, Marta; Maraldi, Susanna; Violatto, Martina B; Bortolin, Monica; De Vecchi, Elena; Bigini, Paolo; Drago, Lorenzo; Romanò, Carlo L

2018-06-01

Implant-related infections are associated with impaired bone healing and osseointegration. In vitro antiadhesive and antibacterial properties and in vivo antiinflammatory effects protecting against bone loss of various formulations of vitamin E have been demonstrated in animal models. However, to the best of our knowledge, no in vivo studies have demonstrated the synergistic activity of vitamin E in preventing bacterial adhesion to orthopaedic implants, thus supporting the bone-implant integration. The purpose of this study was to test whether a vitamin E phosphate coating on titanium implants may be able to reduce (1) the bacterial colonization of prosthetic implants and (2) bone resorption and osteomyelitis in a rat model of Staphylococcus aureus-induced implant-related infection. Twelve rats were bilaterally injected in the femurs with S aureus UAMS-1-Xen40 and implanted with uncoated or vitamin E phosphate-coated titanium Kirschner wires without local or systemic antibiotic prophylaxis. Eight rats represented the uninfected control group. A few hours after surgery, two control and three infected animals died as a result of unexpected complications. With the remaining rats, we assessed the presence of bacterial contamination with qualitative bioluminescence imaging and Gram-positive staining and with quantitative bacterial count. Bone changes in terms of resorption and osteomyelitis were quantitatively analyzed through micro-CT (bone mineral density) and semiquantitatively through histologic scoring systems. Six weeks after implantation, we found only a mild decrease in bacterial count in coated versus uncoated implants (Ti versus controls: mean difference [MD], -3.705; 95% confidence interval [CI], -4.416 to -2.994; p E-treated group compared with uncoated implants (knee joint: MD, -11.88; 95% CI, -16.100 to -7.664; p E-coated nails compared with the uncoated nails. These preliminary findings indicate that vitamin E phosphate implant coatings can exert a

Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws.

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Carlsson, Gunnar E

2014-08-01

To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws

Science.gov (United States)

2014-01-01

PURPOSE To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results. PMID:25177466

Adapted preparation technique for screw-type implants: explorative in vitro pilot study in a porcine bone model.

Science.gov (United States)

Beer, Andreas; Gahleitner, André; Holm, Anders; Birkfellner, Wolfgang; Homolka, Peter

2007-02-01

The aim of this study was to quantify the effect of adapted preparation on the insertion torque of self-tapping implants in cancellous bone. In adapted preparation, bone condensation - and thus, insertion torque - is controlled by changing the diameter of the drilling. After preparation of cancellous porcine vertebral bone with drills of 2.85, 3, 3.15 or 3.35 mm final diameters, Brånemark sytem Mk III implants (3.75 x 11.5 mm) were inserted in 141 sites. During implantation, the insertion torque was recorded. Prior to implant insertion, bone mineralization (bone mineral density (BMD)) was measured with dental quantative computed tomography. The BMD values measured at the implant position were correlated with insertion torque for varying bone condensation. Based on the average torque recorded during implant insertion into the pre-drilled canals with a diameter of 3 mm, torque increased by approximately 17% on reducing the diameter of the drill by 5% (to 2.85 mm). On increasing the diameter of the osteotomy to 3.15 mm (5%) or 3.35 mm (12%), torque values decreased by approximately 21% and 50%, respectively. The results demonstrate a correlation between primary stability (average insertion torque) and the diameter of the implant bed on using a screw-shaped implant. Thus, using an individualized bone mineralization-dependent drilling technique, optimized torque values could be achieved in all tested bone qualities with BMDs ranging from 330 to 500 mg/cm(3). The results indicate that using a bone-dependent drilling technique, higher torque values can also be achieved in poor bone using an individualized drilling resulting in higher bone condensation. As immediate function is dependent on primary stability (high insertion torque), this indicates that primary stability can be increased using a modified drilling technique in lesser mineralized bone.

Peri-Implant Crestal Bone Loss: A Putative Mechanism

Directory of Open Access Journals (Sweden)

Yuko Ujiie

2012-01-01

Full Text Available Purpose. The immunological mechanisms of peri-implant crestal bone loss have, hitherto, not been elucidated. We hypothesized that bacterial products from the microgap cause upregulation of cytokines in otherwise healthy peri-implant cells, which results in osteoclast formation and, ultimately, in bone resorption. Materials and Methods. We used RT-PCR and ELISA to assay mediators of osteoclastogenesis in rat and human macrophages (r-and hMO; bone marrow derived stromal cells (r-and hBMCs; and human gingival fibroblasts (hGF—with or without stimulation by LPS. TRAP positive multinucleate cells were assessed for their resorptive ability. Results. We show that IL-1α, IL-1β, and IL-6 were expressed by all examined cell types, and TNF-α was upregulated in hGF. Secretion of IL-1α and IL-1β proteins was stimulated in hMO by LPS, and IL-6 protein secretion was highly stimulated in hBMCs and hGF. Both LPS and RANKL stimulated macrophages to form osteoclast-like TRAP positive cells, which resorbed calcium phosphate substrates. Conclusion. Taken together, the results of our study support the hypothesis that bacterial endotoxins upregulate enhanced mediators of osteoclastogenesis in resident cells found in the healthy peri-implant compartment and that the local synergistic action of cytokines secreted by such cells results in the genesis of resorptively active osteoclasts.

The clinical study of the early soft tissue healing and marginal bone resorption after non-submerged implants

International Nuclear Information System (INIS)

Xu Anchen; Yang Desheng; Hu Bei; Leng Bin; Zhang Li

2009-01-01

Objective: To compare the amount of early marginal bone resorption in the first three months after non-submerged implants and to explore the relationship between the amount of early marginal bone resorption and the soft tissue healing in the first month. Method: ITI with non-submerged implants were implanted in 33 patients. Digital panoramic radiographs were taken during the operation, one month and three months later. The amount of marginal bone resorption was measured in the first, second and the third month after implant operation. The soft tissue healing was observed after 10 days. Results: There was significant difference (P<0.01) in the amount of early marginal bone resorption between one month and three months later. The early marginal bone resorption in the first month after implantation kept correlation with the soft tissue healing on 10th day(r=0.794, P<0.01). Conclusion: The amount of early marginal bone resorption in the first month exceeds that in the second and the third months after implant operation, and the soft tissue healing affects the amount of early marginal bone resorption in the first month. Biological seal is the critical factor influencing the early marginal bone resorption. (authors)

A comparative study of zirconium and titanium implants in rat: osseointegration and bone material quality.

Science.gov (United States)

Hoerth, Rebecca M; Katunar, María R; Gomez Sanchez, Andrea; Orellano, Juan C; Ceré, Silvia M; Wagermaier, Wolfgang; Ballarre, Josefina

2014-02-01

Permanent metal implants are widely used in human medical treatments and orthopedics, for example as hip joint replacements. They are commonly made of titanium alloys and beyond the optimization of this established material, it is also essential to explore alternative implant materials in view of improved osseointegration. The aim of our study was to characterize the implant performance of zirconium in comparison to titanium implants. Zirconium implants have been characterized in a previous study concerning material properties and surface characteristics in vitro, such as oxide layer thickness and surface roughness. In the present study, we compare bone material quality around zirconium and titanium implants in terms of osseointegration and therefore characterized bone material properties in a rat model using a multi-method approach. We used light and electron microscopy, micro Raman spectroscopy, micro X-ray fluorescence and X-ray scattering techniques to investigate the osseointegration in terms of compositional and structural properties of the newly formed bone. Regarding the mineralization level, the mineral composition, and the alignment and order of the mineral particles, our results show that the maturity of the newly formed bone after 8 weeks of implantation is already very high. In conclusion, the bone material quality obtained for zirconium implants is at least as good as for titanium. It seems that the zirconium implants can be a good candidate for using as permanent metal prosthesis for orthopedic treatments.

Potential Bone to Implant Contact Area of Short Versus Standard Implants: An In Vitro Micro-Computed Tomography Analysis.

Science.gov (United States)

Quaranta, Alessandro; DʼIsidoro, Orlando; Bambini, Fabrizio; Putignano, Angelo

2016-02-01

To compare the available potential bone-implant contact (PBIC) area of standard and short dental implants by micro-computed tomography (μCT) assessment. Three short implants with different diameters (4.5 × 6 mm, 4.1 × 7 mm, and 4.1 × 6 mm) and 2 standard implants (3.5 × 10 mm and 3.3 × 9 mm) with diverse design and surface features were scanned with μCT. Cross-sectional images were obtained. Image data were manually processed to find the plane that corresponds to the most coronal contact point between the crestal bone and implant. The available PBIC was calculated for each sample. Later on, the cross-sectional slices were processed by a 3-dimensional (3D) software, and 3D images of each sample were used for descriptive analysis and display the microtopography and macrotopography. The wide-diameter short implant (4.5 × 6 mm) showed the higher PBIC (210.89 mm) value followed by the standard (178.07 mm and 185.37 mm) and short implants (130.70 mm and 110.70 mm). Wide-diameter short implants show a surface area comparable with standard implants. Micro-CT analysis is a promising technique to evaluate surface area in dental implants with different macrodesign, microdesign, and surface features.

Pedicle screws with a thin hydroxyapatite coating for improving fixation at the bone-implant interface in the osteoporotic spine: experimental study in a porcine model.

Science.gov (United States)

Ohe, Makoto; Moridaira, Hiroshi; Inami, Satoshi; Takeuchi, Daisaku; Nohara, Yutaka; Taneichi, Hiroshi

2018-03-30

OBJECTIVE Instrumentation failure caused by the loosening of pedicle screws (PSs) in patients with osteoporosis is a serious problem after spinal surgery. The addition of a thin hydroxyapatite (HA) surface coating applied by using a sputtering process was reported recently to be a promising method for providing bone conduction around an implant without a significant risk of coating-layer breakage. In this study, the authors evaluated the biomechanical and histological features of the bone-implant interface (BII) of PSs with a thin HA coating in an in vivo porcine osteoporotic spine model. METHODS Three types of PSs (untreated/standard [STPS], sandblasted [BLPS], and HA-coated [HAPS] PSs) were implanted into the thoracic and lumbar spine (T9-L6) of 8 mature Clawn miniature pigs (6 ovariectomized [osteoporosis group] and 2 sham-operated [control group] pigs). The spines were harvested from the osteoporosis group at 0, 2, 4, 8, 12, or 24 weeks after PS placement and from the control group at 0 or 24 weeks. Their bone mineral density (BMD) was measured by peripheral quantitative CT. Histological evaluation of the BIIs was conducted by performing bone volume/tissue volume and bone surface/implant surface measurements. The strength of the BII was evaluated with extraction torque testing. RESULTS The BMD decreased significantly in the osteoporosis group (p < 0.01). HAPSs exhibited the greatest mean extraction peak torque at 8 weeks, and HAPSs and BLPSs exhibited significantly greater mean torque than the STPSs at 12 weeks (p < 0.05). The bone surface/implant surface ratio was significantly higher for HAPSs than for STPSs after 2 weeks (p < 0.05), and bonding between bone and the implant surface was maintained until 24 weeks with no detachment of the coating layer. In contrast, the bone volume/tissue volume ratio was significantly higher for HAPSs than for BLPSs or STPSs only at 4 weeks. CONCLUSIONS Using PSs with a thin HA coating applied using a sputtering process

Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis.

Science.gov (United States)

Hong, Hae Ryong; Pae, Ahran; Kim, Yooseok; Paek, Janghyun; Kim, Hyeong-Seob; Kwon, Kung-Rock

2012-01-01

The aim of this study was to analyze and compare the level and distribution of peri-implant bone stresses associated with mandibular two-implant overdentures with different implant positions. Mathematical models of mandibles and overdentures were designed using finite element analysis software. Two intraosseous implants and ball attachment systems were placed in the interforaminal region. The overdenture, which was supported by the two implants, was designed to withstand bilateral and unilateral vertical masticatory loads (total 100 N). In all, eight types of models, which differed according to assigned implant positions, height of attachments, and angulation, were tested: MI (model with implants positioned in the lateral incisor sites), MC (implants in canine sites), MP (implants in premolar sites), MI-Hi (greater height of attachments), MC-M (canine implants placed with mesial inclination), MC-D (canine implants placed with distal inclination), MC-B (canine implants placed with buccal inclination), and MC-L (canine implants placed with lingual inclination). Peri-implant bone stress levels associated with overdentures retained by lateral incisor implants resulted in the lowest stress levels and the highest efficiency in distributing peri-implant stress. MI-Hi showed increased stress levels and decreased efficiency in stress distribution. As the implants were inclined, stress levels increased and the efficiency of stress distribution decreased. Among the inclined models, MC-B showed the lowest stress level and best efficiency in stress distribution. The lowest stress and the best stability of implants in mandibular two-implant overdentures were obtained when implants were inserted in lateral incisor areas with shorter attachments and were placed parallel to the long axes of the teeth.

A new classification of peri-implant bone morphology: a radiographic study of patients with lower implant-supported mandibular overdentures

NARCIS (Netherlands)

Zhang, L.; Geraets, W.; Zhou, Y.; Wu, W.; Wismeijer, D.

2014-01-01

Objective This study aimed to classify peri-implant bone defects (PIBDs) on the basis of their radiographic appearance in a cohort of patients with lower implant-supported overdentures. Materials and methods Eighty-three patients with lower implant-supported overdentures were recruited to

Marginal bone loss and dental implant failure may be increased in smokers.

Science.gov (United States)

Veitz-Keenan, Analia

2016-03-01

An electronic search was performed in PubMed, Web of Science and the Cochrane Central Register of Controlled Trials up to February 2015. References of included studies were also searched. No language restrictions were applied. Study selection: Prospective, retrospective and randomised clinical trials that compared marginal bone loss and failure rates between smokers and non-smokers. Implant failure was considered as total loss of the implant. Studies with patients who had periodontal disease prior to treatment or who had metabolic diseases were excluded. Two reviewers were involved in the research and screening process and disagreements were resolved by discussion. The quality of the studies was analysed using the Newcastle-Ottawa scale for non-randomised clinical trials. Data extracted from the studies included, when available: follow up period, number of subjects, smoking status, number of implants placed, implant system, implant length and diameter, healing period, antibiotics and mouth-rinse use, marginal bone loss, failure rate and drop-outs. For binary outcomes (implant failure) the estimate of the intervention effect was expressed in the form of an odds ratio (OR) with the confidence interval (CI) of 95%. For continuous outcomes (marginal bone loss) the average and standard deviation (SD) were used to calculate the standardised mean difference with a 95% CI. Meta-analysis was performed for studies with similar outcomes, I(2) a statistical test was used to express the heterogeneity among the studies. Publication bias was explored as well. A total of 15 observational studies were included in the review. The number of participants ranged from 60 to 1727 and the average age was 52.5 years. The follow-up period ranged from eight to 240 months. The total number of implants placed was 5840 in smokers and 14,683 in non-smokers. The Branemak system, (Noble Biocare AB, Goteborg, Sweden), was the most commonly used implant system. There was a statistically significant

Time-dependent cytokine expression in bone of experimental animals after hydroxyapatite (Hap) implantation

International Nuclear Information System (INIS)

Pilmane, M; Salms, G; Salma, I; Skagers, A; Locs, J; Loca, D; Berzina-Cimdina, L

2011-01-01

Proinflammatory cytokines mediate bone loss around the implants in patients with peri-implant disease. However, there is no complete data about the expression of cytokines into the bone around the implants. The aim of this work was to investigate the distribution and appearance of inflammatory cytokines and anti-inflammatory proteins in the bone of jaw of experimental rabbits in different time periods after HAp implantation. Material was obtained from 8 rabbits in lower jaw 6 and 8 months after HAp implants were placed. Tissues were processed for immunohistochemical detection of tumor necrosis factor alfa (TNFα), Interleukin 1, 6, 8, 10 (IL-1, IL-6, IL-8, IL-10) and defensin 2. Results demonstrated practically unchanged expression of IL-6 and IL-10 between both - experimental and control side 6 months after implantation, while IL-1 and IL-8 notably increased in control side. IL-1 and IL-10 expression did not change in either the experimental side nor the controle side after 8 months HAP implantation, but IL-6 and IL-8 demonstrated a decrease in the control sites. Only IL-8 was elevated with time in experimental sites, while IL-10 showed individual variations in 2 cases.

Time-dependent cytokine expression in bone of experimental animals after hydroxyapatite (Hap) implantation

Energy Technology Data Exchange (ETDEWEB)

Pilmane, M [Riga Stradins University, Institute of Anatomy and Anthropology, Dzirciema 16, LV-1007, Riga (Latvia); Salms, G; Salma, I; Skagers, A [Riga Stradins University, Department of Oral and Maxillofacial Surgery, Dzirciema 20. LV-1007, Riga (Latvia); Locs, J; Loca, D; Berzina-Cimdina, L, E-mail: pilmane@latnet.lv [Riga Technical University, Riga Biomaterials innovation and development centre, Pulka 3/3, LV-1007, Riga (Latvia)

2011-06-23

Proinflammatory cytokines mediate bone loss around the implants in patients with peri-implant disease. However, there is no complete data about the expression of cytokines into the bone around the implants. The aim of this work was to investigate the distribution and appearance of inflammatory cytokines and anti-inflammatory proteins in the bone of jaw of experimental rabbits in different time periods after HAp implantation. Material was obtained from 8 rabbits in lower jaw 6 and 8 months after HAp implants were placed. Tissues were processed for immunohistochemical detection of tumor necrosis factor alfa (TNF{alpha}), Interleukin 1, 6, 8, 10 (IL-1, IL-6, IL-8, IL-10) and defensin 2. Results demonstrated practically unchanged expression of IL-6 and IL-10 between both - experimental and control side 6 months after implantation, while IL-1 and IL-8 notably increased in control side. IL-1 and IL-10 expression did not change in either the experimental side nor the controle side after 8 months HAP implantation, but IL-6 and IL-8 demonstrated a decrease in the control sites. Only IL-8 was elevated with time in experimental sites, while IL-10 showed individual variations in 2 cases.

3D perfusion bioreactor-activated porous granules on implant fixation and early bone formation in sheep.

Science.gov (United States)

Ding, Ming; Henriksen, Susan S; Martinetti, Roberta; Overgaard, Søren

2017-11-01

Early fixation of total joint arthroplasties is crucial for ensuring implant survival. An alternative bone graft material in revision surgery is needed to replace the current gold standard, allograft, seeing that the latter is associated with several disadvantages. The incubation of such a construct in a perfusion bioreactor has been shown to produce viable bone graft materials. This study aimed at producing larger amounts of viable bone graft material (hydroxyapatite 70% and β-tricalcium-phosphate 30%) in a novel perfusion bioreactor. The abilities of the bioreactor-activated graft material to induce early implant fixation were tested in a bilateral implant defect model in sheep, with allograft as the control group. Defects were bilaterally created in the distal femurs of the animals, and titanium implants were inserted. The concentric gaps around the implants were randomly filled with either allograft, granules, granules with bone marrow aspirate or bioreactor-activated graft material. Following an observation time of 6 weeks, early implant fixation and bone formation were assessed by micro-CT scanning, mechanical testing, and histomorphometry. Bone formations were seen in all groups, while no significant differences between groups were found regarding early implant fixation. The microarchitecture of the bone formed by the synthetic graft materials resembled that of allograft. Histomorphometry revealed that allograft induced significantly more bone and less fibrous tissue (p formation was observed in all groups, while the bioreactor-activated graft material did not reveal additional effects on early implant fixation comparable to allograft in this model. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2465-2476, 2017. © 2016 Wiley Periodicals, Inc.

Zygomatic bone graft for oral-antral communication closure and implant placement.

Science.gov (United States)

Peñarrocha-Diago, Miguel; García, Berta; Gomez, Dolores; Balaguer, José

2007-01-01

The roots of molar and premolar maxillary teeth are often very close to the floor of the maxillary sinus. As a result, extraction of these teeth can leave an oral-antral communication or lead to a fistula that requires treatment. A woman with an oral-antral communication secondary to extraction of a maxillary molar is presented. The communication was closed by means of a bone graft harvested from the wall of the sinus (zygomatic bone). After 3 months, 2 dental implants were placed, one in the pterygoid area and the other with parasinusal angulation. Rehabilitation followed in the form of a screw-retained, fixed prosthesis 3 months after implant placement. There have been no complications after 1 year of follow-up. This surgical technique allowed closure of an oral-antral communication produced by molar extraction through placement of a zygomatic bone graft and subsequent placement of 2 dental implants.

Esthetic evaluation of single-tooth implants in the anterior maxilla following autologous bone augmentation.

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Hof, M; Pommer, B; Strbac, G D; Sütö, D; Watzek, G; Zechner, W

2013-08-01

Autologous bone augmentation to rebuild compromised alveolar ridge contour prior to implant placement allows for favorable three-dimensional implant positioning to achieve optimum implant esthetics. The aim of the present study was to evaluate peri-implant soft tissue conditions around single-tooth implants following bone grafts in the esthetic zone of the maxilla. Sixty patients underwent autologous bone augmentation of deficient maxillary sites prior to placement of 85 implants in the esthetic zone. In case of multiple implants per patient, one implant was randomly selected. Objective evaluation of 60 single-tooth implants was performed using the Pink-Esthetic-Score (PES) and Papilla Index (PI) and supplemented by subjective patient evaluation, as well as clinical and radiologic examination. Objective ratings of implant esthetics were satisfactory (median PES: 11, median PI: 2) and significantly correlated with high patient satisfaction (mean VAS score: 80%). Both esthetic indices demonstrated respectable levels of inter- as well as intra-observer agreement. Poor implant esthetics (low PES and PI ratings) were significantly associated with increased anatomic crown height, while no influence of horizontal implant-tooth distance could be found. The present investigation indicates that favorable esthetic results may be achieved in the augmented anterior maxilla. However, bony reconstruction of compromised alveolar ridges does not guarantee optimum implant esthetics. © 2011 John Wiley & Sons A/S.

Clinical and Radiographic Assessment of Peri-Implant Tissue in Posterior Areas with and Without the Need for Guided Bone Regeneration

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Seyed Reza Arabi

2016-07-01

Full Text Available Background Dental implants are increasingly used in resorbed alveolar ridges, and the success of implants inserted concomitantly with guided bone regeneration (GBR needs to be evaluated. Objectives This study aimed to clinically and radiographically assess the peri-implant tissues in the posterior maxilla and mandible in cases in which dehiscence or fenestration occurred at the time of implant surgery and treated with GBR (simultaneously with implant placement in one session. A comparison was also made between the above-mentioned patients and controls in which implants were placed in intact bone (entire length of implant in bone. Patients and Methods This study was conducted on 12 patients as cases who received 17 standard implants (dehiscence or fenestration occurred after placement of 4 mm diameter standard implants and GBR was performed and 10 patients as the control group (those who received 17 standard implants, 4 mm in diameter and 10 mm in length, in adequate bone. Periapical (PA radiographs were obtained in the first 24 hours post-surgery. Radiographs were repeated at one month, at the time of loading (two months post-surgery, and at three and six months after loading to assess marginal bone loss. To assess the peri-implant soft tissue, thickness and width of the keratinized gingiva were evaluated. Data were analyzed using t-test and repeated measures analysis of variance. The level of significance was set to P = 0.05. Results The difference in distance from the bone crest to the implant shoulder between the two groups of cases and controls was significant at the following time points: baseline and 2 months post-surgery (P = 0.000, baseline and 6 months after loading (P = 0.01, 2 months post-surgery and 3 months after loading (P = 0.00, and 2 months post-surgery and 6 months after loading (P = 0.00. Changes in the width of the keratinized gingiva were not significant in the two groups of cases and controls at 2 months post-surgery (P = 0

Influence of Piezosurgery on Bone Healing around Titanium Implants: A Histological Study in Rats.

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Sirolli, Marcelo; Mafra, Carlos Eduardo Secco; Santos, Rodrigo Albuquerque Basílio Dos; Saraiva, Luciana; Holzhausen, Marinella; César, João Batista

2016-01-01

The aim of this study was to evaluate histomorphometrically the influence of two techniques of dental implant site preparation on bone healing around titanium implants. Fifteen male Wistar rats (±300 g) were used in the study. Each tibia was randomly assigned to receive the implant site preparation either with a conventional drilling technique (control - DRILL group) or with a piezoelectric device (PIEZO group). The animals were sacrificed after 30 days and then the following histomorphometric parameters were evaluated (percentage) separately for cortical and cancellous regions: proportion of mineralized tissue (PMT) adjacent to implant threads (500 μm adjacent); bone area within the threads (BA) and bone-implant contact (BIC). The results demonstrated that there were no statistically significant differences between both groups for cancellous BIC (p>0.05) and cortical PMT (p>0.05). On the other hand, a higher percentage of BA was observed in the PIEZO group in the cortical (71.50±6.91 and 78.28±4.38 for DRILL and PIEZO groups, respectively; ppiezosurgery also showed higher PMT values in the cancellous zone (9.35±5.54 and 18.72±13.21 for DRILL and PIEZO groups, respectively; ppiezosurgery was beneficial to bone healing rates in the cancellous bone region, while the drill technique produced better results in the cortical bone.

Assessment of activated porous granules on implant fixation and early bone formation in sheep

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Ming Ding

2016-04-01

Conclusion: In conclusion, despite nice bone formation and implant fixation in all groups, bioreactor activated graft material did not convincingly induce early implant fixation similar to allograft, and neither bioreactor nor by adding BMA credited additional benefit for bone formation in this model.

A 5-year clinical and computerized tomographic implant follow-up in sinus-lifted maxillae and native bone.

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Sbordone, Carolina; Toti, Paolo; Ramaglia, Luca; Guidetti, Franco; Sbordone, Ludovico; Martuscelli, Ranieri

2014-09-01

The present study analysed apical and marginal bone remodelling around dental implants placed in both maxillary (sinus elevated with particulated autogenous osseous graft) and corresponding native bone areas, with a follow-up of 5 years. The clinical survival of implants was also observed. In this retrospective chart review, 27 patients were enrolled, with 55 dental implants inserted from 2000 to 2006, 26 of which were followed (one implant per patient); if required, patients were treated via sinus lift with autogenous bone and particulate technique. The internal controls were implants positioned in native areas beneath the sinus. Radiologic survey was assessed via computerized tomographic analysis measuring apical bone level (ABL) and marginal bone level (MBL), at 1- (T1 ), 3- (T2 ) and 5 years (T3 ), around implants (buccal, b; palatal, p; mesial, m; and distal sides, d). Clinical probing depth (CPD) and clinical attachment level (CAL) for all the four peri-implant aspects were measured. Cumulative survival rate (CSR) and survival rate (SR) of implants were calculated. Significances for paired and unpaired comparisons were searched for. A significant degree of apical resorption was recorded between T1 and T3 for the mesial particulate group; again, a significant difference was discovered between the native and particulate procedures for mABL. A further feature was discovered for the particulate procedure, for which ABLs resulted negative at least for three of the aspects. Regarding MBL measurements, similar behaviours were revealed using time-comparison analysis for the two procedures at the buccal aspect. Comparisons among diameters, irrespective of the procedure, showed that resorption times for the bMBL were shorter as the diameter of the implant became wider. The implant CSR was 92% in native areas (two failures/25 implants) and 93.3% in sinuses lifted with particulate bone (two failures/30 implants). The results suggest that a protrusion of the implant

Dental Implant Surrounding Marginal Bone Level Evaluation: Platform Switching versus Platform Matching—One-Year Retrospective Study

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Eisner Salamanca

2017-01-01

Full Text Available The benefits and feasibility of platform switching have been discussed in several studies, reporting lesser crestal bone loss in platform-switched implants than in platform-matched implants. Objective. The aim of the present study was to observe the changes in vertical and horizontal marginal bone levels in platform-switched and platform-matched dental implants. Materials and Methods. 51 patients received 60 dental implants in the present study over a 1-year period. Measurement was performed between the implant shoulder and the most apical and horizontal marginal defect by periapical radiographs to examine the changes of peri-implant alveolar bone before and 12 months after prosthodontic restoration delivery. Results. These marginal bone measurements showed a bone gain of 0.23±0.58 mm in the vertical gap and 0.22±0.53 mm in the horizontal gap of platform matching, while in platform switching a bone gain of 0.93±1 mm (P<0.05 in the vertical gap and 0.50±0.56 mm in the horizontal gap was found. The average vertical gap reduction from the baseline until 12 months was 0.92±1.11 mm in platform switching and 0.29±0.85 mm in platform matching (P<0.05. Conclusions. Within the limitations of the present study, platform switching seemed to be more effective for a better peri-implant alveolar bone vertical and horizontal gap reduction at 1 year.

Autogenous bone graft and ePTFE membrane in the treatment of peri-implantitis. II. Stereologic and histologic observations in cynomolgus monkeys

DEFF Research Database (Denmark)

Schou, Søren; Holmstrup, Palle; Skovgaard, Lene Theil

2003-01-01

autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment......autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment...

Bone Implant Interface Investigation by Synchrotron Radiation X-Ray Microfluorescence

International Nuclear Information System (INIS)

Calasans-Maia, M.; Sales, E.; Lopes, R. T.; Granjeiro, J. M.; Lima, I.

2010-01-01

Zinc is known to play a relevant role in growth and development; it has stimulatory effects on in vitro and in vivo bone formation and an inhibitory effect on in vitro osteoclastic bone resorption. The inorganic component of the bone tissue is nonstoichiometric apatite; changes in the composition of hidroxyapatite are subject of studies in order to improve the tissue response after implantation. The objective of this study was to investigate the effect of 0.5% zinc-containing hydroxyapatite in comparison to hydroxyapatite on osseous repair of rabbit's tibia. Cylinders (2x6 mm) of both materials were produced according to the specification of the International Organization for Standardization. Ethics Commission on Teaching and Research in Animals approved this project (HUAP-195/06). Fifteen White New Zealand rabbits were submitted to general anesthesia and two perforations (2 mm) were made in each tibia for implantation of zinc-containing hydroxyapatite cylinders (left tibia) and hydroxyapatite cylinders (right tibia). After 1, 2 and 4 weeks, the animals were killed and one fragment of each tibia with the cylinder was collected and embedded in a methacrylate-based resin and cut into slices (∼200 μm thickness), parallel to the implant's long axis with a precision diamond saw for Synchrotron Radiation X-ray Microfluorescence investigation. The accomplishment of the standard procedures helped the planning, execution and the comparative analysis of the results. The chemical and physical properties of the biomaterials were modified after its implantation and the incorporation of zinc. Both materials are biocompatible and promote osteoconduction and favored bone repair.

Effect of microthreads on coronal bone healing of narrow-diameter implants with reverse-tapered design in beagle dogs.

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Chang, Yun-Young; Kim, Su-Hwan; Park, Keun-Oh; Yun, Jeong-Ho

2017-12-01

The objective of this study was to investigate the effect of microthreads on the coronal bone healing of narrow-diameter implants with reverse-tapered design. A total of 52 implants were classified into two groups according to presence or absence of coronal microthreads, the reverse-tapered narrow-diameter implant (RTN) group, and the reverse-tapered narrow-diameter implant with microthreads (RTNM) group. The implants were installed in split-mouth design in the edentulous mandible of six dogs. Three animals were sacrificed at 4 weeks and three at 8 weeks. Resonance frequency analysis, bone measurement using microcomputed tomography (micro-CT), removal torque test, and histometric analysis were performed. No significant differences in implant stability quotient value were observed between the groups at baseline, 4 weeks, or 8 weeks. Bone measurement using micro-CT showed that bone-implant contact volume (BICV) and bone-implant contact volume ratio (BICVR) in the coronal part of RTNM were statistically higher than those in RTN at 4 and 8 weeks. Histometric analysis showed statistically higher bone-implant contact length (BICL) in the coronal part of RTNM than in RTN at 4 weeks; however, bone-implant contact ratio (BICR) was not significantly different between the groups. At 8 weeks, the BICL and BICR did not differ significantly between the groups. Removal torque test showed no significant differences between the groups at 4 and 8 weeks. The microthreads might facilitate more coronal bone-implant contact due to increased surface areas at an early healing phase; however, they did not significantly affect coronal bone healing at 8 weeks. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

DEFF Research Database (Denmark)

Babiker, Hassan; Ding, Ming; Overgaard, Søren

2007-01-01

 Introduction: Replacement of extensive local bone loss especially in revision joint arthroplasties is a significant clinical challenge. Autogenous and allogenic cancellous bone grafts have been the gold standard in reconstructive orthopaedic surgery, but it is well known that there is morbidity...... associated with harvesting of autogenous bone graft and limitations in the quantity of bone available. Disadvantages of allograft include the risk of bacterial or viral contamination and non union as well as the potential risk of disease transmission. Alternative options are attractive and continue...... to be sought. Hydroxyapatite and collagen composites have the potential in mimicking and replacing skeletal bones. Aim: This study attempted to determine the effect of hydroxyapatite/collagen composites in the fixation of bone implants. The composites used in this study is produced by Institute of Science...

Influence of Screw Length and Bone Thickness on the Stability of Temporary Implants

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Daniel Jogaib Fernandes

2015-09-01

Full Text Available The purpose of this work was to study the influence of screw length and bone thickness on the stability of temporary implants. A total of 96 self-drilling temporary screws with two different lengths were inserted into polyurethane blocks (n = 66, bovine femurs (n = 18 and rabbit tibia (n = 12 with different cortical thicknesses (1 to 8 mm. Screws insertion in polyurethane blocks was assisted by a universal testing machine, torque peaks were collected by a digital torquemeter and bone thickness was monitored by micro-CT. The results showed that the insertion torque was significantly increased with the thickness of cortical bone from polyurethane (p < 0.0001, bovine (p = 0.0035 and rabbit (p < 0.05 sources. Cancellous bone improved significantly the mechanical implant stability. Insertion torque and insertion strength was successfully moduled by equations, based on the cortical/cancellous bone behavior. Based on the results, insertion torque and bone strength can be estimate in order to prevent failure of the cortical layer during temporary screw placement. The stability provided by a cortical thickness of 2 or 1 mm coupled to cancellous bone was deemed sufficient for temporary implants stability.

The use of bone block allografts in sinus augmentation, followed by delayed implant placement: A case series

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Eurico D Aloja

2013-01-01

Full Text Available Purpose: This article reports the clinical outcomes observed in a large number of patients receiving block bone allograft used for sinus augmentation and delayed implant placement. Patients and Methods: In total, 28 patients (13 males with a mean age of 49.8 ± 10.1 years (range: 33-67 years were included in this case series. All selected patients suffered from severe alveolar ridge atrophy in the posterior maxilla and required bone augmentation procedures, followed by implant placement after 6 months. All patients were followed for 18 months after the grafting, with scheduled monthly visits and/or more frequent visits if required. The survival rates for both the bone blocks and placed implants were then evaluated. Results: A total of 42 blocks and 90 implants were placed. Only one bone graft and 5 implants failed; the survival rate was 97.2% and 95.5% for the bone grafts and implants, respectively. The graft failed due to the onset of post-surgical infectious sinusitis, while in some patients′ implants showed absence of osteointegration at the end of the healing phase. Of note, all failed implants were observed in heavy smokers; in all other patients, blocks and implants were successful. Conclusions: This preliminary case series suggests that the grafting of bone allograft followed by delayed implant placement may be a promising strategy for sinus augmentation. More extended and larger follow-up studies are needed to confirm this preliminary data.

Implant angulation: 2-year retrospective analysis on the influence of dental implant angle insertion on marginal bone resorption in maxillary and mandibular osseous onlay grafts.

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Ramaglia, Luca; Toti, Paolo; Sbordone, Carolina; Guidetti, Franco; Martuscelli, Ranieri; Sbordone, Ludovico

2015-05-01

The purpose of this study was to determine the existence of correlations between marginal peri-implant linear bone loss and the angulation of implants in maxillary and mandibular augmented areas over the course of a 2-year survey. Dependent variables described the sample of the present retrospective chart review. By using three-dimensional radiographs, input variables, describing the implant angulation (buccal-lingual angle [φ] and mesial-distal angle [θ]) were measured; outcome variables described survival rate and marginal bone resorption (MBR) around dental implants in autogenous grafts (10 maxillae and 14 mandibles). Pairwise comparisons and linear correlation coefficient were computed. The peri-implant MBR in maxillary buccal and palatal areas appeared less intensive in the presence of an increased angulation of an implant towards the palatal side. Minor MBR was recorded around mandibular dental implants positioned at a right angle and slightly angulated towards the mesial. Resorption in buccal areas may be less intensive as the angulation of placed implants increases towards the palatal area in the maxilla, whereas for the mandible, a greater inclination towards the lingual area could be negative. In the mandibular group, when the implant was slightly angulated in the direction of the distal area, bone resorption seemed to be more marked in the buccal area. In the planning of dental implant placement in reconstructed alveolar bone with autograft, the extremely unfavourable resorption at the buccal aspect should be considered; this marginal bone loss seemed to be very sensitive to the angulation of the dental implant.

A novel implantation model for evaluation of bone healing response to dental implants: the goat iliac crest.

NARCIS (Netherlands)

Schouten, C.; Meijer, G.J.; Beucken, J.J.J.P van den; Spauwen, P.H.M.; Jansen, J.A.

2010-01-01

OBJECTIVES: Despite the availability of numerous animal models for testing the biological performance of dental and orthopedic implants, the selection of a suitable model is complex. This paper presents a new model for objective and standardized evaluation of bone responses to implants using the

Development and Assessment of a 3D-Printed Scaffold with rhBMP-2 for an Implant Surgical Guide Stent and Bone Graft Material: A Pilot Animal Study

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Ji Cheol Bae

2017-12-01

Full Text Available In this study, a new concept of a 3D-printed scaffold was introduced for the accurate placement of an implant and the application of a recombinant human bone morphogenetic protein-2 (rhBMP-2-loaded bone graft. This preliminary study was conducted using two adult beagles to evaluate the 3D-printed polycaprolactone (PCL/β-tricalcium phosphate (β-TCP/bone decellularized extracellular matrix (bdECM scaffold conjugated with rhBMP-2 for the simultaneous use as an implant surgical guide stent and bone graft material that promotes new bone growth. Teeth were extracted from the mandible of the beagle model and scanned by computed tomography (CT to fabricate a customized scaffold that would fit the bone defect. After positioning the implant guide scaffold, the implant was placed and rhBMP-2 was injected into the scaffold of the experimental group. The two beagles were sacrificed after three months. The specimen block was obtained and scanned by micro-CT. Histological analysis showed that the control and experimental groups had similar new bone volume (NBV, % but the experimental group with BMP exhibited a significantly higher bone-to-implant contact ratio (BIC, %. Within the limitations of this preliminary study, a 3D-printed scaffold conjugated with rhBMP-2 can be used simultaneously as an implant surgical guide and a bone graft in a large bone defect site. Further large-scale studies will be needed to confirm these results.

Development and Assessment of a 3D-Printed Scaffold with rhBMP-2 for an Implant Surgical Guide Stent and Bone Graft Material: A Pilot Animal Study

Science.gov (United States)

Bae, Ji Cheol; Lee, Jin-Ju; Shim, Jin-Hyung; Park, Keun-Ho; Lee, Jeong-Seok; Bae, Eun-Bin; Choi, Jae-Won; Huh, Jung-Bo

2017-01-01

In this study, a new concept of a 3D-printed scaffold was introduced for the accurate placement of an implant and the application of a recombinant human bone morphogenetic protein-2 (rhBMP-2)-loaded bone graft. This preliminary study was conducted using two adult beagles to evaluate the 3D-printed polycaprolactone (PCL)/β-tricalcium phosphate (β-TCP)/bone decellularized extracellular matrix (bdECM) scaffold conjugated with rhBMP-2 for the simultaneous use as an implant surgical guide stent and bone graft material that promotes new bone growth. Teeth were extracted from the mandible of the beagle model and scanned by computed tomography (CT) to fabricate a customized scaffold that would fit the bone defect. After positioning the implant guide scaffold, the implant was placed and rhBMP-2 was injected into the scaffold of the experimental group. The two beagles were sacrificed after three months. The specimen block was obtained and scanned by micro-CT. Histological analysis showed that the control and experimental groups had similar new bone volume (NBV, %) but the experimental group with BMP exhibited a significantly higher bone-to-implant contact ratio (BIC, %). Within the limitations of this preliminary study, a 3D-printed scaffold conjugated with rhBMP-2 can be used simultaneously as an implant surgical guide and a bone graft in a large bone defect site. Further large-scale studies will be needed to confirm these results. PMID:29258172

Abutment-to-fixture load transfer and peri-implant bone stress

NARCIS (Netherlands)

van Oers, R.F.; Feilzer, A.J.

2015-01-01

Purpose: To uncover design principles for the abutment-fixture complex that reduce the stress concentration on the bone. Methods: A 3-dimensional finite element model was used to vary shape, elasticity, and connectivity of the abutment-fixture complex. We compared peri-implant bone stress of these

Measurement of elastic modulus and Vickers hardness of surround bone implant using dynamic microindentation--parameters definition.

Science.gov (United States)

Soares, Priscilla Barbosa Ferreira; Nunes, Sarah Arantes; Franco, Sinésio Domingues; Pires, Raphael Rezende; Zanetta-Barbosa, Darceny; Soares, Carlos José

2014-01-01

The clinical performance of dental implants is strongly defined by biomechanical principles. The aim of this study was to quantify the Vicker's hardness (VHN) and elastic modulus (E) surround bone to dental implant in different regions, and to discuss the parameters of dynamic microindantion test. Ten cylindrical implants with morse taper interface (Titamax CM, Neodent; 3.5 mm diameter and 7 mm a height) were inserted in rabbit tibia. The mechanical properties were analyzed using microhardness dynamic indenter with 200 mN load and 15 s penetration time. Seven continuous indentations were made distancing 0.08 mm between each other perpendicularly to the implant-bone interface towards the external surface, at the limit of low (Lp) and high implant profile (Hp). Data were analyzed by Student's t-test (a=0.05) to compare the E and VHN values obtained on both regions. Mean and standard deviation of E (GPa) were: Lp. 16.6 ± 1.7, Hp. 17.0 ± 2.5 and VHN (N/mm2): Lp. 12.6 ± 40.8, Hp. 120.1 ± 43.7. No statistical difference was found between bone mechanical properties of high and low profile of the surround bone to implant, demonstrating that the bone characterization homogeneously is pertinent. Dynamic microindantion method proved to be highly useful in the characterization of the individual peri-implant bone tissue.

Factors affecting the possibility to detect buccal bone condition around dental implants using cone beam computed tomography

DEFF Research Database (Denmark)

Liedke, Gabriela S; Spin-Neto, Rubens; da Silveira, Heloisa E D

2016-01-01

OBJECTIVES: To evaluate factors with impact on the conspicuity (possibility to detect) of the buccal bone condition around dental implants in cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS: Titanium (Ti) or zirconia (Zr) implants and abutments were inserted into 40 bone blocks...... in a way to obtain variable buccal bone thicknesses. Three combinations regarding the implant-abutment metal (TiTi, TiZr, or ZrZr) and the number of implants (one, two, or three) were assessed. Two CBCT units (Scanora 3D - Sc and Cranex 3D - Cr) and two voxel resolutions (0.2 and 0.13 mm) were used...... variable. Odds ratio (OR) were calculated separately for each CBCT unit. RESULTS: Implant-abutment combination (ZrZr) (OR Sc = 19.18, OR Cr = 11.89) and number of implants (3) (OR Sc = 12.10, OR Cr = 4.25) had major impact on buccal bone conspicuity. The thinner the buccal bone, the higher the risk...

Polyether ether ketone implants achieve increased bone fusion when coated with nano-sized hydroxyapatite: a histomorphometric study in rabbit bone

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Johansson P

2016-04-01

Full Text Available Pär Johansson,1 Ryo Jimbo,1 Yoshihito Naito,2 Per Kjellin,3 Fredrik Currie,3 Ann Wennerberg1 1Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden; 2Oral Implant Center, Tokushima University Hospital, Tokushima, Japan; 3Promimic AB, Stena Center, Göteborg, Sweden Abstract: Polyether ether ketone (PEEK possesses excellent mechanical properties similar to those of human bone and is considered the best alternative material other than titanium for orthopedic spine and trauma implants. However, the deficient osteogenic properties and the bioinertness of PEEK limit its fields of application. The aim of this study was to limit these drawbacks by coating the surface of PEEK with nano-scaled hydroxyapatite (HA minerals. In the study, the biological response to PEEK, with and without HA coating, was investigated. Twenty-four screw-like and apically perforated implants in the rabbit femur were histologically evaluated at 3 weeks and 12 weeks after surgery. Twelve of the 24 implants were HA coated (test, and the remaining 12 served as uncoated PEEK controls. At 3 weeks and 12 weeks, the mean bone–implant contact was higher for test compared to control (P<0.05. The bone area inside the threads was comparable in the two groups, but the perforating hole showed more bone area for the HA-coated implants at both healing points (P<0.01. With these results, we conclude that nano-sized HA coating on PEEK implants significantly improved the osteogenic properties, and in a clinical situation this material composition may serve as an implant where a rapid bone fusion is essential. Keywords: HA, PEEK, osseointegration, histology, orthopedics, in vivo

No influence of simultaneous bone-substitute application on the success of immediately loaded dental implants: a retrospective cohort study.

Science.gov (United States)

Kopp, Sigmar; Behrend, Detlef; Kundt, Günther; Ottl, Peter; Frerich, Bernhard; Warkentin, Mareike

2013-06-01

To examine the influence of bone-substitute application during implantation on the success of immediately placed and loaded dental implants. A total of 147 consecutive patients (age, 16.5-80.4 years) were provided with 696 immediately loaded implants. The mean follow-up time was 34.1 months. Of these implants, 50.4% (n=351) were immediately placed into extraction sockets. A total of 119 implants were added by simultaneous bone-substitute application (NanoBone, Artoss GmbH, Rostock Germany), whereas the other implants were placed in healed bone. Univariate and multivariate analysis was performed using IBM SPSS V.20. The overall implant success rate was 96.1%. Implants with simultaneous bone replacement had a hazard ratio of 0.877 (p=0.837); 95% CI, 0.253-3.04). Factors found to be statistically significant modifiers of success on multivariate analysis (p<0.05) included type of superstructure (p<0.001), implant-abutment connection (p<0.001), membrane use (p=0.010), and jaw (p=0.026). None of the other factors investigated were significant modifiers. The present study demonstrates high success rates for immediately loaded implants and their superstructures independent of the simultaneous application of bone substitute. The declared aim of socket preservation, the prevention avoiding bone loss, is achieved in the immediate implant placement scenario under immediate-loading conditions.

Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss.

Science.gov (United States)

Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Heuberer, Philipp R; Arciero, Robert A; Anderl, Werner; Mazzocca, Augustus D

2017-10-01

The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Controlled laboratory study. Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. The creation of a 30% glenoid defect significantly decreased glenohumeral

Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

Science.gov (United States)

Oldani, C. R.; Dominguez, A. A.

2007-11-01

In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

Energy Technology Data Exchange (ETDEWEB)

Oldani, C R [Materials Department - FCEFyN - Universidad Nacional de Cordoba, Av.Velez Sarsfield 1611 (5016) Cordoba (Argentina); Dominguez, A A [INTI Cordoba, Av. Velez Sarsfield 1561 (5016) Cordoba (Argentina)

2007-11-15

In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

The impact of glucocorticosteroids administered for systemic diseases on the osseointegration and survival of dental implants placed without bone grafting-A retrospective study in 31 patients.

Science.gov (United States)

Petsinis, Vassilis; Kamperos, Georgios; Alexandridi, Foteini; Alexandridis, Konstantinos

2017-08-01

To evaluate the impact of glucocorticosteroids, administered for the treatment of systemic diseases, on the osseointegration and survival of dental implants placed without bone grafting. A retrospective study was conducted in search of patients treated with dental implants while receiving glucocorticosteroid therapy for various systemic diseases. In these cases, a conventional two-stage surgical protocol was used, without bone regeneration procedures. The osseointegration was clinically and radiographically tested at the uncovering of the implants. The follow-up after loading was set at a minimum of 3 years. A total of 31 patients were included in the study. Of the 105 dental implants placed, 104 were osseointegrated (99%). No bone absorption was radiographically noted at the uncovering of the osseointegrated implants. All of the osseointegrated implants were successfully loaded for the prosthetic restoration. The mean follow-up period after loading was 71 months, with an implant survival rate of 99%. Glucocorticosteroid intake for systemic diseases does not have a significant impact on the osseointegration and the 3-year survival of dental implants placed with a conventional two-stage surgical protocol and without bone grafting. Therefore, it should not be considered a contraindication for dental implant placement. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

OpenAIRE

Langhoff, J; Mayer, J; Faber, L; Kästner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

2008-01-01

Objectives: Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. Material and methods...

Laser and Electron Beam Additive Manufacturing Methods of Fabricating Titanium Bone Implants

Directory of Open Access Journals (Sweden)

Bartłomiej Wysocki

2017-06-01

Full Text Available Additive Manufacturing (AM methods are generally used to produce an early sample or near net-shape elements based on three-dimensional geometrical modules. To date, publications on AM of metal implants have mainly focused on knee and hip replacements or bone scaffolds for tissue engineering. The direct fabrication of metallic implants can be achieved by methods, such as Selective Laser Melting (SLM or Electron Beam Melting (EBM. This work compares the SLM and EBM methods used in the fabrication of titanium bone implants by analyzing the microstructure, mechanical properties and cytotoxicity. The SLM process was conducted in an environmental chamber using 0.4–0.6 vol % of oxygen to enhance the mechanical properties of a Ti-6Al-4V alloy. SLM processed material had high anisotropy of mechanical properties and superior UTS (1246–1421 MPa when compared to the EBM (972–976 MPa and the wrought material (933–942 MPa. The microstructure and phase composition depended on the used fabrication method. The AM methods caused the formation of long epitaxial grains of the prior β phase. The equilibrium phases (α + β and non-equilibrium α’ martensite was obtained after EBM and SLM, respectively. Although it was found that the heat transfer that occurs during the layer by layer generation of the component caused aluminum content deviations, neither methods generated any cytotoxic effects. Furthermore, in contrast to SLM, the EBM fabricated material met the ASTMF136 standard for surgical implant applications.

Peri- and intra-implant bone response to microporous Ti coatings with surface modification.

Science.gov (United States)

Braem, Annabel; Chaudhari, Amol; Vivan Cardoso, Marcio; Schrooten, Jan; Duyck, Joke; Vleugels, Jozef

2014-02-01

Bone growth on and into implants exhibiting substantial surface porosity is a promising strategy in order to improve the long-term stable fixation of bone implants. However, the reliability in clinical applications remains a point of discussion. Most attention has been dedicated to the role of macroporosity, leading to the general consensus of a minimal pore size of 50-100 μm in order to allow bone ingrowth. In this in vivo study, we assessed the feasibility of early bone ingrowth into a predominantly microporous Ti coating with an average thickness of 150 μm and the hypothesis of improving the bone response through surface modification of the porous coating. Implants were placed in the cortical bone of rabbit tibiae for periods of 2 and 4 weeks and evaluated histologically and histomorphometrically using light microscopy and scanning electron microscopy. Bone with osteocytes encased in the mineralized matrix was found throughout the porous Ti coating up to the coating/substrate interface, highlighting that osseointegration of microporosities (coating in the host bone in the long term is possible. When surface modifications inside the porous structure further reduced the interconnective pore size to the submicrometer level, bone ingrowth was impaired. On the other hand, application of a sol-gel-derived bioactive glass-ceramic coating without altering the pore characteristics was found to significantly improve bone regeneration around the coating, while still supporting bone ingrowth. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Fixation of revision implants is improved by a surgical technique to crack the sclerotic bone rim.

Science.gov (United States)

Kold, Søren; Bechtold, Joan E; Mouzin, Olivier; Elmengaard, Brian; Chen, Xinqian; Søballe, Kjeld

2005-03-01

Revision joint replacement has poorer outcomes compared with primary joint replacement, and these poor outcomes have been associated with poorer fixation. We investigated a surgical technique done during the revision operation to improve access from the marrow space to the implant interface by locally cracking the sclerotic bone rim that forms during aseptic loosening. Sixteen implants were inserted bilaterally by distal femur articulation of the knee joint of eight dogs, using our controlled experimental model that replicates the revision setting (sclerotic bone rim, dense fibrous tissue, macrophages, elevated cytokines) by pistoning a loaded 6.0-mm implant 500 microm into the distal femur with particulate PE. At 8 weeks, one of two revision procedures was done. Both revision procedures included complete removal of the membrane, scraping, lavaging, and inserting a revision plasma-spray Ti implant. The crack revision procedure also used a splined tool to circumferentially locally perforate the sclerotic bone rim before insertion of an identical revision implant. Superior fixation was achieved with the cracking procedure in this experimental model. Revision implants inserted with the rim cracking procedure had a significantly higher pushout strength (fivefold median increase) and energy to failure (sixfold median increase), compared with the control revision procedure. Additional evaluation is needed of local perforation of sclerotic bone rim as a simple bone-sparing means to improve revision implant fixation and thereby increase revision implant longevity.

Does the Laser-Microtextured Short Implant Collar Design Reduce Marginal Bone Loss in Comparison with a Machined Collar?

Directory of Open Access Journals (Sweden)

B. Alper Gultekin

2016-01-01

Full Text Available Purpose. To compare marginal bone loss between subgingivally placed short-collar implants with machined collars and those with machined and laser-microtextured collars. Materials and Methods. The investigators used a retrospective study design and included patients who needed missing posterior teeth replaced with implants. Short-collar implants with identical geometries were divided into two groups: an M group, machined collar; and an L group, machined and laser-microtextured collar. Implants were evaluated according to marginal bone loss, implant success, and probing depth (PD at 3 years of follow-up. Results. Sixty-two patients received 103 implants (56 in the M group and 47 in the L group. The cumulative survival rate was 100%. All implants showed clinically acceptable marginal bone loss, although bone resorption was lower in the L group (0.49 mm than in the M group (1.38 mm at 3 years (p<0.01. A significantly shallower PD was found for the implants in the L group during follow-up (p<0.01. Conclusions. Our results suggest predictable outcomes with regard to bone loss for both groups; however, bone resorption was less in the L group than in the M group before and after loading. The laser-microtextured collar implant may provide a shallower PD than the machined collar implant.

Costal bone abnormalities: an unusual cause of spontaneous bilateral breast implant deflation†

Science.gov (United States)

Brooker, Jack E.; Gusenoff, Jeffrey A.

2014-01-01

Augmentation mammoplasty is the most common aesthetic surgical procedure performed in the USA. Prosthetic failure is a major reason for surgical reintervention. A number of causes for this have been documented, but costal bone abnormalities leading to perforation of the prosthesis are very unusual. We present the case of a woman who experienced spontaneous deflation of both saline implants in close succession, and who was found to have sharp bony spicules on both sides of her chest. Pathology examination reported reactive changes, suggestive of heterotopic bone. Examination of the implants showed no defects besides small punctures on the back wall, which coincided with the position of the spicules of bone. There are a number of possible causes for these bony growths which we examine in turn. The chest wall should be examined in all cases where unexplained implant deflation has occurred. PMID:25535321

Development of a novel method for surgical implant design optimization through noninvasive assessment of local bone properties.

Science.gov (United States)

Schiuma, D; Brianza, S; Tami, A E

2011-03-01

A method was developed to improve the design of locking implants by finding the optimal paths for the anchoring elements, based on a high resolution pQCT assessment of local bone mineral density (BMD) distribution and bone micro-architecture (BMA). The method consists of three steps: (1) partial fixation of the implant to the bone and creation of a reference system, (2) implant removal and pQCT scan of the bone, and (3) determination of BMD and BMA of all implant-anchoring locations along the actual and alternative directions. Using a PHILOS plate, the method uncertainty was tested on an artificial humerus bone model. A cadaveric humerus was used to quantify how the uncertainty of the method affects the assessment of bone parameters. BMD and BMA were determined along four possible alternative screw paths as possible criteria for implant optimization. The method is biased by a 0.87 ± 0.12 mm systematic uncertainty and by a 0.44 ± 0.09 mm random uncertainty in locating the virtual screw position. This study shows that this method can be used to find alternative directions for the anchoring elements, which may possess better bone properties. This modification will thus produce an optimized implant design. Copyright © 2010 IPEM. Published by Elsevier Ltd. All rights reserved.

Significance of buccopalatal implant position, biotype, platform switching, and pre-implant bone augmentation on the level of the midbuccal mucosa

NARCIS (Netherlands)

Zuiderveld, Elise G; den Hartog, Laurens; Vissink, Arjan; Raghoebar, Gerry M; Meijer, Henny J A

2014-01-01