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.

Perforated schneiderian membrane repair during sinus augmentation in conjunction with immediate implant placement

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K Hameed Fathima

2014-01-01

Full Text Available Dental implant associated rehabilitation of the posterior maxilla poses unique challenge owing to the presence of pneumatized sinuses and atrophied alveolar bone. Sinus augmentation procedure to manage expanded sinuses frequently results in membrane tear resulting in unfavorable stabilization of the graft and associated bone regeneration. Simultaneous implant placement during sinus augmentation procedures frequently requires a minimal alveolar bone height, which when not present forces clinician to defer implant placement resulting in extended treatment duration and multiple surgical appointments. The present case report is about a piezosurgery assisted lateral wall osteotomy approach for sinus augmentation associated with membrane repair with simultaneous implant placement in the posterior maxilla.

Demographic factors influencing educational placement of the hearing-impaired child with a cochlear implant.

Science.gov (United States)

Yehudai, Noam; Tzach, Naama; Shpak, Talma; Most, Tova; Luntz, Michal

2011-08-01

To analyze educational placement settings of Israeli children with cochlear implants (CIs) and evaluate the prognostic influence of the following demographic variables on mainstreaming: age at implantation, experience with CI, socioeconomic status, ethnicity, and parents' educational level. Retrospective review. Tertiary referral center. The study population comprised 245 children with severe-to-profound hearing impairment and at least 1 year of experience with a unilateral CI. Mean age at implantation was 4.5 ± 3.9 years, and mean duration of CI use was 5.4 ± 2.8 years. Follow-up review and statistical analysis of available data on educational placement after cochlear implantation. Placement in mainstream education. Regular schools were attended by 89 children (36.3%) and special education schools by 156 (63.7%). Variables found to be significantly associated with mainstream educational placement were younger age at implantation, higher level of parental education, higher socioeconomic status, and ethnicity. Multivariate analysis using a logistic regression model revealed that the factor with the highest positive correlation with mainstreaming was parental education level. Our results show that parental education, a variable that the health system cannot control, significantly influences postimplantation results in term of educational placement and can thus limit the chances of implanted children to achieve mainstream placement even when identified and implanted at an early age.

Revival of pure titanium for dynamically loaded porous implants using additive manufacturing.

Science.gov (United States)

Wauthle, Ruben; Ahmadi, Seyed Mohammad; Amin Yavari, Saber; Mulier, Michiel; Zadpoor, Amir Abbas; Weinans, Harrie; Van Humbeeck, Jan; Kruth, Jean-Pierre; Schrooten, Jan

2015-09-01

Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. Copyright © 2015 Elsevier B.V. All rights reserved.

Two-stage implant placement technique for the management of irradiated jaws: An animal study.

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Aboushelib, Moustafa N; Arnaout, Mohamed A; Elsafi, Mohamed H; Kassem, Youssef M

2017-10-01

Radiotherapy results in diminished bone remodeling capacity and an elevated risk of osteoradionecrosis, which can negatively influence the survival rate of dental implants. Patients receiving radiotherapy are advised not to receive dental implants during or soon after completing their radiotherapy. The purpose of this animal study was to investigate a 2-stage implant placement technique designed to diminish applied trauma on irradiated bone. Two groups of white New Zealand rabbits received radiotherapy in ascending doses (2, 4, 8 Gy), while a nonirradiated group served as control. Three weeks after completion of the last radiotherapy session, one of the irradiated groups and the control group received titanium dental implants bilaterally in the femur head. For the second irradiated group, an osteotomy was performed, and the surgical wound was left to heal for 2 weeks before implant placement. All animals were sacrificed 4 weeks after implant placement, and histomorphometric analysis was used to study bone-implant contact (n=14, α=.05). Statistical analysis revealed significantly higher (F=159, P<.001) bone-implant contact in the 2-stage (40.2 ±1.9) implant placement technique than in the immediately placed implants (21.2 ±2.3) in irradiated bone. Both of the groups had a significantly lower bone-to-implant contact ratio than the non-irradiated control (64.2 ±3.8). Within the limitations of this animal study, the 2-stage implant placement technique could be used to reduce trauma in irradiated bone and to improve wound healing around dental implants. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

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.

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

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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.

Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

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Nickenig, Hans-Joachim; Eitner, Stephan

2007-01-01

We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

Inherent challenges of immediate implant placement in the aesthetic ...

African Journals Online (AJOL)

Replacement of missing teeth with implant borne prostheses has become generally become acceptable in the field of dentistry. The traditional “Branemark protocol” has advocated for a period of healing after extraction before placement of implants. This presents an aesthetic challenge and the ensuing bone resorption also ...

Comparison of topical and infiltration anesthesia for orthodontic mini-implant placement

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Matheus Miotello Valieri

2014-04-01

Full Text Available Objective: To compare the acceptability and effectiveness of topical and infiltration anesthesia for placement of mini-implants used as temporary anchorage devices. Methods: The sample comprised 40 patients, 17 males and 23 females, whose mean age was 26 years old and who were all undergoing orthodontic treatment and in need for anchorage reinforcement. Mini-implants were bilaterally placed in the maxilla of all individuals, with infiltration anesthesia on one side and topical anesthesia on the other. These 40 patients completed two questionnaires, one before and another after mini-implant placement and pain was measured through a visual analog scale (VAS. The data collected were analyzed using descriptive statistics and the measurements of pain were compared by means of the non-parametric test of Mann-Whitney. Results: It was found that 60% of patients felt more comfortable with the use of topical anesthesia for mini-implant placement; 72.5% of patients described the occurrence of pressure during placement of the anchorage device as the most unpleasant sensation of the entire process; 62.5% of patients felt more pain with the use of topical anesthesia. Conclusion: It was concluded that patients had less pain with the use of infiltration anesthesia, and also preferred this type of anesthetic.

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

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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.

Gelatin functionalised porous titanium alloy implants for orthopaedic applications

Energy Technology Data Exchange (ETDEWEB)

Vanderleyden, E. [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium); Van Bael, S. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Department of Mechanical Engineering, Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Celestijnenlaan 300c, Box 2419, 3001 Heverlee (Belgium); Chai, Y.C. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Tissue Engineering Laboratory, Skeletal Biology and Engineering Research Center, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Kruth, J.-P. [Department of Mechanical Engineering, Division of Production Engineering, Machine Design and Automation, Katholieke Universiteit Leuven, Celestijnenlaan 300b, 3001 Leuven (Belgium); Schrooten, J. [Prometheus, Division of Skeletal Tissue Engineering, Katholieke Universiteit Leuven, O and N 1, Herestraat 49, Box 813, 3000 Leuven (Belgium); Department of Metallurgy and Materials Engineering, Katholieke Universiteit Leuven, Kasteelpark Arenberg 44, Bus 2450, 3001 Leuven (Belgium); Dubruel, P., E-mail: pbmugent@gmail.com [Polymer Chemistry and Biomaterials Research Group, Department of Organic Chemistry, University of Ghent, Krijgslaan 281 S4, 9000 Ghent (Belgium)

2014-09-01

In the present work, we studied the immobilisation of the biopolymer gelatin onto the surface of three dimensional (3D) regular Ti6Al4V porous implants to improve their surface bio-activity. The successful immobilisation of the gelatin coating was made possible by a polydopamine interlayer, a polymer coating inspired by the adhesive nature of mussels. The presence of both coatings was first optimised on two dimensional titanium (2D Ti) substrates and confirmed by different techniques including X-ray photelectron spectroscopy, contact angle measurements, atomic force microscopy and fluorescence microscopy. Results showed homogeneous coatings that are stable for at least 24 h in phosphate buffer at 37 °C. In a next step, the coating procedure was successfully transferred to 3D Ti6Al4V porous implants, which indicates the versatility of the applied coating procedure with regard to complex surface morphologies. Furthermore, the bio-activity of these stable gelatin coatings was enhanced by applying a third and final coating using the cell-attractive protein fibronectin. The reproducible immobilisation process allowed for a controlled biomolecule presentation to the surrounding tissue. This newly developed coating procedure outperformed the previously reported silanisation procedure for immobilising gelatin. In vitro cell adhesion and culture studies with human periosteum-derived cells showed that the investigated coatings did not compromise the biocompatible nature of Ti6Al4V porous implants, but no distinct biological differences between the coatings were found. - Highlights: • Ti6Al4V porous implants were produced by selective laser melting. • A procedure to obtain a stable gelatin coating was developed. • Successful transfer of the coating procedure from 2D to 3D Ti6Al4V porous implants. • In vitro cell studies showed that the developed coatings supported cell growth.

Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

International Nuclear Information System (INIS)

Wauthle, Ruben; Ahmadi, Seyed Mohammad; Amin Yavari, Saber; Mulier, Michiel; Zadpoor, Amir Abbas; Weinans, Harrie; Van Humbeeck, Jan; Kruth, Jean-Pierre; Schrooten, Jan

2015-01-01

Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. - Highlights: • The mechanical properties of CP Ti grade 1 porous structures are studied. • The results are compared with identical structures in Ti6Al4V ELI and tantalum. • Ti6Al4V ELI structures are about two times stronger under a static compressive load. • CP Ti structures deform continuously without fracture while loaded statically. • CP Ti structures have a higher fatigue life compared to Ti6Al4V ELI structures

Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

Energy Technology Data Exchange (ETDEWEB)

Wauthle, Ruben, E-mail: ruben.wauthle@3dsystems.com [KU Leuven, Department of Mechanical Engineering, Section Production Engineering, Machine Design and Automation (PMA), Celestijnenlaan 300B, 3001 Leuven (Belgium); 3D Systems - LayerWise NV, Grauwmeer 14, 3001 Leuven (Belgium); Ahmadi, Seyed Mohammad; Amin Yavari, Saber [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Mulier, Michiel [KU Leuven, Department of Orthopaedics, Weligerveld 1, 3212 Pellenberg (Belgium); Zadpoor, Amir Abbas [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Weinans, Harrie [Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Mekelweg 2, 2628 CD, Delft (Netherlands); Department of Orthopedics & department of Rheumatology, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht (Netherlands); Van Humbeeck, Jan [KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, PB 2450, 3001 Leuven (Belgium); Kruth, Jean-Pierre [KU Leuven, Department of Mechanical Engineering, Section Production Engineering, Machine Design and Automation (PMA), Celestijnenlaan 300B, 3001 Leuven (Belgium); Schrooten, Jan [KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, PB 2450, 3001 Leuven (Belgium); KU Leuven, Prometheus, Division of Skeletal Tissue Engineering, PB 813, O& N1, Herestraat 49, 3000 Leuven (Belgium)

2015-09-01

Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous implants, and none or little interest goes to pure titanium for use in orthopedic or load-bearing implants. Given the special mechanical behavior of cellular structures and the material properties inherent to the additive manufacturing of metals, the aim of this study is to investigate the properties of selective laser melted pure unalloyed titanium porous structures. Therefore, the static and dynamic compressive properties of pure titanium structures are determined and compared to previously reported results for identical structures made from Ti6Al4V ELI and tantalum. The results show that porous Ti6Al4V ELI still remains the strongest material for statically loaded applications, whereas pure titanium has a mechanical behavior similar to tantalum and is the material of choice for cyclically loaded porous implants. These findings are considered to be important for future implant developments since it announces a potential revival of the use of pure titanium for additively manufactured porous implants. - Highlights: • The mechanical properties of CP Ti grade 1 porous structures are studied. • The results are compared with identical structures in Ti6Al4V ELI and tantalum. • Ti6Al4V ELI structures are about two times stronger under a static compressive load. • CP Ti structures deform continuously without fracture while loaded statically. • CP Ti structures have a higher fatigue life compared to Ti6Al4V ELI structures.

Structure Optimization of Porous Dental Implant Based on 3D Printing

Science.gov (United States)

Ji, Fangqiu; Zhang, Chunyu; Chen, Xianshuai

2018-03-01

In this paper, selective laser melting (SLM) technology is used to process complex structures. In combination with the theory of biomedicine, a porous implant with a porous structure is designed to induce bone cell growth. The mechanical strength advantage of SLM was discussed by observing the metallographic structure of SLM specimen with mechanical microscope and mechanical tensile test. The osseointegration of porous implants was observed and analyzed by biological experiments. By establishing a mechanical model, the mechanical properties of the bone implant combined with the jaw bone were studied by the simple mechanical analysis under static multi loading and the finite element mechanical analysis. According to the experimental observation and mechanical research, the optimization suggestions for the structure design of the implant made by SLM technology were put forward.

Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty

Directory of Open Access Journals (Sweden)

William D. Bugbee

2013-01-01

Full Text Available Customized patient instrumentation (CPI combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA. We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.

Treatment by stereotactic radiotherapy of tumoral injuries after implant placement: preliminary study

International Nuclear Information System (INIS)

Meingan, P.; Rio, E.; Labbe-Devilliers, C.; Geffroy, D.; Ricaud-Couprie, M.; Doutriaux-Dumoulin, I.

2009-01-01

Objective: to evaluate the interest and the place of stereotactic radiotherapy in the treatment of primitive or secondary tumoral injuries of the liver. To describe the technique of implants placement. Conclusion: the liver stereotactic radiotherapy, after implant placement, seems to be an alternative or complementary therapy to the radiofrequency for patients refused for surgery, with moderated side effects and a noticeable survival. Complementary studies, especially associated to radiofrequency must be considered. (N.C.)

Accuracy Assessment of Immediate and Delayed Implant Placements Using CAD/CAM Surgical Guides.

Science.gov (United States)

Alzoubi, Fawaz; Massoomi, Nima; Nattestad, Anders

2016-10-01

The aim of this study is to assess the accuracy of immediately placed implants using Anatomage Invivo5 computer-assisted design/computer-assisted manufacturing (CAD/CAM) surgical guides and compare the accuracy to delayed implant placement protocol. Patients who had implants placed using Anatomage Invivo5 CAD/CAM surgical guides during the period of 2012-2015 were evaluated retrospectively. Patients who received immediate implant placements and/or delayed implant placements replacing 1-2 teeth were included in this study. Pre- and postsurgical images were superimposed to evaluate deviations at the crest, apex, and angle. A total of 40 implants placed in 29 patients were included in this study. The overall mean deviations measured at the crest, apex, and angle were 0.86 mm, 1.25 mm, and 3.79°, respectively. The means for the immediate group deviations were: crest = 0.85 mm, apex = 1.10, and angle = 3.49°. The means for the delayed group deviations were: crest = 0.88 mm, apex = 1.59, and angle = 4.29°. No statistically significant difference was found at the crest and angle; however, there was a statistically significant difference between the immediate and delayed group at the apex, with the immediate group presenting more accurate placements at the apical point than the delayed group. CAD/CAM surgical guides can be reliable tools to accurately place implants immediately and/or in a delayed fashion. No statistically significant differences were found between the delayed and the immediate group at the crest and angle, however apical position was more accurate in the immediate group.

Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review.

Science.gov (United States)

Poskevicius, Lukas; Sidlauskas, Antanas; Galindo-Moreno, Pablo; Juodzbalys, Gintaras

2017-01-01

To systematically review changes in mucosal soft tissue thickness and keratinised mucosa width after soft tissue grafting around dental implants. An electronic literature search was conducted of the MEDLINE database published between 2009 and 2014. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in soft tissue thickness or keratinised mucosa width after soft tissue grafting at implant placement or around a present implant at 6-month follow-up or longer were included. The search resulted in fourteen articles meeting the inclusion criteria: Six of them reported connective tissue grafting around present dental implants, compared to eight at the time of implant placement. Better long-term soft tissue thickness outcomes were reported for soft tissue augmentation around dental implants (0.8-1.4 mm), compared with augmentation at implant placement (-0.25-1.43 mm). Both techniques were effective in increasing keratinised tissue width: at implant placement (2.5 mm) or around present dental implants (2.33-2.57 mm). The present systematic review discovered that connective tissue grafts enhanced keratinised mucosa width and soft tissue thickness for an observation period of up to 48 months. However, some shrinkage may occur, resulting in decreases in soft tissue, mostly for the first three months. Further investigations using accurate evaluation methods need to be done to evaluate the appropriate time for grafting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Superior sealing effect of hydroxyapatite in porous-coated implants

DEFF Research Database (Denmark)

Rahbek, Ole; Kold, Søren; Bendix, Knud

2005-01-01

Migration of wear debris to the periprosthetic bone is a major cause of osteolysis and implant failure. Both closed-pore porous coatings and hydroxyapatite (HA) coatings have been claimed to prevent the migration of wear debris. We investigated whether HA could augment the sealing effect of a por......Migration of wear debris to the periprosthetic bone is a major cause of osteolysis and implant failure. Both closed-pore porous coatings and hydroxyapatite (HA) coatings have been claimed to prevent the migration of wear debris. We investigated whether HA could augment the sealing effect...

Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review.

Science.gov (United States)

Esposito, Marco; Grusovin, Maria Gabriella; Loli, Vasiliki; Coulthard, Paul; Worthington, Helen V

2010-01-01

Marco Esposito is the first author of two of the included studies; however, he was not involved in the quality assessment of these trials. This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications' published in The Cochrane Library (see http://www.cochrane.org for more information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic/placebo administration and, if antibiotics are of benefit, to find which type, dosage and duration is the most effective. The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up to 2 June 2010 for randomised controlled clinical trials (RCTs) with a follow-up of at least 3 months comparing the administration of various prophylactic antibiotic regimens versus no antibiotics to patients undergoing dental implant placement. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Meta-analyses were

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

Science.gov (United States)

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.

Immediate placement and restoration of dental implants in the esthetic region: clinical case series.

Science.gov (United States)

Khzam, Nabil; Mattheos, Nikos; Roberts, David; Bruce, William L; Ivanovski, Saso

2014-01-01

The objective of this study was to assess the hard and soft tissue changes following immediate placement and provisional restoration of single-tooth implants in the aesthetic zone. Thirteen patients with immediately placed and restored implants were included in this study. All participating patients underwent the same treatment strategy that involved removal of the failed tooth, flapless surgery, immediate implant placement, and connection of a screw-retained provisional restoration. Three months following implant placement, the temporary crowns were replaced by the definitive restorations. Implant survival rates, and hard and soft tissue changes were measured using periapical X-rays and photographs. The range of the observation period was between 12 and 37 months with a mean period of 23.2 ± 7.6 months. At the time of follow-up, all implants were present with no complications. Radiographic evaluation revealed a mean mesial bone gain of 1.20 ± 1.01 mm and a mean distal bone gain of 0.80 ± 1.14 mm, which reached statistical significance. The mean mid-buccal recession was 0.20 ± 0.78 mm, whereas the mesial and distal papillae height loss was 0.50 ± 1.26 mm and 0.30 ± 0.82 mm, respectively. The changes in the soft tissues did not reach statistical significance. Notwithstanding the limitation of a small sample size, this study shows that immediate implant placement and provisional restoration in the maxillary aesthetic zone can result in favorable treatment outcomes with regards to soft and hard tissues changes over a follow-up period of 23.2 ± 7.6 months. Most clinical trials investigating immediate implant placement and immediate restoration in the maxillary anterior zone have focused on implant survival and implant success, with particular emphasis on radiographically assessed hard tissues changes. However, this study assesses the soft tissue changes associated with this procedure, which is an important area of study

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

Science.gov (United States)

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.

Placement of replace select Ti-Unite-coated type implants using a combination of immediate and submerge techniques after tooth extraction

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Coen Pramono D

2006-06-01

Full Text Available The high success rate of immediate implant placement both in the anterior and posterior regions were reported by many authors, therefore applying this techniques can be considered as a safe surgical procedure and minimizing the dental office visit for patient satisfaction. This paper reports the outcome of immediate placement of implants following extraction of anterior maxillary teeth. Combination technique of immediate and submerge implant placements including bone grafting procedure were used. Four implants with TiUnite surface type were placed immediately in two patients with the short-term result indicated that this technique may serve as a simple and safe procedure for immediate implant placement. It was concluded that immediate implant placement technique combined with TiUnite implant surface was successful in treating region directly after tooth extraction therefore this technique can be use as an alternative surgical method for dental implant rehabilitation.

Electromyography tests in patients with implanted cardiac devices are safe regardless of magnet placement.

Science.gov (United States)

Ohira, Masayuki; Silcox, Jade; Haygood, Deavin; Harper-King, Valerie; Alsharabati, Mohammad; Lu, Liang; Morgan, Marla B; Young, Angela M; Claussen, Gwen C; King, Peter H; Oh, Shin J

2013-01-01

We compared the problems or complications associated with electrodiagnostic testing in 77 patients with implanted cardiac devices. Thirty tests were performed after magnet placement, and 47 were performed without magnet application. All electrodiagnostic tests were performed safely in all patients without any serious effect on the implanted cardiac devices with or without magnet placement. A significantly higher number of patient symptoms and procedure changes were reported in the magnet group (P magnet group patients had an approximately 11-fold greater risk of symptoms than those in the control group. Our data do not support a recommendation that magnet placement is necessary for routine electrodiagnostic testing in patients with implanted cardiac devices, as long as our general and specific guidelines are followed. Copyright © 2012 Wiley Periodicals, Inc.

Effects of pore size, implantation time, and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants.

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Farrell, Brad J; Prilutsky, Boris I; Ritter, Jana M; Kelley, Sean; Popat, Ketul; Pitkin, Mark

2014-05-01

The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40-100 μm and Large, 100-160 μm), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to seven groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all three types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4-6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p skin integration with the potential for a safe seal. Copyright © 2013 Wiley Periodicals, Inc.

Characterizations of additive manufactured porous titanium implants.

Science.gov (United States)

Basalah, Ahmad; Shanjani, Yaser; Esmaeili, Shahrzad; Toyserkani, Ehsan

2012-10-01

This article describes physical, chemical, and mechanical characterizations of porous titanium implants made by an additive manufacturing method to gain insight into the correlation of process parameters and final physical properties of implants used in orthopedics. For the manufacturing chain, the powder metallurgy technology was combined with the additive manufacturing to fabricate the porous structure from the pure tanium powder. A 3D printing machine was employed in this study to produce porous bar samples. A number of physical parameters such as titanium powder size, polyvinyl alcohol (PVA) amount, sintering temperature and time were investigated to control the mechanical properties and porosity of the structures. The produced samples were characterized through porosity and shrinkage measurements, mechanical compression test and scanning electron microscopy (SEM). The results showed a level of porosity in the samples in the range of 31-43%, which is within the range of the porosity of the cancelluous bone and approaches the range of the porosity of the cortical bone. The results of the mechanical test showed that the compressive strength is in the wide range of 56-509 MPa implying the effect of the process parameters on the mechanical strengths. This technique of manufacturing of Ti porous structures demonstrated a low level of shrinkage with the shrinkage percentage ranging from 1.5 to 5%. Copyright © 2012 Wiley Periodicals, Inc.

Evaluation of the influence of implant placement timing on the esthetic outcomes of single tooth implant treatment in the anterior maxilla: A retrospective study.

Science.gov (United States)

Arora, Himanshu; Ivanovski, Saso

2018-05-15

The purpose of this retrospective study was to investigate the influence of implant placement timing on the esthetic outcomes for single implants in the anterior maxilla. One hundred and ten patients (48 males; 62 females) who received a single-tooth implant after extraction either immediately (Type 1); after 4-8 weeks (Type 2); after 8-16 weeks (Type 3); or more than 16 weeks (Type 4) were evaluated in terms of esthetic outcomes after a mean post-placement interval of 26.3 months (range 12-116). Esthetic outcomes were measured using the Pink and White Esthetic Score (PES; WES). Stepwise regression analysis was performed to analyze the effect of timing of placement, as well as patient demographics and other clinical parameters on the esthetic outcomes. No statistically significantly differences in PES were found between the various treatment modalities with Type 1 implants (n = 33) scoring 10.58 ± 1.65 (median: 11), followed by 10.36 ± 2.09 (median: 10.5), 9.68 ± 2.43 (median: 10), and 9.63 ± 2.21 (median: 10) for Type 2 (n = 14), Type 3 (n = 19), and Type 4 (n = 44), respectively. For immediate implants, a trend towards better esthetic outcomes was observed when implant placement was done flaplessly in cases with intact buccal bone (Type 1A, median PES 11) as compared to cases with partial/complete missing buccal plates where a flap was raised (Type 1B, median PES 10). Overall, the only parameter that influenced esthetic outcomes (as measured by PES) was gender, with females having significantly superior results. The median WES was 8 and 96% of the crowns were deemed esthetically acceptable, with crowns placed by specialist prosthodontists yielding higher scores than those placed by general practitioners. Single tooth implants in the anterior maxilla showed satisfactory outcomes when measured with objective esthetic criteria. Timing of implant placement did not significantly influence the esthetic outcomes, although a trend

Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

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Gintaras Juodzbalys

2011-01-01

Full Text Available Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

Development of implant/interconnected porous hydroxyapatite complex as new concept graft material.

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Kazuya Doi

Full Text Available BACKGROUND: Dental implant has been successfully used to replace missing teeth. However, in some clinical situations, implant placement may be difficult because of a large bone defect. We designed novel complex biomaterial to simultaneously restore bone and place implant. This complex was incorporated implant into interconnected porous calcium hydroxyapatite (IP-CHA. We then tested this Implant/IP-CHA complex and evaluated its effect on subsequent bone regeneration and implant stability in vivo. METHODOLOGY/PRINCIPAL FINDINGS: A cylinder-type IP-CHA was used in this study. After forming inside of the cylinder, an implant was placed inside to fabricate the Implant/IP-CHA complex. This complex was then placed into the prepared bone socket in the femur of four beagle-Labrador hybrid dogs. As a control, implants were placed directly into the femur without any bone substrate. Bone sockets were allowed to heal for 2, 3 and 6 months and implant stability quotients (ISQ were measured. Finally, tissue blocks containing the Implant/IP-CHA complexes were harvested. Specimens were processed for histology and stained with toluidine blue and bone implant contact (BIC was measured. The ISQs of complex groups was 77.8±2.9 in the 6-month, 72.0±5.7 in the 3-month and 47.4±11.0 in the 2-month. There was no significant difference between the 3- or 6-month complex groups and implant control groups. In the 2-month group, connective tissue, including capillary angiogenesis, was predominant around the implants, although newly formed bone could also be observed. While, in the 3 and 6-month groups, newly formed bone could be seen in contact to most of the implant surface. The BICs of complex groups was 2.18±3.77 in the 2-month, 44.03±29.58 in the 3-month, and 51.23±8.25 in the 6-month. Significant difference was detected between the 2 and 6-month. CONCLUSIONS/SIGNIFICANCE: Within the results of this study, the IP-CHA/implant complex might be able to achieve both

Electrochemical coating of dental implants with anodic porous titania for enhanced osteointegration

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Amirreza Shayganpour

2015-11-01

Full Text Available Clinical long-term osteointegration of titanium-based biomedical devices is the main goal for both dental and orthopedical implants. Both the surface morphology and the possible functionalization of the implant surface are important points. In the last decade, following the success of nanostructured anodic porous alumina, anodic porous titania has also attracted the interest of academic researchers. This material, investigated mainly for its photocatalytic properties and for applications in solar cells, is usually obtained from the anodization of ultrapure titanium. We anodized dental implants made of commercial grade titanium under different experimental conditions and characterized the resulting surface morphology with scanning electron microscopy equipped with an energy dispersive spectrometer. The appearance of nanopores on these implants confirm that anodic porous titania can be obtained not only on ultrapure and flat titanium but also as a conformal coating on curved surfaces of real objects made of industrial titanium alloys. Raman spectroscopy showed that the titania phase obtained is anatase. Furthermore, it was demonstrated that by carrying out the anodization in the presence of electrolyte additives such as magnesium, these can be incorporated into the porous coating. The proposed method for the surface nanostructuring of biomedical implants should allow for integration of conventional microscale treatments such as sandblasting with additive nanoscale patterning. Additional advantages are provided by this material when considering the possible loading of bioactive drugs in the porous cavities.

A PATIENT WITH EPIDERMAL CYST IN MANDIBULA, SIMULTANEOUSLY ENUCLEATION OF EPIDERMAL CYST AND IMPLANT PLACEMENT:

OpenAIRE

Terzi, Mithat; Karaaslan, Fatih; Çalık, Muhammed; Dilsiz, Alparslan; Altun, Eren

2015-01-01

Dermoid cysts are malformations that rarely seen in oral mucosa and can be defined as an epidermoid when lining presents only epithelium. Epidermoid and dermoid cysts are rarely seen in intraosseous and there was a few report about their presentation in the jaws. The development in implant surfaces and surgical techniques has led to changes in treatment protocol such as immediate implant placement. Immediate implant placement has some advantages such as, reduction in the time of treat- ment a...

Microstructure and mechanical properties of porous titanium structures fabricated by electron beam melting for cranial implants.

Science.gov (United States)

Moiduddin, Khaja

2018-02-01

The traditional methods of metallic bone implants are often dense and suffer from adverse reactions, biomechanical mismatch and lack of adequate space for new bone tissue to grow into the implant. The objective of this study is to evaluate the customized porous cranial implant with mechanical properties closer to that of bone and to improve the aesthetic outcome in cranial surgery with precision fitting for a better quality of life. Two custom cranial implants (bulk and porous) are digitally designed based on the Digital Imaging and Communications in Medicine files and fabricated using additive manufacturing. Initially, the defective skull model and the implant were fabricated using fused deposition modeling for the purpose of dimensional validation. Subsequently, the implant was fabricated using titanium alloy (Ti6Al4V extra low interstitial) by electron beam melting technology. The electron beam melting-produced body diagonal node structure incorporated in cranial implant was evaluated based on its mechanical strength and structural characterization. The results show that the electron beam melting-produced porous cranial implants provide the necessary framework for the bone cells to grow into the pores and mimic the architecture and mechanical properties closer to the region of implantation. Scanning electron microscope and micro-computed tomography scanning confirm that the produced porous implants have a highly regular pattern of porous structure with a fully interconnected network channel without any internal defect and voids. The physical properties of the titanium porous structure, containing the compressive strength of 61.5 MPa and modulus of elasticity being 1.20 GPa, represent a promising means of reducing stiffness and stress-shielding effect on the surrounding bone. This study reveals that the use of porous structure in cranial reconstruction satisfies the need of lighter implants with an adequate mechanical strength and structural characteristics

Virtual planning of dental implant placement using CT double scan-technique - own experience

International Nuclear Information System (INIS)

Wojciechowski, W.; Urbanik, A.; Kownacki, P.; Kownacki, S.

2007-01-01

The correctness of CT performed with the use of a double-scan technique is the basis for achieving proper quality of 3D reconstructions of the maxilla or mandible and subsequent virtual planning of dental implant placement. The aim of this study was the presentation of the methodology of computed tomography scanning and own experience with the use of the double-scan technique. The study group included 26 individuals who underwent MDCT with a double-scan technique using a MDCT scanner SOMATOM Sensation (Siemens, Germany). The parameters of the examination: slice-collimation 10 x 0.75 mm, slice-thickness 0.75 mm. The first CT scan in the procedure was the scan of the patient wearing a radiological prosthesis and occlusal index, which was followed by a separate scan of the radiological prosthesis. These two CT scans were copied and transferred to PC with Procera Software program (Nobel Biocare, Sweden) where dental implant placement was virtually planned. In all 26 patients, precise three-dimensional reconstructions of the anatomical structure were obtained. In 11 patients, on the basis of the virtual planning, the implant placement was performed, 5 patients were referred to preparatory procedures, that is, restoration of the alveolar process, otolaryngological treatment of the maxillary sinuses. The remaining 10 patients did not qualify to the procedure because of unfavorable anatomical ideation's. Correct computed tomography with double-scan technique enables virtual planning of dental implant placement, on the basis of which the real procedure of implantation can be performed. (author)

Placement of implant bridge anterior maxilla post autograft (Serial case

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Rifaat Nurrahma

2016-06-01

Full Text Available An advanced technology with implants based has now been developed in recent years.Implant with the bridge superstructure method is employed after variety of considerations where it is expected to meet its function, aesthetics, and comfortability.The alveolar bone existed is one reason for the process of adding bone (bonegraft.This case report proposes to determine the successful insertion of a superstructure anterior implant bridge post autograft.Two female patients were asked to use dental implant anterior with bridge system.The first case, the autograft application is made for a 20-year-old woman with edentulous teeth 11, 21, 22. One year later it was then inserted in the area of dental implant fixture 11 and 22. After 9 months, the healing abutments and the superstructure were inserted too.2 weeks after, the abutments of bridge and crowns of teeth 11, 21 and 22 with a pontic in the teeth 21 had been inserted. The second case, a 46-year-old woman with edentulous 11,12,21,22.They want to change the denture because they did not feel comfortable with the removable denture acrylic.Fixture placement was done a year after autograft.Insertion of healing abutments and the superstructure printing can be done after 6 months.A month later implant abutments and crowns could be inserted.Labial fullness is corrected; an implant-retained in the region of 12 and 21, 12, and 22 used the pontic.Prosthodontic rehabilitation with a fixed denture using the implant bridge after autograft anterior maxilla is an alternative fixed denture placement with satisfactory results, aesthetic correction and comfortably.

Biomimetic calcium phosphate coating of additively manufactured porous CoCr implants

Energy Technology Data Exchange (ETDEWEB)

Lindahl, Carl [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Department of Engineering Sciences, Ångstrom Laboratory, Uppsala University, Uppsala (Sweden); Xia, Wei, E-mail: wei.xia@angstrom.uu.se [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Department of Engineering Sciences, Ångstrom Laboratory, Uppsala University, Uppsala (Sweden); Engqvist, Håkan [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Department of Engineering Sciences, Ångstrom Laboratory, Uppsala University, Uppsala (Sweden); Snis, Anders [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Arcam AB, Krokslätts Fabriker 27 A, SE-431 37 Mölndal (Sweden); Lausmaa, Jukka [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Department of Chemistry, Materials and Surfaces, SP Technical Research Institute of Sweden, Borås (Sweden); Palmquist, Anders [BIOMATCELL Vinn Excellence Center of Biomaterials and Cell Therapy, Gothenburg (Sweden); Department of Biomaterials, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)

2015-10-30

Highlights: • A route for coating complex shaped electron beam melted implants is presented. • Biomimetic HA coatings were deposited on CoCr alloys using a solution method. • Deposited biomimetic coating was partially crystalline, slightly calcium deficient. • Coating morphology was plate-like with crystallites forming roundish flowers. • Present coating procedure could be useful for porous implants made by EBM. - Abstract: The aim of this work was to study the feasibility to use a biomimetic method to prepare biomimetic hydroxyapatite (HA) coatings on CoCr substrates with short soaking times and to characterize the properties of such coatings. A second objective was to investigate if the coatings could be applied to porous CoCr implants manufactured by electron beam melting (EBM). The coating was prepared by immersing the pretreated CoCr substrates and EBM implants into the phosphate-buffered solution with Ca{sup 2+} in sealed plastic bottles, kept at 60 °C for 3 days. The formed coating was partially crystalline, slightly calcium deficient and composed of plate-like crystallites forming roundish flowers in the size range of 300–500 nm. Cross-section imaging showed a thickness of 300–500 nm. In addition, dissolution tests in Tris–HCl up to 28 days showed that a substantial amount of the coating had dissolved, however, undergoing only minor morphological changes. A uniform coating was formed within the porous network of the additive manufactured implants having similar thickness and morphology as for the flat samples. In conclusion, the present coating procedure allows coatings to be formed on CoCr and could be used for complex shaped, porous implants made by additive manufacturing.

Biomimetic calcium phosphate coating of additively manufactured porous CoCr implants

International Nuclear Information System (INIS)

Lindahl, Carl; Xia, Wei; Engqvist, Håkan; Snis, Anders; Lausmaa, Jukka; Palmquist, Anders

2015-01-01

Highlights: • A route for coating complex shaped electron beam melted implants is presented. • Biomimetic HA coatings were deposited on CoCr alloys using a solution method. • Deposited biomimetic coating was partially crystalline, slightly calcium deficient. • Coating morphology was plate-like with crystallites forming roundish flowers. • Present coating procedure could be useful for porous implants made by EBM. - Abstract: The aim of this work was to study the feasibility to use a biomimetic method to prepare biomimetic hydroxyapatite (HA) coatings on CoCr substrates with short soaking times and to characterize the properties of such coatings. A second objective was to investigate if the coatings could be applied to porous CoCr implants manufactured by electron beam melting (EBM). The coating was prepared by immersing the pretreated CoCr substrates and EBM implants into the phosphate-buffered solution with Ca"2"+ in sealed plastic bottles, kept at 60 °C for 3 days. The formed coating was partially crystalline, slightly calcium deficient and composed of plate-like crystallites forming roundish flowers in the size range of 300–500 nm. Cross-section imaging showed a thickness of 300–500 nm. In addition, dissolution tests in Tris–HCl up to 28 days showed that a substantial amount of the coating had dissolved, however, undergoing only minor morphological changes. A uniform coating was formed within the porous network of the additive manufactured implants having similar thickness and morphology as for the flat samples. In conclusion, the present coating procedure allows coatings to be formed on CoCr and could be used for complex shaped, porous implants made by additive manufacturing.

Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures.

Science.gov (United States)

Waki, Tomonori; Kan, Joseph Y K

2016-01-01

Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations.

Revival of pure titanium for dynamically loaded porous implants using additive manufacturing

NARCIS (Netherlands)

Wauthle, Ruben; Ahmadi, Seyed Mohammad; Amin Yavari, Saber; Mulier, Michiel; Zadpoor, Amir Abbas; Weinans, Harrie; Van Humbeeck, Jan; Kruth, Jean-Pierre; Schrooten, Jan

Additive manufacturing techniques are getting more and more established as reliable methods for producing porous metal implants thanks to the almost full geometrical and mechanical control of the designed porous biomaterial. Today, Ti6Al4V ELI is still the most widely used material for porous

Immediate placement of dental implants in the esthetic zone : a systematic review and pooled analysis

NARCIS (Netherlands)

Slagter, Kirsten W; den Hartog, Laurens; Bakker, Nicolaas A; Vissink, Arjan; Meijer, Henny J A; Raghoebar, Gerry M

Background: Research interest on immediate placement of dental implants has shifted from implant survival toward optimal preservation of soft and hard tissues. The aim of this study is to systematically assess the condition of implant survival, peri-implant hard and soft tissue changes, esthetic

Immediate Placement of Ultrawide-Diameter Implants in Molar Sockets: Description of a Recommended Technique.

Science.gov (United States)

Hattingh, André C; De Bruyn, Hugo; Ackermann, Andrew; Vandeweghe, Stefan

Immediate implant placement is performed less frequently in molar extraction sockets than in single root sockets. This is mainly due to the tripodal anatomical configuration of molar roots, which is perceived as complex and therefore unsuitable. The mechanical burden of molar sites, combined with much larger socket dimensions, make it amenable to the use of ultrawide-diameter dental implants. This article describes a practical, sequenced technique that can be used predictably for immediate implant placement in maxillary and mandibular first molar sockets, using a dry skull model for clarification. This detailed description is based on the experience of more than 580 clinical cases over a 10-year period.

Advances in bone augmentation to enable dental implant placement: Consensus Report of the Sixth European Workshop on Periodontology.

Science.gov (United States)

Tonetti, Maurizio S; Hämmerle, Christoph H F

2008-09-01

Bone augmentation procedures to enable dental implant placement are frequently performed in practice. In this session the European Workshop on Periodontology discussed the evidence in support of the procedures and examined both adverse events and implant performance in the augmented bone. While the available evidence improved both in quantity and quality since previous workshops the conclusions that could be drawn were limited by elements of design and/or reporting that are amenable to improvement. With regards to lateral bone augmentation, a sizable body of evidence supports its use to enable dental implant placement. The group recognized the potential for vertical ridge augmentation procedures to allow implant placement in clinical practice but questioned the applicability of these data to a wider array of operators and clinical settings. With regards to sinus floor augmentation, perforation of the sinus membrane, graft infection and graft loss resulting in inability of implant placement were the major reported adverse events. In cases with dental implants placed in pristine sites. The consensus emphasized the research need to answer questions on: (i) long-term performance of dental implants placed in augmented bone; (ii) the clinical performance of dental implants placed in augmented or pristine sites; and (iii) the clinical benefits of bone augmentation with respect to alternative treatments.

Application of interconnected porous hydroxyapatite ceramic block for onlay block bone grafting in implant treatment: A case report.

Science.gov (United States)

Ohta, Kouji; Tada, Misato; Ninomiya, Yoshiaki; Kato, Hiroki; Ishida, Fumi; Abekura, Hitoshi; Tsuga, Kazuhiro; Takechi, Masaaki

2017-12-01

Autogenous block bone grafting as treatment for alveolar ridge atrophy has various disadvantages, including a limited availability of sufficiently sized and shaped grafts, donor site morbidity and resorption of the grafted bone. As a result, interconnected porous hydroxyapatite ceramic (IP-CHA) materials with high porosity have been developed and used successfully in orthopedic cases. To the best of the author's knowledge, this is the first report of clinical application of an IP-CHA block for onlay grafting for implant treatment in a patient with horizontal alveolar atrophy. The present study performed onlay block grafting using an IP-CHA block to restore bone volume for implant placement in the alveolar ridge area without collecting autogenous bone. Dental X-ray findings revealed that the border of the IP-CHA block became increasingly vague over the 3-year period, whereas CT scanning revealed that the gap between the block and bone had a smooth transition, indicating that IP-CHA improved the process of integration with host bone. In follow-up examinations over a period of 5 years, the implants and superstructures had no problems. An IP-CHA block may be useful as a substitute for onlay block bone grafting in implant treatment.

Seed Placement in Permanent Breast Seed Implant Brachytherapy: Are Concerns Over Accuracy Valid?

Energy Technology Data Exchange (ETDEWEB)

Morton, Daniel, E-mail: dmorton@bccancer.bc.ca [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Hilts, Michelle [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia (Canada); Batchelar, Deidre [Department of Medical Physics, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Crook, Juanita [Department of Radiation Oncology, BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada)

2016-07-01

Purpose: To evaluate seed placement accuracy in permanent breast seed implant brachytherapy (PBSI), to identify any systematic errors and evaluate their effect on dosimetry. Methods and Materials: Treatment plans and postimplant computed tomography scans for 20 PBSI patients were spatially registered and used to evaluate differences between planned and implanted seed positions, termed seed displacements. For each patient, the mean total and directional seed displacements were determined in both standard room coordinates and in needle coordinates relative to needle insertion angle. Seeds were labeled according to their proximity to the anatomy within the breast, to evaluate the influence of anatomic regions on seed placement. Dosimetry within an evaluative target volume (seroma + 5 mm), skin, breast, and ribs was evaluated to determine the impact of seed placement on the treatment. Results: The overall mean (±SD) difference between implanted and planned positions was 9 ± 5 mm for the aggregate seed population. No significant systematic directional displacements were observed for this whole population. However, for individual patients, systematic displacements were observed, implying that intrapatient offsets occur during the procedure. Mean displacements for seeds in the different anatomic areas were not found to be significantly different from the mean for the entire seed population. However, small directional trends were observed within the anatomy, potentially indicating some bias in the delivery. Despite observed differences between the planned and implanted seed positions, the median (range) V{sub 90} for the 20 patients was 97% (66%-100%), and acceptable dosimetry was achieved for critical structures. Conclusions: No significant trends or systematic errors were observed in the placement of seeds in PBSI, including seeds implanted directly into the seroma. Recorded seed displacements may be related to intrapatient setup adjustments. Despite observed seed

Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment.

Science.gov (United States)

Taniguchi, Naoya; Fujibayashi, Shunsuke; Takemoto, Mitsuru; Sasaki, Kiyoyuki; Otsuki, Bungo; Nakamura, Takashi; Matsushita, Tomiharu; Kokubo, Tadashi; Matsuda, Shuichi

2016-02-01

Selective laser melting (SLM) is an additive manufacturing technique with the ability to produce metallic scaffolds with accurately controlled pore size, porosity, and interconnectivity for orthopedic applications. However, the optimal pore structure of porous titanium manufactured by SLM remains unclear. In this study, we evaluated the effect of pore size with constant porosity on in vivo bone ingrowth in rabbits into porous titanium implants manufactured by SLM. Three porous titanium implants (with an intended porosity of 65% and pore sizes of 300, 600, and 900μm, designated the P300, P600, and P900 implants, respectively) were manufactured by SLM. A diamond lattice was adapted as the basic structure. Their porous structures were evaluated and verified using microfocus X-ray computed tomography. Their bone-implant fixation ability was evaluated by their implantation as porous-surfaced titanium plates into the cortical bone of the rabbit tibia. Bone ingrowth was evaluated by their implantation as cylindrical porous titanium implants into the cancellous bone of the rabbit femur for 2, 4, and 8weeks. The average pore sizes of the P300, P600, and P900 implants were 309, 632, and 956μm, respectively. The P600 implant demonstrated a significantly higher fixation ability at 2weeks than the other implants. After 4weeks, all models had sufficiently high fixation ability in a detaching test. Bone ingrowth into the P300 implant was lower than into the other implants at 4weeks. Because of its appropriate mechanical strength, high fixation ability, and rapid bone ingrowth, our results indicate that the pore structure of the P600 implant is a suitable porous structure for orthopedic implants manufactured by SLM. Copyright © 2015 Elsevier B.V. All rights reserved.

Immediate Implant Placement and Provisionalization Using the Patient's Extracted Crown: 12-Month Follow-Up.

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Deliberador, Tatiana Miranda; Begnini, Gilmar José; Tomazinho, Flávia; Rezende, Carlos Eduardo Edwards; Florez, Fernando Luis Esteban; Leonardi, Denise Piotto

2018-03-01

Immediate placement and provisionalization of implants in fresh sockets has been previously demonstrated to be a predictable treatment in the restoration of non-recoverable teeth in the anterior regions of the maxilla. This article reports a clinical case in which an immediate implant placement protocol was used in combination with two distinct and sequential grafts (bovine bone and connective tissue, respectively) followed by immediate implant provisionalization using the patient's crown of an extracted tooth. Physical, clinical, and image examinations of the patient (female, 23 years old) revealed a maxillary central incisor (tooth No. 8) with slight mobility due the presence of extensive cervical resorption. The treatment proposed was the atraumatic extraction of the tooth followed by immediate implant placement and provisionalization. Two grafts (bovine bone and connective tissue) were used due to the presence of a very thin maxillary bone plate associated with a thin gingival biotype. The use of the extracted crown as a temporary crown after immediate implant placement resulted in immediate attainment of an esthetically pleasing outcome and long-term favorable results. The treatment protocol proposed can be efficiently used to immediately restore the patient's esthetics and function while maintaining the health, volume, and contours of gingival tissues over a 12-month follow-up period. Anterior teeth extractions typically require the execution of single-unit prostheses using dental materials of synthetic origin (such as polymers), which often are incapable of achieving the esthetic and physiological results patients expect. The use of the patient's own crown was demonstrated, which allowed good clinical results to be achieved and the natural shape and function of tissues to be maintained.

Placement of endosseous implant in infected alveolar socket with large fenestration defect: A comparative case report

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Balaji Anitha

2010-01-01

Full Text Available Placement of endosseous implants into infected bone is often deferred or avoided due to fear of failure. However, with the development of guided bone regeneration [GBR], some implantologists have reported successful implant placement in infected sockets, even those with fenestration defects. We had the opportunity to compare the osseointegration of an immediate implant placed in an infected site associated with a large buccal fenestration created by the removal of a root stump with that of a delayed implant placed 5 years after extraction. Both implants were placed in the same patient, in the same dental quadrant by the same implantologist. GBR was used with the fenestration defect being filled with demineralized bone graftFNx01 and covered with collagen membraneFNx08. Both implants were osseointegrated and functional when followed up after 12 months.

Biological Strategies for Improved Osseointegration and Osteoinduction of Porous Metal Orthopedic Implants

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Riester, Scott M.; Bonin, Carolina A.; Kremers, Hilal Maradit; Dudakovic, Amel; Kakar, Sanjeev; Cohen, Robert C.; Westendorf, Jennifer J.

2015-01-01

The biological interface between an orthopedic implant and the surrounding host tissue may have a dramatic effect upon clinical outcome. Desired effects include bony ingrowth (osseointegration), stimulation of osteogenesis (osteoinduction), increased vascularization, and improved mechanical stability. Implant loosening, fibrous encapsulation, corrosion, infection, and inflammation, as well as physical mismatch may have deleterious clinical effects. This is particularly true of implants used in the reconstruction of load-bearing synovial joints such as the knee, hip, and the shoulder. The surfaces of orthopedic implants have evolved from solid-smooth to roughened-coarse and most recently, to porous in an effort to create a three-dimensional architecture for bone apposition and osseointegration. Total joint surgeries are increasingly performed in younger individuals with a longer life expectancy, and therefore, the postimplantation lifespan of devices must increase commensurately. This review discusses advancements in biomaterials science and cell-based therapies that may further improve orthopedic success rates. We focus on material and biological properties of orthopedic implants fabricated from porous metal and highlight some relevant developments in stem-cell research. We posit that the ideal primary and revision orthopedic load-bearing metal implants are highly porous and may be chemically modified to induce stem cell growth and osteogenic differentiation, while minimizing inflammation and infection. We conclude that integration of new biological, chemical, and mechanical methods is likely to yield more effective strategies to control and modify the implant–bone interface and thereby improve long-term clinical outcomes. PMID:25348836

Immediate Single-Tooth Implant Placement in Bony Defects in the Esthetic Zone : A 1-Year Randomized Controlled Trial

NARCIS (Netherlands)

Slagter, Kirsten W.; Meijer, Henny J. A.; Bakker, Nicolaas A.; Vissink, Arjan; Raghoebar, Gerry M.

Background: This study aims to assess, with regard to marginal bone level (MBL), whether the outcome of immediate implant placement in bony defects in the esthetic zone was non-inferior to delayed implant placement after 1 year. Methods: Forty patients with a failing tooth in the esthetic zone and a

Effect of pore size on bone ingrowth into porous titanium implants fabricated by additive manufacturing: An in vivo experiment

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Taniguchi, Naoya, E-mail: tani110@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Fujibayashi, Shunsuke, E-mail: shfuji@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Takemoto, Mitsuru, E-mail: m.take@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Sasaki, Kiyoyuki, E-mail: kiy-sasaki@spcom.co.jp [Sagawa Printing Co., Ltd., 5-3, Inui, Morimoto-Cho, Mukou-Shi, Kyoto 617-8588 (Japan); Otsuki, Bungo, E-mail: bungo@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan); Nakamura, Takashi, E-mail: ntaka@kuhp.kyoto-u.ac.jp [National Hospital Organization Kyoto Medical Center, 1-1, Mukaihatacho, Hukakusa, Hushimi, Kyoto 612-8555 (Japan); Matsushita, Tomiharu, E-mail: matsushi@isc.chubu.ac.jp [Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501 (Japan); Kokubo, Tadashi, E-mail: kokubo@isc.chubu.ac.jp [Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501 (Japan); Matsuda, Shuichi, E-mail: smat522@kuhp.kyoto-u.ac.jp [Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507 (Japan)

2016-02-01

Selective laser melting (SLM) is an additive manufacturing technique with the ability to produce metallic scaffolds with accurately controlled pore size, porosity, and interconnectivity for orthopedic applications. However, the optimal pore structure of porous titanium manufactured by SLM remains unclear. In this study, we evaluated the effect of pore size with constant porosity on in vivo bone ingrowth in rabbits into porous titanium implants manufactured by SLM. Three porous titanium implants (with an intended porosity of 65% and pore sizes of 300, 600, and 900 μm, designated the P300, P600, and P900 implants, respectively) were manufactured by SLM. A diamond lattice was adapted as the basic structure. Their porous structures were evaluated and verified using microfocus X-ray computed tomography. Their bone–implant fixation ability was evaluated by their implantation as porous-surfaced titanium plates into the cortical bone of the rabbit tibia. Bone ingrowth was evaluated by their implantation as cylindrical porous titanium implants into the cancellous bone of the rabbit femur for 2, 4, and 8 weeks. The average pore sizes of the P300, P600, and P900 implants were 309, 632, and 956 μm, respectively. The P600 implant demonstrated a significantly higher fixation ability at 2 weeks than the other implants. After 4 weeks, all models had sufficiently high fixation ability in a detaching test. Bone ingrowth into the P300 implant was lower than into the other implants at 4 weeks. Because of its appropriate mechanical strength, high fixation ability, and rapid bone ingrowth, our results indicate that the pore structure of the P600 implant is a suitable porous structure for orthopedic implants manufactured by SLM. - Highlights: • We studied the effect of pore size on bone tissue in-growth in a rabbit in vivo model. • Titanium samples with 300/600/900 μm pore size in three-dimensionally controlled shapes were fabricated by additive manufacturing. • Samples were

Radiologic placement of implantable chest ports in pediatric patients under sedation

International Nuclear Information System (INIS)

Shin, Tae Beom

2003-01-01

To evaluate the safety and efficacy of the radiologic placement of implantable chest ports under intravenous sedation in pediatric patients with malignancy. Between October 2001 and June 2002, 20 chest ports were placed in 19 pediatric patients [13 boys and six girls aged 1-11 (mean, 4.7) years] for the purpose of long-term chemotherapy. In three patients, tunneled central venous catheters had been removed because of catheter extration, infection, and tearing. Under intravenous sedation, the right internal jugular vein was used for access in 19 cases, and the left internal jugular vein in one. Venipucture was performed using a micropuncture needle with real-time ultrasound guidance. A port chamber was created at the infraclavicular fossa, and to prevent catheter kinking, a smooth-angled tunnel was created between the venipuncture site and the subcutaneous pocket. The catheter tip was positioned under fluoroscopy at the junction of the superior vena cava and right atrium. We observed technical success, complications arouse during and after the procedure, and duration of catheter use. Implantation of the port system was successful in all cases, though slight hematoma, treated with manual compression, occurred at a chamber pocket in one case. In addition, the port system was removed from one patient because of wound infection leading to dehiscence and catheter malpositiong. A new port system was implanted through the left internal jugular vein. The median period during which catheter use was followed up was 118 (range, 18-274) days. For long-term chemotherapy in pediatric patients with malignancy, radiologic placement of an implantable chest port under intravenous sedation shows a high technical success rate, with few complications. This method may thus be used instead of surgical port placement

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

Directory of Open Access Journals (Sweden)

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.

Understanding long-term silver release from surface modified porous titanium implants.

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Shivaram, Anish; Bose, Susmita; Bandyopadhyay, Amit

2017-08-01

Prevention of orthopedic device related infection (ODRI) using antibiotics has met with limited amount of success and is still a big concern during post-surgery. As an alternative, use of silver as an antibiotic treatment to prevent surgical infections is being used due to the well-established antimicrobial properties of silver. However, in most cases silver is used in particulate form with wound dressings or with short-term devices such as catheters but not with load-bearing implants. We hypothesize that strongly adherent silver to load-bearing implants can offer longer term solution to infection in vivo. Keeping that in mind, the focus of this study was to understand the long term release study of silver ions for a period of minimum 6months from silver coated surface modified porous titanium implants. Implants were fabricated using a LENS™ system, a powder based additive manufacturing technique, with at least 25% volume porosity, with and without TiO 2 nanotubes in phosphate buffer saline (pH 7.4) to see if the total release of silver ions is within the toxic limit for human cells. Considering the fact that infection sites may reduce the local pH, silver release was also studied in acetate buffer (pH 5.0) for a period of 4weeks. Along with that, the osseointegrative properties as well as cytotoxicity of porous titanium implants were assessed in vivo for a period of 12weeks using a rat distal femur model. In vivo results indicate that porous titanium implants with silver coating show comparable, if not better, biocompatibility and bonding at the bone-implant interface negating any concerns related to toxicity related to silver to normal cells. The current research is based on our recently patented technology, however focused on understanding longer-term silver release to mitigate infection related problems in load-bearing implants that can even arise several months after the surgery. Prevention of orthopedic device related infection using antibiotics has met

Monitoring the osseointegration process in porous Ti6Al4V implants produced by additive manufacturing: an experimental study in sheep.

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Kayacan, Mehmet C; Baykal, Yakup B; Karaaslan, Tamer; Özsoy, Koray; Alaca, İlker; Duman, Burhan; Delikanlı, Yunus E

2018-04-01

This study investigated the design and osseointegration process of transitive porous implants that can be used in humans and all trabecular and compact bone structure animals. The aim was to find a way of forming a strong and durable tissue bond on the bone-implant interface. Massive and transitive porous implants were produced on a direct metal laser sintering machine, surgically implanted into the skulls of sheep and kept in place for 12 weeks. At the end of the 12-week period, the Massive and porous implants removed from the sheep were investigated by scanning electron microscopy (SEM) to monitor the osseointegration process. In the literature, each study has selected standard sizes for pore diameter in the structures they use. However, none of these involved transitional porous structures. In this study, as opposed to standard pores, there were spherical or elliptical pores at the micro level, development channels and an inner region. Bone cells developed in the inner region. Transitive pores grown gradually in accordance with the natural structure of the bone were modeled in the inner region for cells to develop. Due to this structure, a strong and durable tissue bond could be formed at the bone-implant interface. Osseointegration processes of Massive vs. porous implants were compared. It was observed that cells were concentrated on the surface of Massive implants. Therefore, osseointegration between implant and bone was less than that of porous implants. In transitive porous implants, as opposed to Massive implants, an outer region was formed in the bone-implant interface that allowed tissue development.

Effects of pore size, implantation time and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants

OpenAIRE

Farrell, Brad J.; Prilutsky, Boris I.; Ritter, Jana M.; Kelley, Sean; Popat, Ketul; Pitkin, Mark

2013-01-01

The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40–100 microns and Large, 100–160 microns), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to 7 groups. Implant extrusion rate was measured w...

Pain from Dental Implant Placement, Inflammatory Pulpitis Pain, and Neuropathic Pain Present Different Somatosensory Profiles.

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Porporatti, André Luís; Bonjardim, Leonardo Rigoldi; Stuginski-Barbosa, Juliana; Bonfante, Estevam Augusto; Costa, Yuri Martins; Rodrigues Conti, Paulo César

2017-01-01

To address the two following questions: (1) What kind of somatosensory abnormalities may be characterized in patients receiving dental implants (IMP), in ongoing inflammatory dental pulpitis (IP) patients, and in neuropathic pain (atypical odontalgia [AO]) patients? and (2) What sort of sensory and neural changes may result from dental implant placement surgery and pulpectomy? A total of 60 subjects were divided into three groups: the IMP (n = 20), IP (n = 20), and AO groups (n = 20). Quantitative sensory testing (QST) was performed preoperatively (baseline) for all three groups and postoperatively at 1 month and 3 months after dental implant placement or pulpectomy (in the IMP group and IP group, respectively). Statistical analyses were completed with one-way and two-way analysis of variance and z score transformations (α = 5%). The main findings of this study indicated that: (1) Elevations in mechanical detection threshold (MDT) and in current perception threshold (CPT) related to C-fiber activation, indicating a loss of function, were found at baseline in IP patients; (2) Somatosensory abnormalities such as allodynia, reduced MDT and mechanical pain threshold (MPT), and impaired pain modulation were found in AO patients; (3) No somatosensory alterations after implant placement were found in the IMP group; and (4) Somatosensory alterations in the form of reduction in the CPT related to C-fiber activation were reported 3 months after pulpectomy in the IP group. This study showed that somatosensory abnormalities were evident in AO and IP patients, and somatosensory alterations were seen in IP patients even 3 months after pulpectomy. However, no somatosensory alterations were seen after implant placement.

Bone Reduction to Facilitate Immediate Implant Placement and Loading Using CAD/CAM Surgical Guides for Patients With Terminal Dentition.

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Alzoubi, Fawaz; Massoomi, Nima; Nattestad, Anders

2016-10-01

The aim of this study is to present a method, using 3 computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides, to accurately obtain the desired bone reduction followed by immediate implant placements and loading for patients diagnosed with terminal dentition. Patients who had bone reduction, implants placed, and immediate loading using Anatomage Invivo 5 CAD/CAM surgical guides between the period 2013 and 2015 were evaluated retrospectively. Patients diagnosed with terminal dentition and treated using the "3-guide technique" were identified. Pre- and postsurgical images were superimposed to evaluate deviations of the bone reduction and deviations at the crest, apex, and angle of implants placed. Twenty-six implants placed in 5 patients were included in this study. The overall deviation means measured for bone reduction was 1.98 mm. The overall deviation means measured for implant placement at the crest, apex, and angle were 1.43 mm, 1.90 mm, and 4.14°, respectively. The CAD/CAM surgical guide fabrication is an emerging tool that may facilitate the surgical process and aid in safe and predictable execution of bone reduction and immediate implant placement. Using 3 CAD/CAM surgical guides, a method is presented to obtain the desired bone reduction followed by immediate implant placement and loading for patients diagnosed with terminal dentition. This method may improve guide stability for patients with terminal dentition undergoing complete implant-supported treatment by taking advantage of the teeth to be extracted.

The effect of subcrestal placement of the polished surface of ITI implants on marginal soft and hard tissues.

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Hämmerle, C H; Brägger, U; Bürgin, W; Lang, N P

1996-06-01

In order to achieve esthetically more satisfying results, it has been proposed to place ITI implants with their border between the rough and smooth surfaces below the level of the alveolar crest, thereby obtaining a submucosally located implant shoulder following healing. The aim of the present experimental study was to clinically and radiographically evaluate the tissue response to the placement of one-stage transmucosal implants with the border between the rough and the smooth surfaces sunk by 1 mm into a subcrestal location. 11 patients underwent comprehensive dental care including the placement of 2 implants of the ITI Dental Implant System in the same quadrant (test and control). Randomly assigned control implants were placed according to the manufacturer's instructions, i.e. the border between the rough titanium plasma-sprayed and the smooth polished surfaces precisely at the alveolar crest. At the test implant the apical border of the polished surface was placed approximately 1 mm below the alveolar crest. Probing bone levels were assessed at implant placement (baseline), 4 and 12 months later. Modified plaque and modified gingival indices were recorded at 1, 2, 3, 4 and 12 months. Clinical probing depth and "attachment" levels were measured at 4 and 12 months. All parameters were assessed at 6 sites around each implant. The mean for each implant was calculated and used for analysis. The Wilcoxon matched pairs signed rank test and the Student t-test were applied to detect differences over time and between the test and control implants. At baseline, a mean difference in probing bone level of -0.86 mm (SD 0.43 mm, p placed more deeply. Both test and control implants lost a significant amount of clinical bone height during the first 4 months (test 1.16 mm, p placed under standard conditions, the bone adjacent to the polished surface of more deeply placed ITI implants is also lost over time. From a biological point of view, the placement of the border between

Porous, Dexamethasone-loaded polyurethane coatings extend performance window of implantable glucose sensors in vivo.

Science.gov (United States)

Vallejo-Heligon, Suzana G; Brown, Nga L; Reichert, William M; Klitzman, Bruce

2016-01-01

Continuous glucose sensors offer the promise of tight glycemic control for insulin dependent diabetics; however, utilization of such systems has been hindered by issues of tissue compatibility. Here we report on the in vivo performance of implanted glucose sensors coated with Dexamethasone-loaded (Dex-loaded) porous coatings employed to mediate the tissue-sensor interface. Two animal studies were conducted to (1) characterize the tissue modifying effects of the porous Dex-loaded coatings deployed on sensor surrogate implants and (2) investigate the effects of the same coatings on the in vivo performance of Medtronic MiniMed SOF-SENSOR™ glucose sensors. The tissue response to implants was evaluated by quantifying macrophage infiltration, blood vessel formation, and collagen density around implants. Sensor function was assessed by measuring changes in sensor sensitivity and time lag, calculating the Mean Absolute Relative Difference (MARD) for each sensor treatment, and performing functional glucose challenge test at relevant time points. Implants treated with porous Dex-loaded coatings diminished inflammation and enhanced vascularization of the tissue surrounding the implants. Functional sensors with Dex-loaded porous coatings showed enhanced sensor sensitivity over a 21-day period when compared to controls. Enhanced sensor sensitivity was accompanied with an increase in sensor signal lag and MARD score. These results indicate that Dex-loaded porous coatings were able to elicit an attenuated tissue response, and that such tissue microenvironment could be conducive towards extending the performance window of glucose sensors in vivo. In the present article, a coating to extend the functionality of implantable glucose sensors in vivo was developed. Our study showed that the delivery of an anti-inflammatory agent with the presentation of micro-sized topographical cues from coatings may lead to improved long-term glucose sensor function in vivo. We believe that

Successful implant placement in a Case of Florid Cemento-osseous Dysplasia: a case report and literature review.

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Esfahanizadeh, Nasrin; Yousefi, Hila

2018-02-06

Florid cemento-osseus dysplasia (FCOD) has been described as a reactive process in which normal bone is replaced by fibrous connective tissues and cementum-like materials. Radiographically it appears as dense, lobulated masses, often occurring bilaterally with symmetric involvement. In this case report a successful implant placement has been reported in a 62-year-old Caucasian woman with a chief complaint of mandibular partial edentulous. Radiographic images showed the bilateral radio-opaque lesions in edentulous regions of mandible, and mandibular anterior teeth alike. All mandibular teeth were vital and no root resorption was detected. The findings of X-ray images were attributable to FCOD. A highly conservative step-by-step two-stage implant surgery was performed. After 6 months the implants loaded with fixed prosthesis. 2, 4,6,12 and 18 months after the surgery radiographic images were taken, which revealed an optimal functional rehabilitation and complete integration of implants. This report confirms that treating the edentulous area near the FCOD lesions could be planned, if conservative and step-by-step implant placement been considered. To the best of our knowledge, a case of FCOD with successful implant placement has not been reported previously. More studies in more patients are needed to confirm results of such a therapeutic modality.

Optimization in multi-implant placement for immediate loading in edentulous arches using a modified surgical template and prototyping: a case report.

Science.gov (United States)

Jayme, Sérgio J; Muglia, Valdir A; de Oliveira, Rafael R; Novaes, Arthur B Júnior

2008-01-01

Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance throughout the treatment period. Placement of dental implants requires precise planning that accounts for anatomic limitations and restorative goals. Diagnosis can be made with the assistance of computerized tomographic scanning, but transfer of planning to the surgical field is limited. Recently, novel CAD/CAM techniques such as stereolithographic rapid prototyping have been developed to build surgical guides in an attempt to improve precision of implant placement. The aim of this case report was to show a modified surgical template used throughout implant placement as an alternative to a conventional surgical guide.

A trabecular metal implant 4 months after placement: clinical-histologic case report.

Science.gov (United States)

Spinato, Sergio; Zaffe, Davide; Felice, Pietro; Checchi, Luigi; Wang, Hom-Lay

2014-02-01

The aim of this case report was to histologically evaluate the behavior of a trabecular metal (TM) implant composed of titanium and spatial 3-dimensional tantalum (Ta) trabeculae. This study is the first human histologic case report of this implant. A TM implant was placed in a 54-year-old woman exhibiting moderate chronic periodontitis. After periodontal treatment, the implant was inserted under favorable clinical conditions. Patient was not seen for 4 months because of unrelated breast reduction surgery. At the surgical reopening, periimplant inflammation affecting the coronal third of the implant was observed 4 months after implant placement. With patient's consent, the implant was removed for histologic analysis. Histology highlighted a greater amount of bone in close contact with Ta trabeculae than titanium surfaces. The finding of bone formation around the Ta trabeculae suggests that trabecular metal material promotes bone ingrowth for secondary implant stability. Additional evidence is needed to confirm this observation.

Immediate Implant Placement into Extraction Sockets with Labial Plate Dehiscence Defects: A Clinical Case Series.

Science.gov (United States)

Sarnachiaro, Guido O; Chu, Stephen J; Sarnachiaro, Evangelina; Gotta, Sergio Luis; Tarnow, Dennis P

2016-08-01

To measure the buccal plate reconstruction of extraction sockets with labial plate dehiscence defects using a bone allograft in combination with an absorbable collagen membrane and a custom-healing abutment at the time of tooth removal. Ten patients underwent immediate implant placement and reconstruction of the buccal plate. Cone beam computed tomography (CBCT) was performed preextraction, immediately after bone grafting and implant placement (day 0), and between 6 and 9 months following implant surgery. Measurements were taken at three levels: coronal (L1), middle (L2), and apical (L3) level. Implants placed into sockets with labial plate dehiscence defects demonstrated radiographic reformation of the labial plate dehiscence defect at 6 to 9 months posttreatment. The net gain in labial plate on cone beam computerized tomography (CBCT) in L1 and L2 was 3.0 mm, where 0 mm existed at pretreatment. The minimum amount of labial plate thickness of 2.0 mm was achieved in all treated sites, evaluated radiographically at 6 to 9 months postoperatively, in a single procedure, without flap elevation and maintaining the gingival architecture and satisfactory esthetics. Placing an absorbable membrane, bone graft, and custom-healing abutment at the time of flapless anterior tooth extraction and immediate implant placement into a socket with a labial osseous dehiscence is a viable clinical technique to reconstitute the absence of the labial bone plate. © 2015 Wiley Periodicals, Inc.

Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis.

Science.gov (United States)

Lee, Jungwon; Park, Dueun; Koo, Ki-Tae; Seol, Yang-Jo; Lee, Yong-Moo

2018-04-03

This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets. We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up. In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was -0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, -0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG. Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.

Use of the frontal process of the maxillary bone for implant placement to retain a nasal prosthesis: a clinical report.

Science.gov (United States)

Proussaefs, Periklis

2004-01-01

Implant placement to provide support and retention for nasal prostheses has been described in the literature. The anatomic sites that have been utilized for implant placement are the nasal bones, the premaxillary area through the nasal fossae, and the anterior wall of the frontal sinus. In the patient described, after a presurgical computerized tomography scan to determine adequacy of bone volume, 1 conventional threaded hydroxyapatite-coated root-form implant, created for intraoral use, was placed in the frontal process of the maxillary bone and 2 additional conventional implants were placed in the premaxillary area through the nasal fossa. Six months after implant placement, second-stage surgery was completed. A single bar connecting the 3 implants was fabricated. The removable nasal prosthesis was retained on the bar with 2 clips. An examination 1 year postsurgery revealed no clinical signs of pathosis. Long-term clinical follow-up of this case should continue and a sufficient number of additional cases should be investigated before use of the frontal process of the maxillary bone for implant retention can be recommended on a routine basis.

Complex systematic review - Perioperative antibiotics in conjunction with dental implant placement.

Science.gov (United States)

Lund, Bodil; Hultin, Margareta; Tranaeus, Sofia; Naimi-Akbar, Aron; Klinge, Björn

2015-09-01

The aim of this study was to revisit the available scientific literature regarding perioperative antibiotics in conjunction with implant placement by combining the recommended methods for systematic reviews and complex systematic reviews. A search of Medline (OVID), The Cochrane Library (Wiley), EMBASE, PubMed and Health technology assessment (HTA) organizations was performed, in addition to a complementary hand-search. Selected systematic reviews and primary studies were assessed using GRADE and AMSTAR, respectively. A meta-analysis was performed. The literature search identified 846 papers of which 10 primary studies and seven systematic reviews were included. Quality assessment of the systematic reviews revealed two studies of moderate risk of bias and five with high risk of bias. The two systematic reviews of moderate risk of bias stated divergent numbers needed to treat (NNT) to prevent one patient from implant failure. Four of the primary studies comparing antibiotic prophylaxis with placebo were estimated to be of low, or moderate, risk of bias and subjected to meta-analysis. The NNT was 50 (pooled RR 0.39, 95% CI 0.18, 0.84; P = 0.02). None of these four studies individually show a statistical significant benefit of antibiotic prophylaxis. Furthermore, narrative analysis of the studies eligible for meta-analysis reveals clinical heterogeneity regarding intervention and smoking. Antibiotic prophylaxis in conjunction with implant placement reduced the risk for implant loss by 2%. However, the sub-analysis of the primary studies suggests that there is no benefit of antibiotic prophylaxis in uncomplicated implant surgery in healthy patient. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[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.

[Implant placement in the aesthetic zone: the socket-shield-technique].

Science.gov (United States)

Lagas, L J; Pepplinkhuizen, J J F A A; Bergé, S J; Meijer, G J

2015-01-01

Following the extraction of an incisor in the maxilla, resorption of the -alveolar bone always occurs, especially on the buccal side. This often indicates that in the buccocervical area, insufficient bone is present to cover the dental implant. One treatment option is to carry out a bone transplant on the buccal side prior to or during the placement of the implant. An alternative way of supporting the buccocervical gingival is to leave the buccal part of the radixin situ, the so-called socket-shield technique. The results of this treatment for 16 consecutive patients were evaluated and revealed that the socket-shield technique produces good treatment results.

Poly-ε-caprolactone Coated and Functionalized Porous Titanium and Magnesium Implants for Enhancing Angiogenesis in Critically Sized Bone Defects.

Science.gov (United States)

Roland, Laura; Grau, Michael; Matena, Julia; Teske, Michael; Gieseke, Matthias; Kampmann, Andreas; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

2015-12-22

For healing of critically sized bone defects, biocompatible and angiogenesis supporting implants are favorable. Murine osteoblasts showed equal proliferation behavior on the polymers poly-ε-caprolactone (PCL) and poly-(3-hydroxybutyrate)/poly-(4-hydroxybutyrate) (P(3HB)/P(4HB)). As vitality was significantly better for PCL, it was chosen as a suitable coating material for further experiments. Titanium implants with 600 µm pore size were evaluated and found to be a good implant material for bone, as primary osteoblasts showed a vitality and proliferation onto the implants comparable to well bottom (WB). Pure porous titanium implants and PCL coated porous titanium implants were compared using Live Cell Imaging (LCI) with Green fluorescent protein (GFP)-osteoblasts. Cell count and cell covered area did not differ between the implants after seven days. To improve ingrowth of blood vessels into porous implants, proangiogenic factors like Vascular Endothelial Growth Factor (VEGF) and High Mobility Group Box 1 (HMGB1) were incorporated into PCL coated, porous titanium and magnesium implants. An angiogenesis assay was performed to establish an in vitro method for evaluating the impact of metallic implants on angiogenesis to reduce and refine animal experiments in future. Incorporated concentrations of proangiogenic factors were probably too low, as they did not lead to any effect. Magnesium implants did not yield evaluable results, as they led to pH increase and subsequent cell death.

Why are mini-implants lost: the value of the implantation technique!

Science.gov (United States)

Romano, Fabio Lourenço; Consolaro, Alberto

2015-01-01

The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

Why are mini-implants lost: The value of the implantation technique!

Directory of Open Access Journals (Sweden)

Fabio Lourenço Romano

2015-02-01

Full Text Available The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1 Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2 Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3 Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4 The more precise the lancing procedures, the better the implant placement technique; 5 Self-drilling does not mean higher pressures; 6 Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

Connective tissue grafts for thickening peri-implant tissues at implant placement. One-year results from an explanatory split-mouth randomised controlled clinical trial.

Science.gov (United States)

Wiesner, Günter; Esposito, Marco; Worthington, Helen; Schlee, Markus

2010-01-01

Nothing to declare. To evaluate whether connective tissue grafts performed at implant placement could be effective in augmenting peri-implant soft tissues. Ten partially edentulous patients requiring at least one single implant in the premolar or molar areas of both sides of the mandible were randomised to have one side augmented at implant placement with a connective soft tissue graft harvested from the palate or no augmentation. After 3 months of submerged healing, abutments were placed and within 1 month definitive crowns were permanently cemented. Outcome measures were implant success, any complications, peri-implant marginal bone level changes, patient satisfaction and preference, thickness of the soft tissues and aesthetics (pink aesthetic score) evaluated by an independent and blinded assessor 1 year after loading. One year after loading, no patients dropped out, no implants failed and no complications occurred. Both groups lost statistically significant amounts of peri-implant bone 1 year after loading (0.8 mm in the grafted group and 0.6 mm in the non-grafted group), but there was no statistically significant difference between groups. Soft tissues at augmented sites were 1.3 mm thicker (P Connective tissue grafts are effective in increasing soft tissue thickness, thus improving aesthetics. Longer follow-ups are needed to evaluate the stability of peri-implant tissues over time.

Antibiotic use at dental implant placement.

Science.gov (United States)

Veitz-Keenan, Analia; Keenan, James R

2015-06-01

Cochrane Oral Health Groups Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID and EMBASE via OVID. Databases were searched with no language or date restrictions. Two authors independently reviewed the titles and the abstracts for inclusion. Disagreements were resolved by discussion. If needed, a third author was consulted. Included were randomised clinical trials with a follow-up of at least three months which evaluated the use of prophylactic antibiotic compared to no antibiotic or a placebo and examined different antibiotics of different doses and durations in patients undergoing dental implant placement. The outcomes were implant failure (considered as implant mobility, removal of implant due to bone loss or infection) and prosthesis failure (prosthesis could not be placed). Standard Cochrane methodology procedures were followed. Risk of bias was completed independently and in duplicate by two review authors. Results were expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes with 95% confidence intervals (CI). The statistical unit was the participant and not the prosthesis or implant. Heterogeneity including both clinical and methodological factors was investigated. Six randomised clinical trials with 1162 participants were identified for the review. Three trials compared 2 g of preoperative amoxicillin versus placebo (927 participants). One trial compared 3 g of preoperative amoxicillin versus placebo (55 participants). Another trial compared 1 g of preoperative amoxicillin plus 500 mg four times a day for two days versus no antibiotic (80 participants). An additional trial compared four groups: (1) 2 g of preoperative amoxicillin; (2) 2 g of preoperative amoxicillin plus 1 g twice a day for seven days; (3) 1 g of postoperative amoxicillin twice a day for seven days and (4) no antibiotics (100 participants). The overall body of the evidence was considered moderate.The meta-analysis of the

Evaluation of Functionalized Porous Titanium Implants for Enhancing Angiogenesis in Vitro

Directory of Open Access Journals (Sweden)

Laura Roland

2016-04-01

Full Text Available Implant constructs supporting angiogenesis are favorable for treating critically-sized bone defects, as ingrowth of capillaries towards the center of large defects is often insufficient. Consequently, the insufficient nutritional supply of these regions leads to impaired bone healing. Implants with specially designed angiogenic supporting geometry and functionalized with proangiogenic cytokines can enhance angiogenesis. In this study, Vascular Endothelial Growth Factor (VEGF and High Mobility Group Box 1 (HMGB1 were used for incorporation into poly-ε-caprolactone (PCL-coated porous titanium implants. Bioactivity of released factors and influence on angiogenesis of functionalized implants were evaluated using a migration assay and angiogenesis assays. Both implants released angiogenic factors, inducing migration of endothelial cells. Also, VEGF-functionalized PCL-coated titanium implants enhanced angiogenesis in vitro. Both factors were rapidly released in high doses from the implant coating during the first 72 h.

Poly-ε-caprolactone Coated and Functionalized Porous Titanium and Magnesium Implants for Enhancing Angiogenesis in Critically Sized Bone Defects

Directory of Open Access Journals (Sweden)

Laura Roland

2015-12-01

Full Text Available For healing of critically sized bone defects, biocompatible and angiogenesis supporting implants are favorable. Murine osteoblasts showed equal proliferation behavior on the polymers poly-ε-caprolactone (PCL and poly-(3-hydroxybutyrate/poly-(4-hydroxybutyrate (P(3HB/P(4HB. As vitality was significantly better for PCL, it was chosen as a suitable coating material for further experiments. Titanium implants with 600 µm pore size were evaluated and found to be a good implant material for bone, as primary osteoblasts showed a vitality and proliferation onto the implants comparable to well bottom (WB. Pure porous titanium implants and PCL coated porous titanium implants were compared using Live Cell Imaging (LCI with Green fluorescent protein (GFP-osteoblasts. Cell count and cell covered area did not differ between the implants after seven days. To improve ingrowth of blood vessels into porous implants, proangiogenic factors like Vascular Endothelial Growth Factor (VEGF and High Mobility Group Box 1 (HMGB1 were incorporated into PCL coated, porous titanium and magnesium implants. An angiogenesis assay was performed to establish an in vitro method for evaluating the impact of metallic implants on angiogenesis to reduce and refine animal experiments in future. Incorporated concentrations of proangiogenic factors were probably too low, as they did not lead to any effect. Magnesium implants did not yield evaluable results, as they led to pH increase and subsequent cell death.

Accurate pre-surgical determination for self-drilling miniscrew implant placement using surgical guides and cone-beam computed tomography.

Science.gov (United States)

Miyazawa, Ken; Kawaguchi, Misuzu; Tabuchi, Masako; Goto, Shigemi

2010-12-01

Miniscrew implants have proven to be effective in providing absolute orthodontic anchorage. However, as self-drilling miniscrew implants have become more popular, a problem has emerged, i.e. root contact, which can lead to perforation and other root injuries. To avoid possible root damage, a surgical guide was fabricated and cone-beam computed tomography (CBCT) was used to incorporate guide tubes drilled in accordance with the planned direction of the implants. Eighteen patients (5 males and 13 females; mean age 23.8 years; minimum 10.7, maximum 45.5) were included in the study. Forty-four self-drilling miniscrew implants (diameter 1.6, and length 8 mm) were placed in interradicular bone using a surgical guide procedure, the majority in the maxillary molar area. To determine the success rates, statistical analysis was undertaken using Fisher's exact probability test. CBCT images of post-surgical self-drilling miniscrew implant placement showed no root contact (0/44). However, based on CBCT evaluation, it was necessary to change the location or angle of 52.3 per cent (23/44) of the guide tubes prior to surgery in order to obtain optimal placement. If orthodontic force could be applied to the screw until completion of orthodontic treatment, screw anchorage was recorded as successful. The total success rate of all miniscrews was 90.9 per cent (40/44). Orthodontic self-drilling miniscrew implants must be inserted carefully, particularly in the case of blind placement, since even guide tubes made on casts frequently require repositioning to avoid the roots of the teeth. The use of surgical guides, fabricated using CBCT images, appears to be a promising technique for placement of orthodontic self-drilling miniscrew implants adjacent to the dental roots and maxillary sinuses.

Stresses generated by two zygomatic implant placement techniques associated with conventional inclined anterior implants

Directory of Open Access Journals (Sweden)

Paulo H.T. Almeida

2018-06-01

Full Text Available Purpose: To make a comparative evaluation, by means of the finite element method, of the stress generated on supporting tissues and prosthetic system components, using zygomatic implants with the exteriorized and extramaxillary techniques, and different placement positions, associated either with inclined anterior implants, or those without inclination. Materials and methods: Eight (8 tridimensional models were created to represent the clinical situations being researched, using the dataset of scanned images of an edentulous model. The implants and prosthetic components were photographed on millimeter paper and inserted into Rhinoceros 3D modeling computer software. From the measurements made on the image, the virtual models were made. The application force was distributed on the occlusal surface of the working side of the left maxillary first molar, first and second premolars, and incisal regions of the central incisor, simulating the occlusal load during mastication, in a total of 150 N. Results: The extramaxillary technique presented considerable variation in increased tension on the prosthesis screws and bone tissue. In the exteriorized technique, the highest tension values occurred in the region of the ridge, and the lowest, on the zygomatic process; the absence of cantilever reduced the stress on bone tissue in almost all regions. Conclusion: The exteriorized technique was shown to be more favorable to the distribution of stresses on the micro-unit screws and bone tissue, with the model with zygomatic implant placed in the region of the first molar and inclined anterior implant presenting the best results. Keywords: Zygomatic implants, Atrophic maxilla, Finite element analysis, Cantilever, Inclined implant

Osteogenecity of octacalcium phosphate coatings applied on porous metal implants

NARCIS (Netherlands)

Barrère, F.; van der Valk, Chantal M.; Dalmeijer, Remco A.J.; Meijer, Gert; van Blitterswijk, Clemens; de Groot, K.; Layrolle, Pierre

2003-01-01

The biomimetic route allows the homogeneous deposition of calcium phosphate (Ca-P) coatings on porous implants by immersion in simulated physiologic solution. In addition, various Ca-P phases, such as octacalcium phosphate (OCP) or bone-like carbonated apatite (BCA), which are stable only at low

Minimally invasive piezosurgery for a safe placement of blade dental implants in jaws with severe bone loss

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F. Rossi

2014-10-01

Full Text Available Aim :Severe atrophies of edentulous jaws require major reconstructive bone surgery in order to allow the placement of root-form implants with standard diameter. These bone augmentation techniques represent the best option reported in the literature, but they are often rejected by patients because of their high economic and biological costs in addition to the possibility of failure in the short and/or long term. In the maxilla regenerative methods (onlay, inlay, and distraction have high success rates, whereas in the mandible, especially in the distal atrophic area, they are not so predictable. In such situations an alternative technique for fixed prosthethic rebilitation is the insertion of platform blade implants, which have their elective indication for atrophic bone ridges with reduced width, owing to their reduced thickness. The aim of this study is to assess the effectiveness of the use of piezoelectric ultrasonic handpieces, in order to simplify the placement of blade implants, making it safer and less traumatic than with conventional surgical procedures. Materials and methods: Platform blade implants are extension implant functionally and aesthetically reliable, even if they require a more difficult surgical technique compared with the one currently in use for screw implants. A minimally invasive procedure by means of piezosurgery that was performed on 142 subjects is presented and a case is reported which highlights the successful results. Results: and conclusion The use of piezoelectric ultrasonic handpieces simplifies the surgical procedure for the placement of blade implant, making it safer and less traumatic.

Immediate loading of implants in the aesthetic zone: comparison between two placement timings.

Science.gov (United States)

Carini, Fabrizio; Longoni, Salvatore; Pisapia, Valeria; Francesconi, Manuel; Saggese, Vito; Porcaro, Gianluca

2014-01-01

Implant rehabilitation delivered in accordance with the traditional protocol has proven to be highly predictable and acceptable (1). Nevertheless, the application of immediate loading on post-extraction implants, especially for aesthetic zones, has now considerably increased (2). The aim of this work is to illustrate the immediate loading of implants placed in the aesthetic zone through tapered design fixtures with microgeometry of a high degree of porosity inserted at the same time or 4-8 weeks from dental avulsion (TSA® Advance, Phibo®). A total of 15 implant fixtures of which 8 at an interval of 4-8 weeks from extraction (type 2) and the remaining according to the immediate post-extraction technique (type 1) were positioned. All implants were prosthesized within 24 hours from the placement. Definitive crowns replaced provisional restorations after 20-24 weeks. After 4 and 12 months from implant insertion, the following parameters were assessed: X-ray image, pain, mobility or suppuration, soft tissue condition and aesthetic appearance. Percentage of osseointegration was 93.75%, and 53.5% of the osseointegrated fixtures was type 2. No statistically significant difference between the mean ISQ values for implants of type 1 and 2 both in the post-operative period and after 12 months was evident, indicating that the timing of insertion did not affect the achievement of stability for the implant fixtures tested in our study. Immediate post-extraction implants showed a greater propensity for gingival recession and a peri-implant radiolucency greater than those placed at an interval of 4-8 weeks. The values obtained for the PES/WES and the subjective evaluation of the analyzed sample showed the considerable aesthetic value and the high level of satisfaction guaranteed by the implant technique illustrated. Although well-designed, high quality, randomized clinical trials are still needed as well as the requirement to establish a common, complete, and reproducible index

The immediate placement of dental implants into extraction sites with periapical lesions: a retrospective chart review.

Science.gov (United States)

Bell, Christopher Lincoln; Diehl, David; Bell, Brian Michael; Bell, Robert E

2011-06-01

The purpose of this study was to evaluate the success of dental implants placed immediately into extraction sites in the presence of chronic periapical pathology. The charts of 655 patients who had implants immediately placed into fresh extraction sites were reviewed for the presence or absence of periapical radiolucencies. A total of 922 implants were included. Of the 922 implants, 285 were immediately placed into sockets that had chronic periapical infections. The remaining 637 implants, without signs of periapical pathology, were used as the control group. Success of the implants was defined as successful osseointegration, successful restoration, and absence of evidence of bone loss or peri-implantitis. Other variables such as age, gender, smoking, diabetes, bisphosphonate use, lucencies of adjacent teeth, and implant stability at the time of placement were also evaluated. Of the 922 implants, 285 were placed into sockets with periapical radiolucencies. The success rate of implants placed in the study group was 97.5%, whereas the success rate of the control group was 98.7%. The difference was not found to be statistically significant. The mean follow-up was 19.75 months, with a maximum of 93 months and a minimum of 3 months. A statistically higher failure rate was found for implants placed adjacent to retained teeth with periapical pathology. The placement of implants in sockets affected by chronic periapical pathology can be considered a safe and viable treatment option. There is a risk of implant failure when placing implants adjacent to teeth with periapical radiolucencies. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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.

Awake craniotomy for assisting placement of auditory brainstem implant in NF2 patients.

Science.gov (United States)

Zhou, Qiangyi; Yang, Zhijun; Wang, Zhenmin; Wang, Bo; Wang, Xingchao; Zhao, Chi; Zhang, Shun; Wu, Tao; Li, Peng; Li, Shiwei; Zhao, Fu; Liu, Pinan

2018-06-01

Auditory brainstem implants (ABIs) may be the only opportunity for patients with NF2 to regain some sense of hearing sensation. However, only a very small number of individuals achieved open-set speech understanding and high sentence scores. Suboptimal placement of the ABI electrode array over the cochlear nucleus may be one of main factors for poor auditory performance. In the current study, we present a method of awake craniotomy to assist with ABI placement. Awake surgery and hearing test via the retrosigmoid approach were performed for vestibular schwannoma resections and auditory brainstem implantations in four patients with NF2. Auditory outcomes and complications were assessed postoperatively. Three of 4 patients who underwent awake craniotomy during ABI surgery received reproducible auditory sensations intraoperatively. Satisfactory numbers of effective electrodes, threshold levels and distinct pitches were achieved in the wake-up hearing test. In addition, relatively few electrodes produced non-auditory percepts. There was no serious complication attributable to the ABI or awake craniotomy. It is safe and well tolerated for neurofibromatosis type 2 (NF2) patients using awake craniotomy during auditory brainstem implantation. This method can potentially improve the localization accuracy of the cochlear nucleus during surgery.

Decoronation followed by dental implants placement: fundamentals, applications and explanations

Science.gov (United States)

Consolaro, Alberto; Ribeiro, Paulo Domingos; Cardoso, Maurício A.; Miranda, Dario A. Oliveira; Salfatis, Monica

2018-01-01

ABSTRACT Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported. PMID:29791693

Orthodontic space closure versus implant placement in subjects with missing teeth.

Science.gov (United States)

Thilander, B

2008-01-01

The aim was to give a systematic review of alternative orthodontic space closure and implant placement in young adults with missing teeth. A literary search was made in the MEDLINE (Pub Med) database from 1990 to 2007. Totally 146 articles were found. Only studies in the English language or other languages with an English abstract were accepted, which reduced the number to 91 articles. Among them, only one prospective and three retrospective articles, two review papers and five case reports with discussion were found. The others presented one or two cases, or focused on treatment planning of missing teeth in general. Consequently, they were excluded. Moreover, a manual search of bibliographies in relevant journals gave no additional information. Thus, only 11 relevant articles were accepted. This systematic review clearly showed, that both alternatives (space closure or implant placement) present advantages as well as disadvantages. Knowledge about tissue reaction of orthodontic space closure and dento-facial development (including continuous changes of the dentition and its supporting tissues) are significant factors in the choice of treatment. Thus, we need more research on basic level and clinical follow-up studies of large samples.

The effect of one-time abutment placement on interproximal bone levels and peri-implant soft tissues: a prospective randomized clinical trial.

Science.gov (United States)

Molina, Ana; Sanz-Sánchez, Ignacio; Martín, Conchita; Blanco, Juan; Sanz, Mariano

2017-04-01

To compare the effect of placing the definitive abutment at the time of implant placement versus at a later stage, on the soft and hard tissue changes around dental implants. Platform-switched implants were placed in the posterior maxilla or mandible of partial edentulous patients and they were randomized to receive the definitive abutment at the moment of implant placement, or 6-12 weeks later. Final prostheses were delivered 2-4 weeks later. Radiographic assessment of vertical bone level changes (primary outcome), clinical status of peri-implant tissues, changes in soft tissues margin, papilla filling, patient-related outcomes and adverse events were assessed 6 and 12 months after loading. 60 implants were placed in 40 patients, replacing single or multiple absent teeth. One implant was lost 1 week after insertion (overall survival rate: 98.3%). A statistically significant greater bone resorption from surgery to 6 months post-loading was observed for those implants subjected to abutment change (control group: -1.24 ± 0.79 mm; test group: -0.61 ± 0.40 mm; P = 0.028). Periodontal clinical parameters and patient-related outcomes, however, did not demonstrate significant differences between groups at any time point. A significant increase in papilla height was observed from loading to 12 months in all implants (control group: 1.17 ± 1.47 mm; test group: 0.98 ± 0.89 mm) and a slight but not significant coronal migration of the gingival margin. The connection and disconnection of healing abutments is associated with significantly increased bone loss during the healing period between implant placement and 6 months post-loading, when compared to one-time abutment placement. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Alveolar Ridge Contouring with Free Connective Tissue Graft at Implant Placement: A 5-Year Consecutive Clinical Study.

Science.gov (United States)

Hanser, Thomas; Khoury, Fouad

2016-01-01

This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implant placement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissue volume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P connective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal alveolar volume deficiencies in single implants.

Demographics of implant placement and complications of a patient subgroup in a dental hospital population.

LENUS (Irish Health Repository)

Brennan, Maire

2011-03-14

Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information.

Demographics of implant placement and complications of a patient subgroup in a dental hospital population.

LENUS (Irish Health Repository)

Brennan, Maire

2010-05-01

Little has been reported about the demographics of implant placement in the Irish population and the complications that occur. This is important in terms of service planning and providing patient information.

Antibiotic prophylaxis for dental implant placement?

Science.gov (United States)

Keenan, James R; Veitz-Keenan, Analia

2015-06-01

Electronic searches without time or language restrictions were performed in PubMed, Web of Science and the Cochrane Oral Health Group trials Register. A vast manual search was done in many dental implant-related journals. Reference lists were scanned for possible additional studies. Ongoing clinical trials were also searched. Titles and abstracts of the reports identified were read independently by the three authors. Disagreements were resolved by discussion. Rejected studies were recorded with the reasons for exclusion. The inclusion criteria included clinical human studies, either randomised or not, comparing the implant failure/survival rates in any group of patients receiving antibiotic prophylaxis versus not receiving antibiotics prior to implant placement. Case reports and non-human studies were excluded. Implant failure was considered as complete loss of the implant. Data were extracted by the authors. Study risk of bias was assessed. Implant failure and post-operative infection were the outcomes measured, both dichotomous outcomes. Results were expressed using fixed or a random effect model depending on the heterogeneity calculated using an I(2) statistical test. The estimate of relative effect was expressed in risk ratio (RR) with 95% confidence interval. Number needed to treat (NNT) was calculated and sensitivity analysis was performed to detect differences among the studies considered to have high a risk of bias. Fourteen trials were included in the review and evaluated a total of 14,872 implants. Of the fourteen studies included in the review eight were randomised clinical trials, four were controlled clinical trials and two were retrospective studies. Seven studies had both patients and operators/outcome assessors blinded to the tested intervention. Nine studies had short follow-ups; six of them with a follow-up of four months, one of five months and two of six months.The antibiotic regimen was variable: seven studies did not use post-op antibiotics in

Selective laser melting of titanium alloy enables osseointegration of porous multi-rooted implants in a rabbit model.

Science.gov (United States)

Peng, Wei; Xu, Liangwei; You, Jia; Fang, Lihua; Zhang, Qing

2016-07-21

Osseointegration refers to the direct connection between living bone and the surface of a load-bearing artificial implant. Porous implants with well-controlled porosity and pore size can enhance osseointegration. However, until recently implants were produced by machining solid core titanium rods. The aim of this study was to develop a multi-rooted dental implant (MRI) with a connected porous surface structure to facilitate osseointegration. MRIs manufactured by selective laser melting (SLM) and commercial implants with resorbable blasting media (RBM)-treated surfaces were inserted into the hind limbs of New Zealand white rabbits. Osseointegration was evaluated periodically over 12 weeks by micro-computerized tomography (CT) scanning, histological analysis, mechanical push-out tests, and torque tests. Bone volume densities were consistently higher in the MRI group than in the RBM group throughout the study period, ultimately resulting in a peak value of 48.41 % for the MRI group. Histological analysis revealed denser surrounding bone growth in the MRIs; after 4 and 8 weeks, bone tissue had grown into the pore structures and root bifurcation areas, respectively. Biomechanics tests indicated binding of the porous MRIs to the neobone tissues, as push-out forces strengthened from 294.7 to 446.5 N and maximum mean torque forces improved from 81.15 to 289.57 N (MRI), versus 34.79 to 87.8 N in the RBM group. MRIs manufactured by SLM possess a connected porous surface structure that improves the osteogenic characteristics of the implant surface.

Placement of single tooth implant in healed socket with immediate temporization: Clinical study

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Jeevan Lata

2012-01-01

Full Text Available Introduction: Edentulous condition inadequately compensated for, by dentures, impair oral function and is accompanied by reduced self–confidence. In a continued effort to achieve these goals, implant dentistry was introduced. Immediate temporization is somehow a recent concept, which allows the maintenance of soft tissue contours, along with interdental alveolar contours. Aims and Obectives: Aims of the present study were to study the placement of implant in the post-extracted healed tooth socket of anterior maxilla and to evaluate the feasibility of early function on implants placed. Materials and Methods: In the present study, HI-TECH IMPLANTS TRX-OP one-piece immediate loading implant system with the built on abutment has been used.Immediate temporisation has been done and results have been evaluated in terms of stability, gingival health, esthetics, marginal bone loss, patient′s psychological attitude, and satisfaction.
Results: Out of eight implants, 6 successfully healed whereas 2 implants suffered failure
Conclusion: Overall conclusion drawn from the study is, immediate temporization is a successful method providing psychological, financial and emotional benefits to the patient.

Immediate implant placement and provisional crown fabrication after a minimally invasive extraction of a peg-shaped maxillary lateral incisor: a clinical report.

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Turkyilmaz, Ilser; Suarez, Jose Carlos; Company, Andrea M

2009-09-01

The aim of this case report is to describe the replacement of a maxillary peg-shaped lateral incisor with the placement of an immediate implant and a provisional restoration following a minimally invasive extraction to preserve anterior esthetics. Extraction sites in the anterior maxilla can present restorative challenges with regard to esthetics. Resistance to wearing a temporary removable partial denture during healing makes immediate implant therapy an appealing alternative to patients. Implant placement into fresh extraction sockets using no flap elevation has recently become more popular due to some advantages including less bleeding, swelling, and the preservation of existing soft tissue contours. A 20-year-old woman with a peg-shaped maxillary left lateral incisor was treated using an implant placed into the fresh extraction socket using a flapless approach and immediate provisional crown fabrication. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. Using a previously fabricated acrylic index, a provisional acrylic crown was fabricated on the adjusted temporary abutment and delivered to the patient the same day during the extraction visit. This report describes the diagnosis and treatment of an over-prepared peg-shaped maxillary left lateral incisor associated with multiple crown decementations. The tooth was extracted without flap elevation and an implant was inserted immediately using flapless surgery and placement of an immediate provisional single crown. Flapless implant insertion into fresh extraction sockets and placement of immediate provisional crowns in cases involving the maxillary anterior region represent a viable treatment option in appropriate clinical situations where esthetics are a high priority. The strategy preserves optimum gingival contours and papillary height may be a viable option compared to fixed partial

Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

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Wang, Xiaojian; Xu, Shanqing; Zhou, Shiwei; Xu, Wei; Leary, Martin; Choong, Peter; Qian, M; Brandt, Milan; Xie, Yi Min

2016-03-01

One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Oral Rehabilitation of a Patient With Ectodermal Dysplasia Treated With Fresh-Frozen Bone Allografts and Computer-Guided Implant Placement: A Clinical Case Report.

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Maiorana, Carlo; Poli, Pier Paolo; Poggio, Carlo; Barbieri, Paola; Beretta, Mario

2017-05-01

Ectodermal dysplasia (ED) is an inherited disorder characterized by abnormality of ectodermally derived structures. A recurrent oral finding is oligodontia, which in turn leads to a severely hypotrophic alveolar process with typical knife-edge morphology and adverse ridge contours. This unfavorable anatomy can seriously hamper proper implant placement. Fresh-frozen bone (FFB) allografts recently have been proposed to augment the residual bone volume for implant placement purposes; however, scientific evidence concerning the use of FFB to treat ED patients is absent. Similarly, data reporting computer-aided template-guided implant placement in medically compromised patients are limited. Thus the purpose of this report is to illustrate the oral rehabilitation of a female patient affected by ED and treated with appositional FFB block grafts and consecutive computer-guided flapless implant placement in a 2-stage procedure. Fixed implant-supported dental prostheses were finally delivered to the patient, which improved her self-esteem and quality of life. During the follow-up recall 1 year after the prosthetic loading, the clinical examination showed healthy peri-implant soft tissues with no signs of bleeding on probing or pathologic probing depths. The panoramic radiograph confirmed the clinical stability of the result. Peri-implant marginal bone levels were radiographically stable with neither pathologic bone loss at the mesial and distal aspects of each implant nor peri-implant radiolucency. Within the limitations of this report, the use of FFB allografts in association with computer-aided flapless implant surgery might be considered a useful technique in patients affected by ED. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Selective laser melting porous metallic implants with immobilized silver nanoparticles kill and prevent biofilm formation by methicillin-resistant Staphylococcus aureus.

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van Hengel, Ingmar A J; Riool, Martijn; Fratila-Apachitei, Lidy E; Witte-Bouma, Janneke; Farrell, Eric; Zadpoor, Amir A; Zaat, Sebastian A J; Apachitei, Iulian

2017-09-01

Implant-associated infection and limited longevity are two major challenges that orthopedic devices need to simultaneously address. Additively manufactured porous implants have recently shown tremendous promise in improving bone regeneration and osseointegration, but, as any conventional implant, are threatened by infection. In this study, we therefore used rational design and additive manufacturing in the form of selective laser melting (SLM) to fabricate porous titanium implants with interconnected pores, resulting in a 3.75 times larger surface area than corresponding solid implants. The SLM implants were biofunctionalized by embedding silver nanoparticles in an oxide surface layer grown using plasma electrolytic oxidation (PEO) in Ca/P-based electrolytes. The PEO layer of the SLM implants released silver ions for at least 28 days. X-ray diffraction analysis detected hydroxyapatite on the SLM PEO implants but not on the corresponding solid implants. In vitro and ex vivo assays showed strong antimicrobial activity of these novel SLM PEO silver-releasing implants, without any signs of cytotoxicity. The rationally designed SLM porous implants outperformed solid implants with similar dimensions undergoing the same biofunctionalization treatment. This included four times larger amount of released silver ions, two times larger zone of inhibition, and one additional order of magnitude of reduction in numbers of CFU in an ex vivo mouse infection model. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications.

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Esposito, Marco; Grusovin, Maria Gabriella; Worthington, Helen V

2013-07-31

Some dental implant failures may be due to bacterial contamination at implant insertion. Infections around biomaterials are difficult to treat, and almost all infected implants have to be removed. In general, antibiotic prophylaxis in surgery is only indicated for patients at risk of infectious endocarditis; with reduced host-response; when surgery is performed in infected sites; in cases of extensive and prolonged surgical interventions; and when large foreign materials are implanted. A variety of prophylactic systemic antibiotic regimens have been suggested to minimise infections after dental implant placement. More recent protocols recommended short-term prophylaxis, if antibiotics have to be used. Adverse events may occur with the administration of antibiotics, and can range from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics is the selection of antibiotic-resistant bacteria. The use of prophylactic antibiotics in implant dentistry is controversial. To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic or placebo administration and, if antibiotics are beneficial, to determine which type, dosage and duration is the most effective. We searched the Cochrane Oral Health Group's Trials Register (to 17 June 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 5), MEDLINE via OVID (1946 to 17 June 2013) and EMBASE via OVID (1980 to 17 June 2013). There were no language or date restrictions placed on the searches of the electronic databases. Randomised controlled clinical trials (RCTs) with a follow-up of at least three months, that compared the administration of various prophylactic antibiotic regimens versus no antibiotics to people undergoing dental implant placement. Outcome measures included prosthesis failures, implant failures, postoperative infections and adverse

Implant-buccal plate distance as diagnostic parameter: a prospective cohort study on implant placement in fresh extraction sockets.

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Capelli, Matteo; Testori, Tiziano; Galli, Fabio; Zuffetti, Francesco; Motroni, Alessandro; Weinstein, Roberto; Del Fabbro, Massimo

2013-12-01

The aim of this study is to investigate contour changes around immediate implants in fresh extraction sockets when different grafting procedures are performed, based on the distance between the external implant collar and the bony surface on the buccal plate (I-BP). A secondary aim is to assess the esthetic outcome via the implant esthetic score (IAS). This prospective cohort study was performed in three centers. Suitable patients to undergo implant placement in fresh extraction sockets were selected. Periodontal biotype, horizontal and vertical peri-implant bone defects, and dehiscences were assessed. Depending on I-BP, two types of grafting procedures were performed. In group A (I-BP sockets. No implant failed during the observation period. The mean follow-up was 25 months (range: 12 to 37 months). After 1 year of loading, group A showed a slight decrease in mean buccal volume, whereas group B had an increase in volume (P = 0.02). IAS was higher for group B than group A. When implants are placed immediately after tooth extraction, I-BP may represent a useful diagnostic parameter in choosing the most appropriate grafting procedure (IG versus IEG). In clinical cases in which the distance between implant surface and the buccal plate is <4 mm, the combination of internal and external grafting (IEG) is recommended to maintain the volume and the contour of the ridge and achieve a successful esthetic outcome.

Immediate Placement of Ultrawide-Diameter Implants in Molar Sockets: Description of a Recommended Technique

NARCIS (Netherlands)

Hattingh, A.C.; Bruyn, H. de; Ackermann, A.; Vandeweghe, S.

2018-01-01

Immediate implant placement is performed less frequently in molar extraction sockets than in single root sockets. This is mainly due to the tripodal anatomical configuration of molar roots, which is perceived as complex and therefore unsuitable. The mechanical burden of molar sites, combined with

The Influence of Surface Roughness on the Displacement of Osteogenic Bone Particles during Placement of Titanium Screw-Type Implants

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Tabassum, A.; Walboomers, F.; Wolke, J.G.C.; Meijer, G.J.; Jansen, J.A.

2011-01-01

Background: Previously, we demonstrated that bone debris, which is translocated during dental implant placement, has osteogenic potential. Therefore, it was hypothesized that implant surface roughness can influence the amount of translocated bone debris/particles and thereby the osteogenic response.

Surgical pitfalls with custom-made porous hydroxyapatite cranial implants

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Bruno Zanotti

2015-03-01

Full Text Available Aim: Cranioplasty implants are used primarily in cases of surgical cranial decompression following pathological elevations of intracranial pressure. Available bone substitutes include porous hydroxyapatite (HA and polymethylmethacrylate. Whichever material is used, however, prosthetic cranial implants are susceptible to intra- and postsurgical complications and even failure. The aim of this study was to investigate such occurrences in HA cranioplasty implants, seeking not only to determine the likely causes (whether correlated or not with the device itself but also, where possible, to suggest countermeasures. Methods: We analyzed information regarding failures or complications reported in postmarketing surveillance and clinical studies of patients treated worldwide with custom-made HA cranial implants (Custom Bone Service Fin-Ceramica Faenza, Italy in the period 1997-2013. Results: The two most common complications were implant fractures (84 cases, 2.9% of the total fitted and infections (51 cases, 1.77%. Conclusion: Although cranioplasties are superficial and not difficult types of surgery, and use of custom-made implants are often considered the "easy" option from a surgical perspective, these procedures are nonetheless plagued by potential pitfalls. If performed well they yield more than satisfactory results from the points of view of both the patient and surgeon, but lack of appropriate care can open the door to numerous potential sources of failure, which can compromise-even irreparably-the ability to heal.

[A PhD completed 1. Immediate dental implant placement in the aesthetic zone].

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Slagter, K W

2016-05-01

When aesthetics play a role in an extraction, the tendency is to place an implant in the extraction socket immediately, preferably in combination with a temporary crown. This tendency is probably related to evolving social factors: demanding patients who want an instant and attactive result. In 2 randomised clinical trials (total 80 patients) the results of clinical treatment involving immediate implants in the aesthetic zone are investigated. Depending on the size of the bone defect (aesthetic indecees and patient-satisfaction. The most important conclusion is that immediate placements of implants in the aesthetic zone, results in -outstanding short-term (1-year) results with respect to the outcome variables. If this also leads to good long-term results has yet to be investigated.

Development and evaluation of porous dental implants in miniature swine.

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Karagianes, M T; Westerman, R E; Rasmussen, J J; Lodmell, A M

1976-01-01

Organized bone ingrowth in endosteal porous implants fabricated from VMC titanium alloy and surgically implanted with a tight interference fit, securely anchored the implants in fresh and healed mandibular premolar sites of miniature swine. This bone-implant union retained its integrity under high as well as slight masticatory stresses up to one-year after implantation. Bone invasion of the alumina porcelain implants was impeded by the lack of adequate interconnecting porosity; when the porosity was increased, insufficient ceramic strength prohibited a tight initial bone-implant fit. As a consequence, inadequate initial implant stability resulted in a soft tissue encapsulation of the majority of the ceramic implants. Histological examination and mechanical testing results were similar for bone-ingrown implants exposed to different experimental stresses for 4, 5, 8, and 12 months. Bone ingrowth and interface shear strengths were also similar in the different VMC pore sizes and shapes investigated. The design of intraoral attachments appeared critical, at least in swine where no postoperative treatment was administered. Gingival inflammation and alveolar bone resorption caused by calculus were severe around truncated cone-shaped devices. Slender transgingival posts, occlusal caps, and crown restorations were less susceptible to calculus accumulation, resulting in a more satisfactory gingival and subgingival response. Excessive epithelial invagination was a problem only in implants with transgingival truncated cones. Good adherence of soft tissue to metal under the gingival mucosa prevented epithelial migration around implants with other transgingival devices. Alveolar bone resportion around the tops of bone-ingrown implants was minimal at the time intervals examined (up to one year); however, a definite conclusion should be delayed until longer-term implants under full occlusion are evaluated.

Immediate implant placement into posterior sockets with or without buccal bone dehiscence defects: A retrospective cohort study.

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Hu, Chen; Gong, Ting; Lin, Weimin; Yuan, Quan; Man, Yi

2017-10-01

To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects. Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n=40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n= N10), the defect depth measured 3-5 mm from the gingival margin. 2) Group 2(n=9), the depth ranged from 5mm to 7mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3. No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P=0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups. Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts. Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Laser beam melting 3D printing of Ti6Al4V based porous structured dental implants: fabrication, biocompatibility analysis and photoelastic study

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Yang, Fei; Chen, Chen; Zhou, Qianrong; Gong, Yiming; Li, Ruixue; Li, Chichi; Klämpfl, Florian; Freund, Sebastian; Wu, Xingwen; Sun, Yang; Li, Xiang; Schmidt, Michael; Ma, Duan; Yu, Youcheng

2017-03-01

Fabricating Ti alloy based dental implants with defined porous scaffold structure is a promising strategy for improving the osteoinduction of implants. In this study, we use Laser Beam Melting (LBM) 3D printing technique to fabricate porous Ti6Al4V dental implant prototypes with three controlled pore sizes (200, 350 and 500 μm). The mechanical stress distribution in the surrounding bone tissue is characterized by photoelastography and associated finite element simulation. For in-vitro studies, experiments on implants’ biocompatibility and osteogenic capability are conducted to evaluate the cellular response correlated to the porous structure. As the preliminary results, porous structured implants show a lower stress-shielding to the surrounding bone at the implant neck and a more densed distribution at the bottom site compared to the reference implant. From the cell proliferation tests and the immunofluorescence images, 350 and 500 μm pore sized implants demonstrate a better biocompatibility in terms of cell growth, migration and adhesion. Osteogenic genes expression of the 350 μm group is significantly increased alone with the ALP activity test. All these suggest that a pore size of 350 μm provides an optimal provides an optimal potential for improving the mechanical shielding to the surrounding bones and osteoinduction of the implant itself.

Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases

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Anshul Jain

2016-01-01

Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.

Investigation of MeV-Cu implantation and channeling effects into porous silicon formation

International Nuclear Information System (INIS)

Ahmad, M.; Naddaf, M.

2011-01-01

P-type (1 1 1) silicon wafers were implanted by copper ions (2.5 MeV) in channeling and random directions using ion beam accelerator of the Atomic Energy Commission of Syria (AECS). The effect of implantation direction on formation process of porous silicon (PS) using electrochemical etching method has been investigated using scanning electron microscope (SEM) and photoluminescence (PL) techniques. SEM observations revealed that the size, shape and density of the formed pores are highly affected by the direction of beam implantation. This in turn is seen to influence the PL behavior of the PS.

Investigation of MeV-Cu implantation and channeling effects into porous silicon formation

International Nuclear Information System (INIS)

Ahmad, M.; Naddaf, M.

2012-01-01

P-type (1 1 1) silicon wafers were implanted by copper ions (2.5 MeV) in channeling and random directions using ion beam accelerator of the Atomic Energy Commission of Syria (AECS). The effect of implantation direction on formation process of porous silicon (PS) using electrochemical etching method has been investigated using scanning electron microscope (SEM) and photoluminescence (PL) techniques. SEM observations revealed that the size, shape and density of the formed pores are highly affected by the direction of beam implantation. This in turn is seen to influence the PL behavior of the PS.(author)

Investigation of MeV-Cu implantation and channeling effects into porous silicon formation

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Ahmad, M.; Naddaf, M.

2011-11-01

P-type (1 1 1) silicon wafers were implanted by copper ions (2.5 MeV) in channeling and random directions using ion beam accelerator of the Atomic Energy Commission of Syria (AECS). The effect of implantation direction on formation process of porous silicon (PS) using electrochemical etching method has been investigated using scanning electron microscope (SEM) and photoluminescence (PL) techniques. SEM observations revealed that the size, shape and density of the formed pores are highly affected by the direction of beam implantation. This in turn is seen to influence the PL behavior of the PS.

Patients' perceptions of implant placement surgery, the post-surgical healing and the transitional implant prostheses: a qualitative study.

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Kashbour, Wafa A; Rousseau, Nikki; Thomason, J Mark; Ellis, Janice S

2017-07-01

This study aimed to explore patients' thoughts, feelings about, and experiences of, implant placement surgery (IPS), the post-surgical healing stage and the immediate post-surgical transitional implant prosthesis (TIP) (fixed and removable). A qualitative study design was chosen and 38 semi-structured telephone and face-to-face interviews were conducted with 34 patients at different stages of implant treatment. The interviews were transcribed verbatim; the data collection and coding process followed the principles of thematic analysis, which was facilitated through the use of NVivo10. Patients anticipated that surgery would be painful and unpleasant but were prepared to accept this temporary discomfort for the expected benefits of implant treatment. However, a key finding was that patients felt they had overestimated the trauma of surgery but underestimated the discomfort and difficulties of the healing phase. A number of difficulties were also identified with the TIP phase following implant surgery. Existing research has tended to focus on the longer term benefits of dental implant treatment. This qualitative study has investigated in-depth patients' perceptions of dental implant surgery, including their experiences related to sedation, and of transitional implant restoration. While patients felt their concerns were overestimated in relation to the implant surgery, they experienced greater morbidity than they expected in the healing phase. Recommendations are made for relatively small changes in care provision which might improve the overall patient experience. Partial dentate patients treated with a fixed transitional prosthesis experienced advantages more quickly than patients with an overdenture. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

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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.

Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

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Katsuhiko Imai

2016-08-01

Full Text Available Cardiac implantable electronic devices (CIEDs have become important in the treatment of cardiac disease and placement rates increased significantly in the last decade. However, despite the use of appropriate antimicrobial prophylaxis, CIED infection rates are increasing disproportionately to the implantation rate. CIED infection often requires explantation of all hardware, and at times results in death. Surgical site infection (SSI is the most common cause of CIED infection as a pocket infection. The best method of combating CIED infection is prevention. Prevention of CIED infections comprises three phases: before, during, and after device implantation. The most critical factors in the prevention of SSIs are detailed operative techniques including the practice of proper technique by the surgeon and surgical team.

Reliability of a CAD/CAM Surgical Guide for Implant Placement: An In Vitro Comparison of Surgeons' Experience Levels and Implant Sites.

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Park, Su-Jung; Leesungbok, Richard; Cui, Taixing; Lee, Suk Won; Ahn, Su-Jin

This in vitro study evaluated the reliability of a surgical guide with regard to different levels of operator surgical experience and implant site. A stereolithographic surgical guide for epoxy resin mandibles with three edentulous molar sites was produced using a computer-aided design/computer-assisted manufacture (CAD/CAM) system. Two surgeons with and two surgeons without implant surgery experience placed implants in a model either using or not using the CAD/CAM surgical guide. Four groups were created: inexperienced surgeon without the guide (group 1); experienced surgeon without the guide (group 2); inexperienced surgeon with the guide (group 3); and experienced surgeon with the guide (group 4). Planned implants and placed implants were superimposed using digital software, and deviation parameters were calculated. There were no significant differences in any of the deviation parameters between the groups when using the surgical guide. With respect to the implant sites, there were no significant differences among the groups in any parameter. Use of the CAD/CAM surgical guide reduced discrepancies among operators performing implant surgery regardless of their level of experience. Whether or not the guide was used, differences in the anterior-posterior implant site in the molar area did not affect the accuracy of implant placement.

Selective laser melting porous metallic implants with immobilized silver nanoparticles kill and prevent biofilm formation by methicillin-resistant Staphylococcus aureus

NARCIS (Netherlands)

van Hengel, Ingmar A. J.; Riool, Martijn; Fratila-Apachitei, Lidy E.; Witte-Bouma, Janneke; Farrell, Eric; Zadpoor, Amir A.; Zaat, Sebastian A. J.; Apachitei, Iulian

2017-01-01

Implant-associated infection and limited longevity are two major challenges that orthopedic devices need to simultaneously address. Additively manufactured porous implants have recently shown tremendous promise in improving bone regeneration and osseointegration, but, as any conventional implant,

POROUS POLYMER IMPLANTS FOR REPAIR OF FULL-THICKNESS DEFECTS OF ARTICULAR-CARTILAGE - AN EXPERIMENTAL-STUDY IN RABBIT AND DOG

NARCIS (Netherlands)

JANSEN, HWB; VETH, RPH; NIELSEN, HKL; DEGROOT, JH; PENNINGS, AJ

1992-01-01

Full-thickness defects of articular cartilage were repaired by implantation of porous polymer implants in rabbits and dogs. The quality of the repair tissue was determined by collagen typing with antibodies. Implants with varying pore sizes and chemical composition were used. The effect of loading

Multi-layer porous fiber-reinforced composites for implants: in vitro calcium phosphate formation in the presence of bioactive glass.

Science.gov (United States)

Nganga, Sara; Zhang, Di; Moritz, Niko; Vallittu, Pekka K; Hupa, Leena

2012-11-01

Glass-fiber-reinforced composites (FRCs), based on bifunctional methacrylate resin, have recently shown their potential for use as durable cranioplasty, orthopedic and oral implants. In this study we suggest a multi-component sandwich implant structure with (i) outer layers out of porous FRC, which interface the cortical bone, and (ii) inner layers encompassing bioactive glass granules, which interface with the cancellous bone. The capability of Bioglass(®) 45S5 granules (100-250μm) to induce calcium phosphate formation on the surface of the FRC was explored by immersing the porous FRC-Bioglass laminates in simulated body fluid (SBF) for up to 28d. In both static (agitated) and dynamic conditions, bioactive glass granules induced precipitation of calcium phosphate at the laminate surfaces as confirmed by scanning electron microscopy. The proposed dynamic flow system is useful for the in vitro simulation of bone-like apatite formation on various new porous implant designs containing bioactive glass and implant material degradation. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The efficacy of antibiotic prophylaxis at placement of dental implants: a Cochrane systematic review of randomised controlled clinical trials.

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Esposito, Marco; Grusovin, Maria Gabriella; Coulthard, Paul; Oliver, Richard; Worthington, Helen V

To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic/placebo administration and, if antibiotics are of benefit, to find which type, dosage and duration is the most effective. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched and several journals were handsearched with no language restriction up to January 2008. Randomised controlled trials (RCTs) with a follow up of at least 3 months comparing the administration of various prophylactic antibiotic regimens versus no antibiotics to patients undergoing dental implant placement were eligible. Screening of studies, quality assessment and data extraction were conducted in duplicate. Missing information was requested. Outcome measures were: prosthesis and implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Two RCTs were identified: one comparing 2 g of preoperative amoxicillin versus placebo (316 patients) and the other comparing 2 g of preoperative amoxicillin + 500 mg four times a day for 2 days versus no antibiotics (80 patients). The meta-analyses of the two trials showed a statistically significant higher number of patients experiencing implant failures in the group not receiving antibiotics: RR = 0.22 (95% CI 0.06 to 0.86). The number needed to treat (NNT) to prevent one patient having an implant failure is 25 (95% CI 13 to 100), based on a patient implant failure rate of 6% in patients not receiving antibiotics. The other outcomes were not statistically significant, and only two minor adverse events were recorded, one of which was in the placebo group. There is some evidence suggesting that 2 g of amoxicillin given 1 hour preoperatively significantly reduce failures of dental implants placed in ordinary conditions. It remains unclear whether postoperative antibiotics are beneficial, and which is the most effective antibiotic. It might be

Immediate implant placement and provisionalization with simultaneous guided bone regeneration in the esthetic zone

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Chih-Long Chen

2011-03-01

Full Text Available The procedure for immediate implant placement and provisionalization is time-saving, possibly with only one surgical intervention required, although allowing maximal preservation of peri-implant tissues. In this case, we extracted a fractured maxillary right central incisor of a 46-year-old woman with high esthetic expectations, and a transmucosal implant was immediately installed. Simultaneous guided bone regeneration was performed to correct the defects at the facial side of the socket and augment the alveolar ridge horizontally. Primary stability of the implant body and wound closure without tension were confirmed. Connection of a 15° angled abutment and fabrication of a provisional acrylic resin crown without occlusal contact were also completed in the same appointment. After intensive follow-up and soft-tissue molding for 6 months, the customized zirconia abutment and all-ceramic crown were definitively fabricated. During the 18-month follow-up period, the patient was satisfied with the esthetic and functional results.

Horizontal alveolar ridge expansion followed by immediate placement of implants and rehabilitation with zirconia prosthesis

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Tatiana Miranda Deliberador

2017-01-01

Full Text Available In recent years, there have been a growing number of procedures involving dental implants. Most cases, though, are characterized by bone atrophy, especially horizontal atrophy. This clinical case aims to report a technique for the expansion of the horizontal alveolar ridge. A longitudinal fracture was created in the alveolar ridge to expand the bone, followed by immediate insertion of dental implants along with a particulate allogeneic bone graft. Eight implants were placed in the maxilla, and after 12 months, a surgical reopening was performed, along with rehabilitation with a protocol-type prosthesis, for which a zirconia infrastructure was made. The patient was observed during a 10-month follow-up period in which an effective osseointegration of all implants was achieved as a result of such a technique. The split-crest technique followed by the immediate placement of implants and a particulate allogeneic bone graft proved to be effective, with a predictable osseointegration.

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

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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.

Purposeful exposure of a polylactic acid barrier to achieve socket preservation for placement of dental implants: case series report.

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Rosen, Paul S; Rosen, Adam D

2013-01-01

This retrospective case series reports on the use of a polylactic acid barrier that was left exposed in the process of socket preparation for the placement of dental implants. A retrospective chart review found 43 patients with 48 extraction sockets that were treated in this manner. Teeth were removed and the sockets were thoroughly debrided, with 40 of them receiving a bone replacement graft covered by the polylactic acid barrier and the additional 8 receiving the membrane alone. Suturing left the barrier exposed, and the sites were re-entered on average at 23 weeks for the placement of a dental implant. All sites were able to receive a dental implant, demonstrating the ability to leave a polylactic acid barrier exposed and achieve successful guided bone regeneration (GBR) results. This ultimately helped avoid some of the negative sequelae of trying to achieve primary closure of the flaps at the time of tooth extraction.

Immediate Implant Placement in Single-Tooth Molar Extraction Sockets: A 1- to 6-Year Retrospective Clinical Study.

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Amato, Francesco; Polara, Giorgio

The aim of this study was to investigate the survival rate of implants immediately placed in fresh extraction sockets of molars in the maxilla and mandible with a single-stage procedure. A total of 102 patients were treated, and 107 implants (53 in the maxilla and 54 in the mandible) were placed in a fresh molar extraction socket and connected to a healing abutment. After a mean follow-up of 3 years (range: 1 to 6 years) 1 implant failed, for a cumulative success rate of 99.06% (98.11% for the mandible and 100% for the maxilla). The results of this study support placement of an implant immediately after the extraction of a molar, applying a single-stage procedure.

Single-staged vs. two-staged implant placement using bone ring technique in vertically deficient alveolar ridges - Part 1: histomorphometric and micro-CT analysis.

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Nakahara, Ken; Haga-Tsujimura, Maiko; Sawada, Kosaku; Kobayashi, Eizaburo; Mottini, Matthias; Schaller, Benoit; Saulacic, Nikola

2016-11-01

Simultaneous implant placement with bone grafting shortens the overall treatment period, but might lead to the peri-implant bone loss or even implant failure. The aim of this study was to compare the single-staged to two-staged implant placement using the bone ring technique. Four standardized alveolar bone defects were made in the mandibles of nine dogs. Dental implants (Straumann BL ® , Basel, Switzerland) were inserted simultaneously with bone ring technique in test group and after 6 months of healing period in control group. Animals of both groups were euthanized at 3 and 6 months of osseointegration period. The harvested samples were analyzed by means of histology and micro-CT. The amount of residual bone decreased while the amount of new bone increased up to 9 months of healing period. All morphometric parameters remained stable between 3 and 6 months of osseointegration period within groups. Per a given time point, median area of residual bone graft was higher in test group and area of new bone in control group. The volume of bone ring was greater in test than in control group, reaching the significance at 6 months of osseointegration period (P = 0.002). In the present type of bone defect, single-staged implant placement may be potentially useful to shorten an overall treatment period. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Immediate implant placement and restoration in the anterior maxilla: Tissue dimensional changes after 2-5 year follow up.

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Arora, Himanshu; Khzam, Nabil; Roberts, David; Bruce, William L; Ivanovski, Saso

2017-08-01

Immediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region. This prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation. Thirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES). All implants remained osseointegrated during the follow up period of 2-5 years (mean 47 ± 15 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic evaluation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally, respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 ± 0.64 mm and 0.16 ± 0.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was 0.29 ± 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the final follow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P = .001). In addition to a favorable implant success rate and peri-implant bony response, the soft tissue levels and overall aesthetics around single immediately placed and restored implants can also be maintained in the mid-long term. © 2017 Wiley Periodicals, Inc.

Osteointegration of Porous Poly-ε-Caprolactone-Coated and Previtalised Magnesium Implants in Critically Sized Calvarial Bone Defects in the Mouse Model

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Michael Grau

2017-12-01

Full Text Available Metallic biomaterials are widely used in maxillofacial surgery. While titanium is presumed to be the gold standard, magnesium-based implants are a current topic of interest and investigation due to their biocompatible, osteoconductive and degradable properties. This study investigates the effects of poly-ε-caprolactone-coated and previtalised magnesium implants on osteointegration within murine calvarial bone defects: After setting a 3 mm × 3 mm defect into the calvaria of 40 BALB/c mice the animals were treated with poly-ε-caprolactone-coated porous magnesium implants (without previtalisation or previtalised with either osteoblasts or adipose derived mesenchymal stem cells, porous Ti6Al4V implants or without any implant. To evaluate bone formation and implant degradation, micro-computertomographic scans were performed at day 0, 28, 56 and 84 after surgery. Additionally, histological thin sections were prepared and evaluated histomorphometrically. The outcomes revealed no significant differences within the differently treated groups regarding bone formation and the amount of osteoid. While the implant degradation resulted in implant shifting, both implant geometry and previtalisation appeared to have positive effects on vascularisation. Although adjustments in degradation behaviour and implant fixation are indicated, this study still considers magnesium as a promising alternative to titanium-based implants in maxillofacial surgery in future.

Sacroiliac joint stability: Finite element analysis of implant number, orientation, and superior implant length.

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Lindsey, Derek P; Kiapour, Ali; Yerby, Scott A; Goel, Vijay K

2018-03-18

To analyze how various implants placement variables affect sacroiliac (SI) joint range of motion. An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the SI joint using various placement configurations of triangular implants (iFuse Implant System ® ). Placement configurations were varied by changing implant orientation, superior implant length, and number of implants. The range of motion of the SI joint was calculated using a constant moment of 10 N-m with a follower load of 400 N. The changes in motion were compared between the treatment groups to assess how the different variables affected the overall motion of the SI joint. Transarticular placement of 3 implants with superior implants that end in the middle of the sacrum resulted in the greatest reduction in range of motion (flexion/extension = 73%, lateral bending = 42%, axial rotation = 72%). The range of motions of the SI joints were reduced with use of transarticular orientation (9%-18%) when compared with an inline orientation. The use of a superior implant that ended mid-sacrum resulted in median reductions of (8%-14%) when compared with a superior implant that ended in the middle of the ala. Reducing the number of implants, resulted in increased SI joint range of motions for the 1 and 2 implant models of 29%-133% and 2%-39%, respectively, when compared with the 3 implant model. Using a validated finite element model we demonstrated that placement of 3 implants across the SI joint using a transarticular orientation with superior implant reaching the sacral midline resulted in the most stable construct. Additional clinical studies may be required to confirm these results.

Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part I: a Systematic Review of Surgical Techniques

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Boris Abayev

2015-03-01

Full Text Available Objectives: The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN repositioning with a minimum 6 months of follow-up. Results: A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. Conclusions: Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments.

Immediate Implant Placement of a Single Central Incisor Using a CAD/CAM Crown-Root Form Technique: Provisional to Final Restoration.

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Vafiadis, Dean; Goldstein, Gary; Garber, David; Lambrakos, Anthony; Kowalski, Bj

2017-02-01

Preserving soft and hard tissues after extraction and implant placement is crucial for anterior esthetics. This technique will show how the information gathered from a cone-beam computed tomography (CBCT) scan of the maxillary left central incisor and an intra-oral digital impression can be merged to fabricate a CAD/CAM crown-root matrix to be used as an immediate provisional restoration that mimics the natural anatomy. Due to trauma, a left central incisor appeared to be fractured and was scheduled for extraction and implant placement. The crown-root configuration captured by the CBCT scan was merged with the digital files from an intra-oral digital impression. A CAD/CAM crown-root matrix was fabricated. Because the matrix shell was fabricated with the exact anatomy of the natural tooth, it replicated the position and three dimensional anatomy of the soft and hard tissue. It was connected to the implant with a customized provisional abutment. A digital impression of a coded healing abutment was made to fabricate the final implant abutment and final restoration. Throughout the treatment time and 36 months after completion, the thickness of tissue, emergence profile, and adjacent papilla was analyzed by clinical evaluation and photography and seemed to be maintained. The use of a pre-operative intra-oral digital scan of the clinical crown-root architecture and the CBCT scan of the bone/root anatomy, can be used together to fabricate a CAD/CAM crown-root form provisional matrix. This digital design helps in the preservation of the 3D tissue topography, as well as the final restoration. The preservation of soft and hard tissue after extraction and implant placement has always been paramount for ideal anterior implant esthetics. Using the information from digital files from CBCT scans and intra-oral scans may help the clinician identify critical anatomical features that can be replicated in the provisional and final CAD/CAM restoration. (J Esthet Restor Dent 29

Monitoring failure rates of commercial implant brands; substantial equivalence in question?

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Hujoel, Philippe; Becker, William; Becker, Burton

2013-07-01

The aim of this study was to report on the failure rates of two distinct dental implant systems in a clinical practice setting. Date of implant placement and loss were entered prospectively in a data registry system. Failure rates of two commercially pure titanium implants, one with a porous oxydized surface (POS) and the other with a chemically altered surface (CAS), were assessed using a quality control chart and survival analyses. A total of 860 POS and 759 CAS implants were placed. A warning of an increased failure rate of the CAS implant was identified by means of the quality control chart. Survival analyses indicated that the CAS implant failure rate was twice that of the POS implant (Hazard Ratio: 2.08; 95% CI: 1.33-3.28, P-value POS implant was associated with a non-significant 64% drop in the implant failure rate within less than a year (HR: 0.36; 95% CI: 0.12-1.14; P-value POS implant and an 8% failure with the CAS implant appears inconsistent with the assumption of substantial equivalence. © 2012 John Wiley & Sons A/S.

SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

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Julia Matena

2015-04-01

Full Text Available To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF, high mobility group box 1 (HMGB1 and chemokine (C-X-C motif ligand 12 (CXCL12. As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI. Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release.

SLM Produced Porous Titanium Implant Improvements for Enhanced Vascularization and Osteoblast Seeding

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Matena, Julia; Petersen, Svea; Gieseke, Matthias; Kampmann, Andreas; Teske, Michael; Beyerbach, Martin; Murua Escobar, Hugo; Haferkamp, Heinz; Gellrich, Nils-Claudius; Nolte, Ingo

2015-01-01

To improve well-known titanium implants, pores can be used for increasing bone formation and close bone-implant interface. Selective Laser Melting (SLM) enables the production of any geometry and was used for implant production with 250-µm pore size. The used pore size supports vessel ingrowth, as bone formation is strongly dependent on fast vascularization. Additionally, proangiogenic factors promote implant vascularization. To functionalize the titanium with proangiogenic factors, polycaprolactone (PCL) coating can be used. The following proangiogenic factors were examined: vascular endothelial growth factor (VEGF), high mobility group box 1 (HMGB1) and chemokine (C-X-C motif) ligand 12 (CXCL12). As different surfaces lead to different cell reactions, titanium and PCL coating were compared. The growing into the porous titanium structure of primary osteoblasts was examined by cross sections. Primary osteoblasts seeded on the different surfaces were compared using Live Cell Imaging (LCI). Cross sections showed cells had proliferated, but not migrated after seven days. Although the cell count was lower on titanium PCL implants in LCI, the cell count and cell spreading area development showed promising results for titanium PCL implants. HMGB1 showed the highest migration capacity for stimulating the endothelial cell line. Future perspective would be the incorporation of HMGB1 into PCL polymer for the realization of a slow factor release. PMID:25849656

An update on implant placement and provisionalization in extraction, edentulous, and sinus-grafted sites. A clinical report on 3200 sites over 8 years.

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Petrungaro, Paul S

2008-06-01

Provisionalization of dental implants at placement has become more prominent in the field of implantology over the past several years, especially in the esthetic zone. The benefits of this treatment option include immediate tooth replacement, formation and maintenance of esthetic soft-tissue contours, containment for bone-grafting and tissue-regenerative procedures, and an improved sense of the patient's perception of the implant process. The blending together of the surgical and prosthetic/esthetic phase has never been more important as implant systems, abutment options, and surgical techniques have helped optimize procedures that can be accomplished at the surgical visit. This article reviews the guidelines for surgical success first described by the author in 2003 and expands upon those results. This article highlights the results of more than 3200 immediately restored implants placed in edentulous, fresh extraction sockets, and sinus-grafted sites, over an 8-year period, and presents a case for each area of placement.

Systematic Review of Soft Tissue Alterations and Esthetic Outcomes Following Immediate Implant Placement and Restoration of Single Implants in the Anterior Maxilla.

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Khzam, Nabil; Arora, Himanshu; Kim, Paul; Fisher, Anthony; Mattheos, Nikos; Ivanovski, Saso

2015-12-01

The aim of this review is to assess the outcome of single-tooth immediate implant placement and restoration (IPR) in the maxillary anterior region, with a particular emphasis on soft tissue and esthetic outcomes. An electronic search in Medline, EBSCOhost, and Ovid (PubMed) was performed to identify studies that reported on soft tissue outcomes following immediate placement and restoration of implants in the maxillary esthetic region with a mean follow-up of ≥1 year. Nineteen studies on single implants inserted immediately into fresh extraction sockets and provisionally restored in the maxillary esthetic region were included. Soft tissue changes were found to be acceptable, with most studies reporting mean gingival recession of 0.27 ± 0.38 mm and mean papillary height loss of 0.23 ± 0.27 mm after follow-up of ≥1 year. Advanced buccal recession (>1 mm) occurred in 11% of cases. Long-term follow-up studies (>2 years) reported that the interdental papillae, in particular, showed a tendency to rebound over time. The few studies that reported on patient-centered outcomes showed a high level of patient satisfaction with the outcomes of IPR treatment. The IPR protocol resulted in generally acceptable soft tissue and esthetic outcomes, with suboptimal results reported in ≈11% of low-risk cases. Factors such as preoperative tissue biotype or use of a flap or connective tissue graft did not significantly influence soft tissue and esthetic outcomes. Long-term prospective controlled clinical trials are necessary to identify factors that may influence the esthetic outcomes associated with IPR.

Systemic Assessment of Calcium and Phosphorus Level after Implantation of Porous Iron in Rats

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Siallagan, S. F.; Amelia, F.; Utami, N. D.; Ulum, M. F.; Boediono, A.; Estuningsih, S.; Hermawan, H.; Noviana, D.

2017-07-01

One of important aspects in bone healing process is physiological level of calcium (Ca), and phosphorus (P) that can be altered by implantation of biodegradable porous iron. Therefore, this study aims to investigate the concentration of Ca, P and Ca/P ratio in the peripheral blood during the implantation period up to 4 months. Forty adult male Sprague Dawley rats were used and divided into 3 groups receiving different pore size of iron implants (pore size 450, 580, 800μm) and one group of sham. The implants (5x2x0.5mm) were inserted into flat bone defects at latero-medial of femoral bone. Blood sample was taken from ventral tail artery before and after 4 month of implantation. Calcium and P concentrations in the blood were determined by BA-88A Semi-Auto Chemistry Analyzer. Results showed that concentration of Ca and P are slightly higher after implantation than before implantation, except for the 450μm group. The Ca/P ratio before and after implantation was increased in the sham group, and decreased in the 450 and 800μm groups. Concentration of Ca, P and Ca/P ratio insignificantly change between before and 4 months after surgery in some groups.

Transaxillary Subpectoral Placement of Cardiac Implantable Electronic Devices in Young Female Patients

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Joo Hyun Oh

2017-01-01

Full Text Available BackgroundThe current indications of cardiac implantable electronic devices (CIEDs have expanded to include young patients with serious cardiac risk factors, but CIED placement has the disadvantage of involving unsightly scarring and bulging of the chest wall. A collaborative team of cardiologists and plastic surgeons developed a technique for the subpectoral placement of CIEDs in young female patients via a transaxillary approach.MethodsFrom July 2012 to December 2015, subpectoral CIED placement via an axillary incision was performed in 10 young female patients, with a mean age of 25.9 years and mean body mass index of 20.1 kg/m2. In the supine position, with the patient's shoulder abducted, an approximately 5-cm linear incision was made along one of the deepest axillary creases. The submuscular plane was identified at the lateral border of the pectoralis major, and the dissection continued over the clavipectoral fascia until the subpectoral pocket could securely receive a pulse generator. Slight upward dissection also exposed an entrance to the subclavian vein, allowing the cardiology team to gain access to the vein. One patient with dilated cardiomyopathy underwent augmentation mammoplasty and CIED insertion simultaneously.ResultsOne case of late-onset device infection occurred. All patients were highly satisfied with the results and reported that they would recommend the procedure to others.ConclusionsWith superior aesthetic outcomes compared to conventional methods, the subpectoral placement of CIEDs via a transaxillary approach is an effective, single-incision method to hide operative scarring and minimize bulging of the device, and is particularly beneficial for young female or lean patients.

Blistering in a porous surface layer of materials. [He ion implantation

Energy Technology Data Exchange (ETDEWEB)

Afrikanov, I.N.; Vladimirov, B.G.; Guseva, M.I.; Ivanov, S.M.; Martynenko, Yu.V.; Nikol' skij, Yu.V.; Ryazanov, A.I.

1981-03-01

The effect of porous structure on the nature and rate of radiation erosion during implantation of helium ions into nickel and the OKh15N15M3B stainless steel is studied. The investigation results showed sharp dependence of the erosion rate due to blistering on the dimension and density of pores in the by-surface layer. The rate of the surface erosion increased in one order as compared with the control specimens without pores at 1% swelling for stainless steel and 4% for nickel.

Osseointegration of dental implants in extraction sockets preserved with porous titanium granules - an experimental study.

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Verket, Anders; Lyngstadaas, Ståle P; Rønold, Hans J; Wohlfahrt, Johan C

2014-02-01

This study investigated osseointegration of dental implants inserted in healed extraction sockets preserved with porous titanium granules (PTG). Three adult female minipigs (Gøttingen minipig; Ellegaard A/S, Dalmose, Denmark) had the mandibular teeth P2, P3 and P4 extracted. The extraction sockets were preserved with metallic PTG (Tigran PTG; Tigran Technologies AB, Malmö, Sweden) n = 12, heat oxidized white porous titanium granules (WPTG) (Tigran PTG White) n = 12 or left empty (sham) n = 6. All sites were covered with collagen membranes (Bio-Gide; Geistlich Pharma, Wolhausen, Switzerland) and allowed 11 weeks of healing before implants (Straumann Bone Level; Straumann, Basel, Switzerland) were inserted. The temperature was measured during preparation of the osteotomies. Resonance frequency analysis (RFA, Osstell; Osstell AB, Gothenburg, Sweden) was performed at implant insertion and at termination. After 6 weeks of submerged implant healing, the pigs were euthanized and jaw segments were excised for microCT and histological analyses. In the temperature and RFA analyses no significant differences were recorded between the test groups. The microCT analysis demonstrated an average bone volume of 61.7% for the PTG group compared to 50.3% for the WPTG group (P = 0.03) and 57.1% for the sham group. Histomorphometry demonstrated an average bone-to-implant contact of 68.2% for the PTG group compared to 36.6% for the WPTG group and 60.9% for the sham group (n.s). Eight out of ten implants demonstrated apical osseous defects in the WPTG group, but similar defects were observed in all groups. PTG preserved extraction sockets demonstrate a similar outcome as the sham control group for all analyses suggesting that this material potentially can be used for extraction socket preservation prior to implant installment. Apical osseous defects were however observed in all groups including the sham group, and a single cause could not be determined. © 2012 John Wiley & Sons A/S.

Mechanical characterization of structurally porous biomaterials built via additive manufacturing: experiments, predictive models, and design maps for load-bearing bone replacement implants.

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Melancon, D; Bagheri, Z S; Johnston, R B; Liu, L; Tanzer, M; Pasini, D

2017-11-01

Porous biomaterials can be additively manufactured with micro-architecture tailored to satisfy the stringent mechano-biological requirements imposed by bone replacement implants. In a previous investigation, we introduced structurally porous biomaterials, featuring strength five times stronger than commercially available porous materials, and confirmed their bone ingrowth capability in an in vivo canine model. While encouraging, the manufactured biomaterials showed geometric mismatches between their internal porous architecture and that of its as-designed counterpart, as well as discrepancies between predicted and tested mechanical properties, issues not fully elucidated. In this work, we propose a systematic approach integrating computed tomography, mechanical testing, and statistical analysis of geometric imperfections to generate statistical based numerical models of high-strength additively manufactured porous biomaterials. The method is used to develop morphology and mechanical maps that illustrate the role played by pore size, porosity, strut thickness, and topology on the relations governing their elastic modulus and compressive yield strength. Overall, there are mismatches between the mechanical properties of ideal-geometry models and as-manufactured porous biomaterials with average errors of 49% and 41% respectively for compressive elastic modulus and yield strength. The proposed methodology gives more accurate predictions for the compressive stiffness and the compressive strength properties with a reduction of the average error to 11% and 7.6%. The implications of the results and the methodology here introduced are discussed in the relevant biomechanical and clinical context, with insight that highlights promises and limitations of additively manufactured porous biomaterials for load-bearing bone replacement implants. In this work, we perform mechanical characterization of load-bearing porous biomaterials for bone replacement over their entire design

Flapless postextraction socket implant placement in the esthetic zone: part 1. The effect of bone grafting and/or provisional restoration on facial-palatal ridge dimensional change-a retrospective cohort study.

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Tarnow, Dennis P; Chu, Stephen J; Salama, Maurice A; Stappert, Christian F J; Salama, Henry; Garber, David A; Sarnachiaro, Guido O; Sarnachiaro, Evangelina; Gotta, Sergio Luis; Saito, Hanae

2014-01-01

The dental literature has reported vertical soft tissue changes that can occur with immediate implant placement, bone grafting, and provisional restoration ranging from a gain or loss of 1.0 mm. However, little is known of the effects of facial-palatal collapse of the ridge due to these clinical procedures. Based upon treatment modalities rendered, an ensuing contour change can occur with significant negative esthetic consequences. The results of a retrospective clinical cohort study evaluating the change in horizontal ridge dimension associated with implant placement in anterior postextraction sockets are presented for four treatment groups: (1) group no BGPR = no bone graft and no provisional restoration; (2) group PR = no bone graft, provisional restoration; (3) group BG = bone graft, no provisional restoration; and (4) group BGPR = bone graft, provisional restoration. Bone grafting at the time of implant placement into the gap in combination with a contoured healing abutment or a provisional restoration resulted in the smallest amount of ridge contour change. Therefore, it is recommended to place a bone graft and contoured healing abutment or provisional restoration at the time of flapless postextraction socket implant placement.

Mode of communication and classroom placement impact on speech intelligibility.

Science.gov (United States)

Tobey, Emily A; Rekart, Deborah; Buckley, Kristi; Geers, Ann E

2004-05-01

To examine the impact of classroom placement and mode of communication on speech intelligibility scores in children aged 8 to 9 years using multichannel cochlear implants. Classroom placement (special education, partial mainstream, and full mainstream) and mode of communication (total communication and auditory-oral) reported via parental rating scales before and 4 times after implantation were the independent variables. Speech intelligibility scores obtained at 8 to 9 years of age were the dependent variables. The study included 131 congenitally deafened children between the ages of 8 and 9 years who received a multichannel cochlear implant before the age of 5 years. Higher speech intelligibility scores at 8 to 9 years of age were significantly associated with enrollment in auditory-oral programs rather than enrollment in total communication programs, regardless of when the mode of communication was used (before or after implantation). Speech intelligibility at 8 to 9 years of age was not significantly influenced by classroom placement before implantation, regardless of mode of communication. After implantation, however, there were significant associations between classroom placement and speech intelligibility scores at 8 to 9 years of age. Higher speech intelligibility scores at 8 to 9 years of age were associated with classroom exposure to normal-hearing peers in full or partial mainstream placements than in self-contained, special education placements. Higher speech intelligibility scores in 8- to 9-year-old congenitally deafened cochlear implant recipients were associated with educational settings that emphasize oral communication development. Educational environments that incorporate exposure to normal-hearing peers were also associated with higher speech intelligibility scores at 8 to 9 years of age.

Evaluation of porous vitreous carbon or silicon implants by radiology in rat's skull

International Nuclear Information System (INIS)

Vaccari-Mazzetti, Marcelo Paulo; Kobata, Celio Toshiro; Fabiani, Paulo; Martins, Dulce Maria Fonseca Soares; Gomes, Paulo de Oliveira; Martins, Jose Luiz

2008-01-01

Purpose: Evaluate by CT the use of porous vitreous carbon (PVC) and silicon (S) implants as the replacement bone in the craniofacial skeleton of rats. Methods: 40 rats divided in: Group A (n=20) PVC submitted to the implant of a fragment in skull. After the euthanasia, the animals were divided into two subgroups: A I: 10 animals, studied in the 7th postoperative day (P.O) and AII: 10 animals, studied in the 28th P.O. In group B, S, 20 rats were submitted to S implant in the skull. All other steps were identical to group A, with designation of subgroups BI and BII. CT with beams in axial cuts of 1 mm thickness to obtain 3-D information It was used Hounsfield scale for evaluate the radio density of the implant. They were used non parametric tests to analyze the results. Results: The 7th PO boss remained in the two groups, but for 28th PO, observed reduction in the volume of the implant in Group A, not observed in group B. CT studies noticed different radio densities around all of S prostheses (pseudo capsule), that do not appeared in CPV implants. The S has remained unchanged in the CT, but the CPV has had a modification in its radio density (p≤0,05), in all implants. Conclusion: In CT evaluation the implants of CPV have greater deformation that the S, which makes them not suitable for replacement of membranous bone in the rat skull. (author)

Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

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J. S. Vieira

2017-01-01

Full Text Available Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14, the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

Comparison of Reconstructive Outcomes in Breast Cancer Patients With Preexisting Subpectoral Implants: Implant-Sparing Mastectomy With Delayed Implant Exchange Versus Immediate Tissue Expander Reconstruction.

Science.gov (United States)

Parabkaharan, Sangeetha; Melody, Megan; Trotta, Rose; Lleshi, Amina; Sun, Weihong; Smith, Paul D; Khakpour, Nazanin; Dayicioglu, Deniz

2016-06-01

Women who have undergone prior augmentation mammoplasty represent a unique subset of breast cancer patients with several options available for breast reconstruction. We performed a single institution review of surgical outcomes of breast reconstruction performed in patients with breast cancer with prior history of subpectoral breast augmentation. Institutional review board-approved retrospective review was conducted among patients with previously mentioned criteria treated at our institution between 2000 and 2014. Reconstructions were grouped into 2 categories as follows: (1) removal of preexisting subpectoral implant during mastectomy with immediate tissue expander placement and (2) implant-sparing mastectomy followed by delayed exchange to a larger implant. We reviewed demographics, tumor features, and reconstruction outcomes of these groups. Fifty-three patients had preexisting subpectoral implants. Of the 63 breast reconstructions performed, 18 (28.6%) had immediate tissue expander placed and 45 (71.4%) had implant-sparing mastectomy followed by delayed implant exchange. The groups were comparable based on age, body mass index, cancer type, tumor grade, TNM stage at presentation, and hormonal receptor status. No significant difference was noted between tumor margins or subsequent recurrence, mastectomy specimen weight, removed implant volume, volume of implant placed during reconstruction, or time from mastectomy to final implant placement. Rates of complications were significantly higher in the tissue expander group compared to the implant-sparing mastectomy group 7 (38.9%) versus 4 (8.9%) (P = 0.005). Implant-sparing mastectomy with delayed implant exchange in patients with preexisting subpectoral implants is safe and has fewer complications compared to tissue expander placement. There was no difference noted in the final volume of implant placed, time interval for final implant placement, or tumor margins.

Fortifying the Bone-Implant Interface Part 1: An In Vitro Evaluation of 3D-Printed and TPS Porous Surfaces.

Science.gov (United States)

MacBarb, Regina F; Lindsey, Derek P; Bahney, Chelsea S; Woods, Shane A; Wolfe, Mark L; Yerby, Scott A

2017-01-01

An aging society and concomitant rise in the incidence of impaired bone health have led to the need for advanced osteoconductive spinal implant surfaces that promote greater biological fixation ( e.g. for interbody fusion cages, sacroiliac joint fusion implants, and artificial disc replacements). Additive manufacturing, i.e. 3D-printing, may improve bone integration by generating biomimetic spinal implant surfaces that mimic bone morphology. Such surfaces may foster an enhanced cellular response compared to traditional implant surfacing processes. This study investigated the response of human osteoblasts to additive manufactured (AM) trabecular-like titanium implant surfaces compared to traditionally machined base material with titanium plasma spray (TPS) coated surfaces, with and without a nanocrystalline hydroxyapatite (HA) coating. For TPS-coated discs, wrought Ti6Al4V ELI was machined and TPS-coating was applied. For AM discs, Ti6Al4V ELI powder was 3D-printed to form a solid base and trabecular-like porous surface. The HA-coating was applied via a precipitation dip-spin method. Surface porosity, pore size, thickness, and hydrophilicity were characterized. Initial cell attachment, proliferation, alkaline phosphatase (ALP) activity, and calcium production of hFOB cells ( n =5 per group) were measured. Cells on AM discs exhibited expedited proliferative activity. While there were no differences in mean ALP expression and calcium production between TPS and AM discs, calcium production on the AM discs trended 48% higher than on TPS discs ( p =0.07). Overall, HA-coating did not further enhance results compared to uncoated TPS and AM discs. Results demonstrate that additive manufacturing allows for controlled trabecular-like surfaces that promote earlier cell proliferation and trends toward higher calcium production than TPS coating. Results further showed that nanocrystalline HA may not provide an advantage on porous titanium surfaces. Additive manufactured porous

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...

Effect of MeV energy He and N pre-implantation on the formation of porous silicon

International Nuclear Information System (INIS)

Manuaba, A.; Paszti, F.; Ortega, C.; Grosman, A.; Horvath, Z.E.; Szilagyi, E.; Khanh, N.Q.; Vickridge, I.

2001-01-01

The effects of MeV energy He and N pre-implantation of Si substrate on the structure of porous silicon formed by anodic etching were studied by measuring the depth profiles of 15 N decorating the pores walls. Radiation damage was recovered by annealing after the implantation. It was found that the He implant accelerates the etching process, probably due to the bubbles or the remaining lattice damage. At a dose of 8x10 16 ions/cm 2 the He containing layer was formed with a significantly enhanced porosity due to the contribution of the large-sized bubbles. At the highest dose of 32.5x10 16 ions/cm 2 flaking took place during the anodic etching. In contrast to He, N stopped the anodic etching at a depth of critical N concentration of ∼0.9 at.%. For the lowest implantation dose, where the peak concentration was below this limit, the pores propagate through the implanted layer with an enhanced speed

Benefits of mineralized bone cortical allograft for immediate implant placement in extraction sites: an in vivo study in dogs.

Science.gov (United States)

Orti, Valérie; Bousquet, Philippe; Tramini, Paul; Gaitan, Cesar; Mertens, Brenda; Cuisinier, Frédéric

2016-10-01

The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.

Stereotaxic implantation of dispersed cell suspensions into brain. A systematic appraisal of cell placement and survival

International Nuclear Information System (INIS)

Plunkett, R.J.; Weber, R.J.; Oldfield, E.H.

1988-01-01

The application of several recent advances in cell biology, brain implantation, and cell-mediated tumor immunotherapy requires successful and reproducible placement of viable cell suspensions into brain. Stereotaxic implantation is being used to inject cytotoxic lymphocytes into gliomas and to replace dopaminergic cells in parkinsonian models. Systematic assessment of the factors that influence success in implantation of cell suspensions into solid tissues is needed. A model was developed for investigation of stereotaxic implantation using radiolabeled rat lymphokine-activated killer (LAK) cells. Anesthetized rats received microliter injections of cell suspension into the right caudate nucleus. The injection volume, cell concentration, infusion rate, and needle size were varied systematically. The animals were sacrificed 1 hour after injection; the brain was removed and sectioned, and the radioactivity was counted. Three aliquots of the suspension were injected into counting tubes for control analysis. Recovery of radioactivity was expressed as the percent of mean counts per minute (cpm) in the right frontal lobe/mean cpm in the three control tubes. To assess the viability of implanted cells, the right frontal region was mechanically dissociated in media and centrifuged, and the pellet and supernatant were counted. By using small needles and slow infusion of volumes of 10 microliters or less, 85% to 90% of the radioactivity was recovered in the caudate nucleus. At least half of the implanted cells were viable. Consistent, accurate implantation of dispersed cells into brain over a range of volumes, cell concentrations, infusion rates, and needle sizes was achieved

Diagnostic value of NobelGuide to minimize the need for reconstructive surgery of jaws before implant placement: a review.

Science.gov (United States)

Scotti, Roberto; Pellegrino, Gerardo; Marchetti, Claudio; Corinaldesi, Guiseppe; Ciocca, Leonardo

2010-01-01

To test if using a CAD/CAM system might reduce the necessity of bone augmentation in patients with atrophic maxillary arches before implant therapy. Twenty male and female patients consecutively scheduled for bone augmentation of the jaw before implant surgery were included in this study, with a total of 29 jaws (maxillary and mandibular) to analyze for the implant-supported fixed prosthesis group and 19 maxillary arches for the implant-supported removable prosthesis group. NobelGuide System (Nobel Biocare), Autocad System (Autodesk), and routine manual CT measurements of available bone were used in this study. The total results of the mean values of the fixed prosthesis group plus the mean values of the removable prosthesis group showed a statistically significant difference between the NobelGuide intervention score and both manual (P = .004) and Autocad (P = .001) measurements. The NobelGuide System represents a viable diagnostic device to reduce the entity or avoid bone reconstructive surgery before implant placements in the atrophic maxilla and mandible.

Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account.

Science.gov (United States)

Liberale, Gabriel

2017-04-01

Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove. This allows us to introduce the port and to place it on the anterolateral part of the thorax, thus avoiding an unaesthetic scar on the anterior part of the thorax. Our modified technique for TIVAD implantation is described.

Expansion of Mandibular Knife-Edge Ridge and Simultaneous Implant Placement to Retain Overdentures: One-Year Clinical and Radiographic Results of a Prospective Study.

Science.gov (United States)

ELsyad, Moustafa Abdou; Hammouda, Nelly Ibrahim

2017-02-01

The aim of this study was to evaluate and compare the clinical and radiographic outcomes of two implants placed in expanded mandibular knife-edge ridge and implants placed in unexpanded ridges to retain overdentures. Fifteen completely edentulous patients with knife-edge ridges at canine areas of the mandible received two implants using the ridge expansion technique (study group, SG). Expansion was performed using piezoelectric corticotomy, and self-threading expanders. The control group (CG) comprised patients who received two-implant at canine areas without ridge expansion but were all case matched to SG and served as historical cohort. In both groups, mandibular overdentures were connected to the implants with Locator attachments 3 months after implant placement. Clinical (Plaque index; PI, Gingival index; GI, Probing depth; PD, and implant stability; ISQ) and radiographic (Vertical bone loss; VBL) parameters were recorded at time of overdenture insertion (base line, T0), 6 months (T6), and 12 months (T12) after insertion. The cumulative success rates were 100% and 96.4% for CG and SG, respectively, without significant difference between groups. All tested parameters increased significantly with advance of time in both groups. There was no significant difference in PI, GI, PD, and ISQ between groups. However, SG recorded significant higher VBL than CG at T6 and T12. Expansion of mandibular knife edge ridge and simultaneous placement of implants to retain overdentures is associated with clinic and radiographic outcomes comparable to implants placed in unexpanded ridges after 1 year. However, long term randomized controlled trials with sufficient sample size are still needed to ensure the findings of the present study. © 2016 Wiley Periodicals, Inc.

Monitoring the evolution of boron doped porous diamond electrode on flexible retinal implant by OCT and in vivo impedance spectroscopy

International Nuclear Information System (INIS)

Hébert, Clément; Cottance, Myline; Degardin, Julie; Scorsone, Emmanuel; Rousseau, Lionel; Lissorgues, Gaelle; Bergonzo, Philippe; Picaud, Serge

2016-01-01

Nanocrystalline Boron doped Diamond proved to be a very attractive material for neural interfacing, especially with the retina, where reduce glia growth is observed with respect to other materials, thus facilitating neuro-stimulation over long terms. In the present study, we integrated diamond microelectrodes on a polyimide substrate and investigated their performances for the development of neural prosthesis. A full description of the microfabrication of the implants is provided and their functionalities are assessed using cyclic voltammetry and electrochemical impedance spectroscopy. A porous structure of the electrode surface was thus revealed and showed promising properties for neural recording or stimulation. Using the flexible implant, we showed that is possible to follow in vivo the evolution of the electric contact between the diamond electrodes and the retina over 4 months by using electrochemical impedance spectroscopy. The position of the implant was also monitored by optical coherence tomography to corroborate the information given by the impedance measurements. The results suggest that diamond microelectrodes are very good candidates for retinal prosthesis. - Highlights: • Microfabrication of porous diamond electrode on flexible retinal implant • Electrochemical characterization of microelectrode for neural interfacing • In vivo impedance spectroscopy of retinal tissue

Monitoring the evolution of boron doped porous diamond electrode on flexible retinal implant by OCT and in vivo impedance spectroscopy

Energy Technology Data Exchange (ETDEWEB)

Hébert, Clément, E-mail: clement.hebert@icn2.cat [CEA-LIST, Diamond Sensors Laboratory, Gif-sur-Yvette 91191 (France); Cottance, Myline [Université Paris-Est, ESYCOM-ESIEE Paris, Noisy le Grand (France); Degardin, Julie [INSERM, U968, Institut de la Vision, Paris (France); Scorsone, Emmanuel [CEA-LIST, Diamond Sensors Laboratory, Gif-sur-Yvette 91191 (France); Rousseau, Lionel; Lissorgues, Gaelle [Université Paris-Est, ESYCOM-ESIEE Paris, Noisy le Grand (France); Bergonzo, Philippe [CEA-LIST, Diamond Sensors Laboratory, Gif-sur-Yvette 91191 (France); Picaud, Serge [INSERM, U968, Institut de la Vision, Paris (France)

2016-12-01

Nanocrystalline Boron doped Diamond proved to be a very attractive material for neural interfacing, especially with the retina, where reduce glia growth is observed with respect to other materials, thus facilitating neuro-stimulation over long terms. In the present study, we integrated diamond microelectrodes on a polyimide substrate and investigated their performances for the development of neural prosthesis. A full description of the microfabrication of the implants is provided and their functionalities are assessed using cyclic voltammetry and electrochemical impedance spectroscopy. A porous structure of the electrode surface was thus revealed and showed promising properties for neural recording or stimulation. Using the flexible implant, we showed that is possible to follow in vivo the evolution of the electric contact between the diamond electrodes and the retina over 4 months by using electrochemical impedance spectroscopy. The position of the implant was also monitored by optical coherence tomography to corroborate the information given by the impedance measurements. The results suggest that diamond microelectrodes are very good candidates for retinal prosthesis. - Highlights: • Microfabrication of porous diamond electrode on flexible retinal implant • Electrochemical characterization of microelectrode for neural interfacing • In vivo impedance spectroscopy of retinal tissue.

Interface mechanics and histomorphometric analysis of hydroxyapatite-coated and porous glass-ceramic implants in canine bone

DEFF Research Database (Denmark)

Nimb, L; Jensen, J S; Gotfredsen, K

1995-01-01

A canine study was performed to make a histological and biomechanical evaluation of the interface between bone and two different bioceramic implants. A newly developed glass-ceramic formed by P2O5, CaO, SiO2, and Al2O3, giving a crystal phase composed of CaP2O6-AlPO4-SiP2O7, was compared...... analysis. The ultimate shear strength for the HA-coated implants was significantly higher than in the glass-ceramic group. When these values were related to the histomorphometric measurements, the difference could be explained by the tissue-to-implant contact. The glass-ceramic showed direct contact only...... with nonmineralized, osteoid bone. The HA-coated implants, however, were integrated into the bone. The study indicated that porous glass-ceramic containing AlPO4 causes local osteomalacia and might not be suitable for clinical purposes....

Implant Therapy in the Esthetic Zone-Surgical Considerations

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Marković Aleksa

2016-07-01

Full Text Available Implant placement in the esthetic zone is a complex procedure and requires a restoration-driven approach. Proper selection of patients and implant together with individual assessment of the risk of esthetic complications are very important. Correct 3D-implant positioning and sufficient bone volume should provide long-term esthetic and function. Esthetic region is a zone in which expectations and possibilities collide. Clinician should bring the important decision on the appropriate time of implant placement. Immediate implant placement is particularly challenging in the esthetic zone. Patient desire for reduced treatment time should be weighed against the possible risk factors. Protocol of immediate implant placement in conditions of unfavourable gingival biotypes, the lack of bone or soft tissue in patients with a high smile line lead to esthetic failure which is very important in the esthetic region.

Histological and biomechanical analysis of porous additive manufactured implants made by direct metal laser sintering: a pilot study in sheep.

Science.gov (United States)

Stübinger, Stefan; Mosch, Isabel; Robotti, Pierfrancesco; Sidler, Michéle; Klein, Karina; Ferguson, Stephen J; von Rechenberg, Brigitte

2013-10-01

It was the aim of this study to analyze osseointegrative properties of porous additive manufactured titanium implants made by direct metal laser sintering in a sheep model after an implantation period of 2 and 8 weeks. Three different types of implants were placed in the pelvis of six sheep. In each sheep were placed three standard machined (M), three sandblasted and etched (SE), and three porous additive manufactured (AM) implants. Of these three implants (one per type) were examined histologically and six implants were tested biomechanically. Additionally a semiquantitative histomorphometrical and qualitative fluorescent microscopic analysis were performed. After 2 and 8 weeks bone-to-implant-contact (BIC) values of the AM surface (2w: 20.49% ± 5.18%; 8w: 43.91% ± 9.69%) revealed no statistical significant differences in comparison to the M (2w: 20.33% ± 11.50%; 8w: 25.33% ± 4.61%) and SE (2w: 43.67 ± 12.22%; 8w: 53.33 ± 8.96%) surfaces. AM surface showed the highest increase of the BIC between the two observation time points. Considering the same implantation period histomorphometry and fluorescent labelling disclosed no significant differences in the bone surrounding the three implants groups. In contrast Removal-torque-test showed a significant improve in fixation strength (P ≤ 0.001) for the AM (1891.82 ± 308, 44 Nmm) surface after eight weeks in comparison to the M (198.93±88,04 Nmm) and SE (730.08 ± 151,89 Nmm) surfaces. All three surfaces (M, SE, and AM) showed sound osseointegration. AM implants may offer a possible treatment option in clinics for patients with compromised bone situations. Copyright © 2013 Wiley Periodicals, Inc., a Wiley Company.

The Effect of Microphone Placement on Interaural Level Differences and Sound Localization Across the Horizontal Plane in Bilateral Cochlear Implant Users.

Science.gov (United States)

Jones, Heath G; Kan, Alan; Litovsky, Ruth Y

2016-01-01

This study examined the effect of microphone placement on the interaural level differences (ILDs) available to bilateral cochlear implant (BiCI) users, and the subsequent effects on horizontal-plane sound localization. Virtual acoustic stimuli for sound localization testing were created individually for eight BiCI users by making acoustic transfer function measurements for microphones placed in the ear (ITE), behind the ear (BTE), and on the shoulders (SHD). The ILDs across source locations were calculated for each placement to analyze their effect on sound localization performance. Sound localization was tested using a repeated-measures, within-participant design for the three microphone placements. The ITE microphone placement provided significantly larger ILDs compared to BTE and SHD placements, which correlated with overall localization errors. However, differences in localization errors across the microphone conditions were small. The BTE microphones worn by many BiCI users in everyday life do not capture the full range of acoustic ILDs available, and also reduce the change in cue magnitudes for sound sources across the horizontal plane. Acute testing with an ITE placement reduced sound localization errors along the horizontal plane compared to the other placements in some patients. Larger improvements may be observed if patients had more experience with the new ILD cues provided by an ITE placement.

Effect of MeV energy He and N pre-implantation on the formation of porous silicon

Energy Technology Data Exchange (ETDEWEB)

Manuaba, A. E-mail: manu@rmki.kfki.hu; Paszti, F.; Ortega, C.; Grosman, A.; Horvath, Z.E.; Szilagyi, E.; Khanh, N.Q.; Vickridge, I

2001-06-01

The effects of MeV energy He and N pre-implantation of Si substrate on the structure of porous silicon formed by anodic etching were studied by measuring the depth profiles of {sup 15}N decorating the pores walls. Radiation damage was recovered by annealing after the implantation. It was found that the He implant accelerates the etching process, probably due to the bubbles or the remaining lattice damage. At a dose of 8x10{sup 16} ions/cm{sup 2} the He containing layer was formed with a significantly enhanced porosity due to the contribution of the large-sized bubbles. At the highest dose of 32.5x10{sup 16} ions/cm{sup 2} flaking took place during the anodic etching. In contrast to He, N stopped the anodic etching at a depth of critical N concentration of {approx}0.9 at.%. For the lowest implantation dose, where the peak concentration was below this limit, the pores propagate through the implanted layer with an enhanced speed.

Nanoscale Topographical Characterization of Orbital Implant Materials

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Marco Salerno

2018-04-01

Full Text Available The search for an ideal orbital implant is still ongoing in the field of ocular biomaterials. Major limitations of currently-available porous implants include the high cost along with a non-negligible risk of exposure and postoperative infection due to conjunctival abrasion. In the effort to develop better alternatives to the existing devices, two types of new glass-ceramic porous implants were fabricated by sponge replication, which is a relatively inexpensive method. Then, they were characterized by direct three-dimensional (3D contact probe mapping in real space by means of atomic force microscopy in order to assess their surface micro- and nano-features, which were quantitatively compared to those of the most commonly-used orbital implants. These silicate glass-ceramic materials exhibit a surface roughness in the range of a few hundred nanometers (Sq within 500–700 nm and topographical features comparable to those of clinically-used “gold-standard” alumina and polyethylene porous orbital implants. However, it was noted that both experimental and commercial non-porous implants were significantly smoother than all the porous ones. The results achieved in this work reveal that these porous glass-ceramic materials show promise for the intended application and encourage further investigation of their clinical suitability.

Oral Abstract Session 3: Orthognathic/Implants

DEFF Research Database (Denmark)

Hartlev, Jens

Immediate Placement And Provisionalization Of Single-tooth Implants Involving A Final Individual Abutment. A 3-year Clinical And Radiographic Retrospektive Study......Immediate Placement And Provisionalization Of Single-tooth Implants Involving A Final Individual Abutment. A 3-year Clinical And Radiographic Retrospektive Study...

Basics of clinical diagnosis in implant dentistry

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Manu Rathee

2015-01-01

Full Text Available Implant-based prosthetic rehabilitation requires an understanding of associated anatomical structures. The ultimate predictability of an implant site is determined by the existing anatomy as related to dentition and the associated hard and soft tissues. Meticulous clinical assessment helps in determining the suitability of the potential site for implant placement. The purpose of this article is to present the clinical assessment for dental implants' placement to modulate peri-implant tissue characteristics in individual clinical need.

Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket

Directory of Open Access Journals (Sweden)

Kasturi Bhattacharjee

2014-01-01

Full Text Available Purpose: The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG. Study Design: Prospective comparative study. Materials and Methods: A total of 24 patients of severe socket contracture (Grade 2-4 Krishna′s classification were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed-up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured. Results: In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001 and motility (P = 0.004 between the two groups was significant. Conclusion: Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention.

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

Science.gov (United States)

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

Bone regeneration by the osteoconductivity of porous titanium implants manufactured by selective laser melting: a histological and micro computed tomography study in the rabbit.

Science.gov (United States)

de Wild, Michael; Schumacher, Ralf; Mayer, Kyrill; Schkommodau, Erik; Thoma, Daniel; Bredell, Marius; Kruse Gujer, Astrid; Grätz, Klaus W; Weber, Franz E

2013-12-01

The treatment of large bone defects still poses a major challenge in orthopaedic and cranio-maxillofacial surgery. One possible solution could be the development of personalized porous titanium-based implants that are designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined with growth factor-loaded hydrogels or cell constructs to realize advanced bone tissue engineering strategies. Such implants could prove useful for mandibular reconstruction, spinal fusion, the treatment of extended long bone defects, or to fill in gaps created on autograft harvesting. The aim of this study was to determine the mechanical properties and potential of bone formation of light weight implants generated by selective laser melting (SLM). We mainly focused on osteoconduction, as this is a key feature in bone healing and could serve as a back-up for osteoinduction and cell transplantation strategies. To that end, defined implants were produced by SLM, and their surfaces were left untreated, sandblasted, or sandblasted/acid etched. In vivo bone formation with the different implants was tested throughout calvarial defects in rabbits and compared with untreated defects. Analysis by micro computed tomography (μCT) and histomorphometry revealed that all generatively produced porous Ti structures were well osseointegrated into the surrounding bone. The histomorphometric analysis revealed that bone formation was significantly increased in all implant-treated groups compared with untreated defects and significantly increased in sand blasted implants compared with untreated ones. Bone bridging was significantly increased in sand blasted acid-etched scaffolds. Therefore, scaffolds manufactured by SLM should be surface treated. Bone augmentation beyond the original bone margins was only seen in implant-treated defects, indicating an osteoconductive potential of the implants that could be utilized clinically for bone

Primary prevention of peri-implantitis: Managing peri-implant mucositis

OpenAIRE

Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; LAMBERT, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni; Schwarz, Frank; Serino, Giovanni

2015-01-01

Abstract AIMS: Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considere...

Combined Ahmed Glaucoma Valve Placement, Intravitreal Fluocinolone Acetonide Implantation and Cataract Extraction for Chronic Uveitis.

Science.gov (United States)

Chang, Ingrid T; Gupta, Divakar; Slabaugh, Mark A; Vemulakonda, Gurunadh A; Chen, Philip P

2016-10-01

To report the outcomes of combined Ahmed glaucoma valve (AGV) placement, intravitreal fluocinolone acetonide implant, and cataract extraction procedure in the treatment of chronic noninfectious uveitis. Retrospective case series of patients with chronic noninfectious uveitis who underwent AGV placement, intravitreal fluocinolone acetonide implantation, and cataract extraction in a single surgical session performed at 1 institution from January 2009 to November 2014. Outcome measures included intraocular pressure (IOP) and glaucoma medication use. Secondary outcome measures included visual acuity, systemic anti-inflammatory medications, number of uveitis flares, and complications. Fifteen eyes of 10 patients were studied, with a mean age of 40.3±15.7 and mean follow-up duration of 26 months (range, 13 to 39 mo). Before surgery, the IOP was 18.5±7.3 mm Hg and patients were using 1.5±1.5 topical glaucoma medications. At the 12-month follow-up, IOP was 12.8±3.2 mm Hg (P=0.01) and patients were using 0.5±0.8 (P=0.03) topical glaucoma medications. At 36 months of follow-up, late, nonsustained hypotony had occurred in 3 eyes (20%), and 1 eye (6%) had received a second AGV for IOP control. Before treatment, patients had 2.7±1.5 uveitis flares in the year before surgery while on an average of 2.1±0.6 systemic anti-inflammatory medications, which decreased to an average of 0.1±0.3 (Pglaucoma medications at 12 months after treatment in patients with chronic uveitis.

The Effect of Subepithelial Connective Tissue Graft Placement on Esthetic Outcomes After Immediate Implant Placement: Systematic Review.

Science.gov (United States)

Lee, Chun-Teh; Tao, Chih-Yun; Stoupel, Janet

2016-02-01

Immediate implantation, despite many advantages, carries a risk of gingival recession, papilla loss, collapse of ridge contour, and other esthetic complications. Soft tissue graft placement combined with immediate implantation may be used to reduce these concerns. This review aims to systematically analyze clinical esthetic outcomes of the immediate implant combined with soft tissue graft (IMITG). The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews were used. The electronic search was conducted using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from January 1980 to October 2014. Quality assessments of selected articles were performed. Mid-buccal gingival level, interproximal gingival level, facial gingival thickness, gingival ridge dimension, and width of keratinized gingiva were the esthetic outcomes reviewed. Weighted mean difference of mid-buccal gingival level (WDBGL), papilla index score (WDPIS), and width of keratinized gingiva (WDKG) between initial and last measurements were calculated. Other esthetic outcomes were assessed by the descriptive analysis. Ten studies with a minimum of 6-month follow-up were included, and reported esthetic outcomes were analyzed. Mid-buccal gingival level (WDBGL, 0.07 mm; 95% confidence interval [CI] = -0.44 to 0.59; P = 0.12) and interproximal gingival level did not significantly change after IMITG (WDPIS in the mesial site, 0.31; 95% CI = -0.01 to 0.64; P = 0.06; and WDPIS in the distal site, 0.29; 95% CI = -0.06 to 0.65; P = 0.11). Width of keratinized gingiva significantly increased after IMITG (WDKG, 1.27 mm; 95% CI = -0.08 to 2.46; P = 0.04). Facial gingival thickness and gingival ridge dimension could be increased after IMITG. Because of the heterogeneity and limited number of selected studies, no conclusive statement could be made regarding the benefit of IMITG on esthetic outcomes. More randomized controlled trials

Influence of immediate loading on provisional restoration in dental implant stability

Science.gov (United States)

Ikbal, M.; Odang, R. W.; Indrasari, M.; Dewi, R. S.

2017-08-01

The success of dental implant treatment is determined by the primary stability at placement. One factor that could influence this stability is occlusal loading through provisional restoration. Two types of loading protocols are usually used: immediate and delayed loading. However, some controversies remain about the influence of occlusal loading on implant stability. Therefore, the influence of immediate loading on implant stability must be studied. An animal study was conducted by placing nine dental implants in the mandibular jaw of three Macaca fascicularis. Provisional restorations with various occlusal contacts (no, light, and normal contact) were placed on the implant. The implant stability was measured using the Ostell ISQ three times: immediately (baseline) and at the first and second months after implant placement. The implant stability between implants with no and normal occlusal contact as well as light and normal occlusal contact showed significant differences (p implant placement. However, no significant increase (p > 0.05) in implant stability was seen at the baseline and the first and second months after implant placement for all occlusal contact groups. Immediate loading influenced the implant stability, and provisional restoration of implant without occlusal contact showed the highest implant stability.

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.

Immediate Placement of Dental Implants into Fresh Extraction Socket of Periapical Lesion with Bone Augmentation Using Growth Factors (PRGF) and Graft Bone (Bio-Oss)

OpenAIRE

Piuryk, V. P.; Kareem, Shujairi Ahmed

2016-01-01

Immediate implant placement and loading can be done in a compromised bone. Curettage, cleaning of the whole area up to good bone quality and primary stability are the main necessities for success. The effect of local application of scaffold-like preparation rich in growth factors (PRGF) on bone regeneration in artificial defects and the potential effect of humidifying titanium dental implants with liquid PRGF on their osseointegration were investigated. The PRGF formulations were obtained fro...

Bone modelling at fresh extraction sockets: immediate implant placement versus spontaneous healing: an experimental study in the beagle dog.

Science.gov (United States)

Vignoletti, Fabio; Discepoli, Nicola; Müller, Anna; de Sanctis, Massimo; Muñoz, Fernando; Sanz, Mariano

2012-01-01

The purpose of this investigation is to describe histologically the undisturbed healing of fresh extraction sockets when compared to immediate implant placement. In eight beagle dogs, after extraction of the 3P3 and 4P4, implants were inserted into the distal sockets of the premolars, while the mesial sockets were left to heal spontaneously. Each animal provided four socket sites (control) and four implant sites (test). After 6 weeks, animals were sacrificed and tissue blocks were dissected, prepared for ground sectioning. The relative vertical buccal bone resorption in relation to the lingual bone was similar in both test and control groups. At immediate implant sites, however, the absolute buccal bone loss observed was 2.32 (SD 0.36) mm, what may indicate that while an apical shift of both the buccal and lingual bone crest occurred at the implant sites, this may not happen in naturally healing sockets. The results from this investigation showed that after tooth extraction the buccal socket wall underwent bone resorption at both test and control sites. This resorption appeared to be more pronounced at the implant sites, although the limitations of the histological evaluation method utilized preclude a definite conclusion. © 2011 John Wiley & Sons A/S.

High strength, surface porous polyether-ether-ketone for load-bearing orthopaedic implants

Science.gov (United States)

Evans, Nathan T.; Torstrick, F. Brennan; Lee, Christopher S.D.; Dupont, Kenneth M.; Safranski, David L.; Chang, W. Allen; Macedo, Annie E.; Lin, Angela; Boothby, Jennifer M.; Whittingslow, Daniel C.; Carson, Robert A.; Guldberg, Robert E.; Gall, Ken

2015-01-01

Despite its widespread clinical use in load-bearing orthopaedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer thickness was 399.6±63.3 µm and possessed a mean pore size of 279.9±31.6 µm, strut spacing of 186.8±55.5 µm, porosity of 67.3±3.1%, and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via µCT and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopaedic applications. PMID:25463499

Chitosan-glycerol phosphate/blood implants elicit hyaline cartilage repair integrated with porous subchondral bone in microdrilled rabbit defects.

Science.gov (United States)

Hoemann, C D; Sun, J; McKee, M D; Chevrier, A; Rossomacha, E; Rivard, G-E; Hurtig, M; Buschmann, M D

2007-01-01

We have previously shown that microfractured ovine defects are repaired with more hyaline cartilage when the defect is treated with in situ-solidified implants of chitosan-glycerol phosphate (chitosan-GP) mixed with autologous whole blood. The objectives of this study were (1) to characterize chitosan-GP/blood clots in vitro, and (2) to develop a rabbit marrow stimulation model in order to determine the effects of the chitosan-GP/blood implant and of debridement on the formation of incipient cartilage repair tissue. Blood clots were characterized by histology and in vitro clot retraction tests. Bilateral 3.5 x 4 mm trochlear defects debrided into the calcified layer were pierced with four microdrill holes and filled with a chitosan-GP/blood implant or allowed to bleed freely as a control. At 1 day post-surgery, initial defects were characterized by histomorphometry (n=3). After 8 weeks of repair, osteochondral repair tissues between or through the drill holes were evaluated by histology, histomorphometry, collagen type II expression, and stereology (n=16). Chitosan-GP solutions structurally stabilized the blood clots by inhibiting clot retraction. Treatment of drilled defects with chitosan-GP/blood clots led to the formation of a more integrated and hyaline repair tissue above a more porous and vascularized subchondral bone plate compared to drilling alone. Correlation analysis of repair tissue between the drill holes revealed that the absence of calcified cartilage and the presence of a porous subchondral bone plate were predictors of greater repair tissue integration with subchondral bone (Phyaline and integrated repair tissue associated with a porous subchondral bone replete with blood vessels. Concomitant regeneration of a vascularized bone plate during cartilage repair could provide progenitors, anabolic factors and nutrients that aid in the formation of hyaline cartilage.

Osteoblast growth behavior on porous-structure titanium surface

Energy Technology Data Exchange (ETDEWEB)

Tian Yuan; Ding Siyang; Peng Hui; Lu Shanming; Wang Guoping [Research Institute of Stomatology, Nanjing Medical University, Nanjing 210029 (China); Xia Lu, E-mail: shelueia@yahoo.com.cn [Research Institute of Stomatology, Nanjing Medical University, Nanjing 210029 (China); Wang Peizhi, E-mail: wangpzi@sina.com [Research Institute of Stomatology, Nanjing Medical University, Nanjing 210029 (China)

2012-11-15

Highlights: Black-Right-Pointing-Pointer Micro-arc oxidation technology formed a porous feature on titanium surface. Black-Right-Pointing-Pointer This porous surface accelerated adhesion, proliferation and differentiation compared with smooth surface. Black-Right-Pointing-Pointer Osteogenesis-related proteins and genes were up regulated by this porous surface. Black-Right-Pointing-Pointer It is anticipated that micro-arc oxidation surface could enhance osteoblastic activity and bone regeneration. - Abstract: A bioavailable surface generated by nano-technology could accelerate implant osteointegration, reduce healing time and enable implants to bear early loading. In this study, a nano-porous surface of titanium wafers was modified using micro-arc oxidation technique; surface of smooth titanium was used as control group. Surface characteristic was evaluated by investigating morphology, roughness and hydrophilicity of titanium wafers. In vitro studies, osteoblastic adhesion, proliferation and ALP activity, as well as gene and protein expressions relative to mineralization were assayed. Our results showed that a crater-liked nano-porous surface with greater roughness and better hydrophilicity were fabricated by micro-arc oxidation. It was further indicated that nano-porous surface could enhance adhesion, proliferation and ALP activity of osteoblasts compared with smooth surfaces. In addition, gene and protein expression of collagen-I, osteocalcin and osteopontin were also obviously increased. In summary, micro-arc oxidized techniques could form an irregular nano-porous morphology on implant surface which is favorable to improve osteoblastic function and prospected to be a potent modification of dental implant.

Osteoblast growth behavior on porous-structure titanium surface

International Nuclear Information System (INIS)

Tian Yuan; Ding Siyang; Peng Hui; Lu Shanming; Wang Guoping; Xia Lu; Wang Peizhi

2012-01-01

Highlights: ► Micro-arc oxidation technology formed a porous feature on titanium surface. ► This porous surface accelerated adhesion, proliferation and differentiation compared with smooth surface. ► Osteogenesis-related proteins and genes were up regulated by this porous surface. ► It is anticipated that micro-arc oxidation surface could enhance osteoblastic activity and bone regeneration. - Abstract: A bioavailable surface generated by nano-technology could accelerate implant osteointegration, reduce healing time and enable implants to bear early loading. In this study, a nano-porous surface of titanium wafers was modified using micro-arc oxidation technique; surface of smooth titanium was used as control group. Surface characteristic was evaluated by investigating morphology, roughness and hydrophilicity of titanium wafers. In vitro studies, osteoblastic adhesion, proliferation and ALP activity, as well as gene and protein expressions relative to mineralization were assayed. Our results showed that a crater-liked nano-porous surface with greater roughness and better hydrophilicity were fabricated by micro-arc oxidation. It was further indicated that nano-porous surface could enhance adhesion, proliferation and ALP activity of osteoblasts compared with smooth surfaces. In addition, gene and protein expression of collagen-I, osteocalcin and osteopontin were also obviously increased. In summary, micro-arc oxidized techniques could form an irregular nano-porous morphology on implant surface which is favorable to improve osteoblastic function and prospected to be a potent modification of dental implant.

Enhanced angiogenesis and osteogenesis in critical bone defects by the controlled release of BMP-2 and VEGF: implantation of electron beam melting-fabricated porous Ti6Al4V scaffolds incorporating growth factor-doped fibrin glue

International Nuclear Information System (INIS)

Lv, Jia; Xiu, Peng; Tan, Jie; Cai, Hong; Liu, Zhongjun; Jia, Zhaojun

2015-01-01

Electron beam melting (EBM)-fabricated porous titanium implants possessing low elastic moduli and tailored structures are promising biomaterials for orthopedic applications. However, the bio-inert nature of porous titanium makes reinforcement with growth factors (GFs) a promising method to enhance implant in vivo performance. Bone-morphogenic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) are key factors of angiogenesis and osteogenesis. Therefore, the present study is aimed at evaluating EBM-fabricated porous titanium implants incorporating GF-doped fibrin glue (FG) as composite scaffolds providing GFs for improvement of angiogenesis and osteogenesis in rabbit femoral condyle defects. BMP-2 and VEGF were added into the constituent compounds of FG, and then this GF-doped FG was subsequently injected into the porous scaffolds. In five groups of implants, angiogenesis and osteogenesis were evaluated at 4 weeks post-implantation using Microfil perfusion and histological analysis: eTi (empty scaffolds), cTi (containing undoped FG), BMP/cTi (containing 50 μg rhBMP-2), VEGF/cTi (containing 0.5 μg VEGF) and Dual/cTi (containing 50 μg rhBMP-2 and 0.5 μg VEGF). The results demonstrate that these composite implants are biocompatible and provide the desired gradual release of the bioactive growth factors. Incorporation of GF delivery, whether a single factor or dual factors, significantly enhanced both angiogenesis and osteogenesis inside the porous scaffolds. However, the synergistic effect of the dual factors combination was observable on angiogenesis but absent on osteogenesis. In conclusion, fibrin glue is a biocompatible material that could be employed as a delivery vehicle in EBM-fabricated porous titanium for controlled release of BMP-2 and VEGF. Application of this method for loading a porous titanium scaffold to incorporate growth factors is a convenient and promising strategy for improving osteogenesis of critical-sized bone defects

Micro CT and human histological analysis of a peri-implant osseous defect grafted with porous titanium granules: a case report.

Science.gov (United States)

Wohlfahrt, Johan Caspar; Aass, Anne Merete; Ronold, Hans Jacob; Lyngstadaas, Stale Petter

2011-01-01

Treatment of peri-implant osseous defects represents a significant challenge for clinicians, and the need to evolve within predictable surgical procedures is important. This case report describes the surgical treatment and grafting with porous titanium granules (PTG) of one patient with a peri-implant osseous defect. The suggested thrombogenic properties of titanium are intriguing from the perspective of osseous reconstructive surgery. In an ongoing randomized clinical trial using PTG for treatment of peri-implant osseous defects, one patient with one test implant was excluded and scheduled for implant removal. The surgical therapy included open flap debridement with surface decontamination with 24% EDTA gel, grafting with PTG, and resubmersion of the implant. After 12 months of healing, the implant with surrounding tissues was excised en bloc and micro CT and histological analyses were performed. Analyses showed PTG in close contact with new bone and with bone growing both into the porosities of the graft material and onto the adjacent implant surface. Element analysis demonstrated calcium and phosphorus in the new tissue embedding the PTG and the implant. Int J Oral Maxillofac Implants 2011;26:e9-e14.

Minimal invasive epicardial lead implantation: optimizing cardiac resynchronization with a new mapping device for epicardial lead placement.

Science.gov (United States)

Maessen, J G; Phelps, B; Dekker, A L A J; Dijkman, B

2004-05-01

To optimize resynchronization in biventricular pacing with epicardial leads, mapping to determine the best pacing site, is a prerequisite. A port access surgical mapping technique was developed that allowed multiple pace site selection and reproducible lead evaluation and implantation. Pressure-volume loops analysis was used for real time guidance in targeting epicardial lead placement. Even the smallest changes in lead position revealed significantly different functional results. Optimizing the pacing site with this technique allowed functional improvement up to 40% versus random pace site selection.

Complementary study of the internal porous silicon layers formed under high-dose implantation of helium ions

Energy Technology Data Exchange (ETDEWEB)

Lomov, A. A., E-mail: lomov@ftian.ru; Myakon’kikh, A. V. [Russian Academy of Sciences, Institute of Physics and Technology (Russian Federation); Chesnokov, Yu. M. [National Research Centre “Kurchatov Institute” (Russian Federation); Shemukhin, A. A.; Oreshko, A. P. [Moscow State University (Russian Federation)

2017-03-15

The surface layers of Si(001) substrates subjected to plasma-immersion implantation of helium ions with an energy of 2–5 keV and a dose of 5 × 10{sup 17} cm{sup –2} have been investigated using high-resolution X-ray reflectivity, Rutherford backscattering, and transmission electron microscopy. The electron density depth profile in the surface layer formed by helium ions is obtained, and its elemental and phase compositions are determined. This layer is found to have a complex structure and consist of an upper amorphous sublayer and a layer with a porosity of 30–35% beneath. It is shown that the porous layer has the sharpest boundaries at a lower energy of implantable ions.

Combined analyses of ion beam synthesized layers in porous silicon

International Nuclear Information System (INIS)

Ramos, A.R.; Silva, M.F. da; Silva, M.R. da; Soares, J.C.; Paszti, F.; Horvath, Z.E.; Vazsonyi, E.; Conde, O.

2001-01-01

High dose ion implantation was used to form polycrystalline silicide films on porous silicon with different native concentrations of light impurities (C and O). Porous silicon layers several μm thick were implanted with 170 KeV Cr + ions to fluences of 3x10'1 7 ions/cm 2 both at room temperature and 450 o C. Similar samples were implanted with 100 keV Co + ions to fluences of 2x10 17 ions/cm 2 at room temperature and 350 o C and 450 o C. The formed silicide compounds were studied by Rutherford backscattering spectrometry, elastic recoil detection, glancing incidence X-ray diffraction, and four point-probe sheet resistance measurements. Selected Co implanted samples were analysed by cross-section transmission electron microscopy. Results show that the light impurities were partially expelled from the forming silicide layer. Combining cross-section transmission electron microscopy with ion beam methods it was possible to show that, in the implanted region, the porous structure collapses and densities during implantation, but the underlying porous silicon remains intact. The layer structure as well as the quality and type of the formed silicide, were found to depend on the original impurity level, implantation temperature, and annealing. (author)

Miniscrew implant applications in contemporary orthodontics

Directory of Open Access Journals (Sweden)

Hong-Po Chang

2014-03-01

Full Text Available The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality obtained by preoperative diagnostic computed tomography (CT or by cone-beam computed tomography (CBCT prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.

Evaluation of egg white ovomucin-based porous scaffold as an implantable biomaterial for tissue engineering.

Science.gov (United States)

Carpena, Nathaniel T; Abueva, Celine D G; Padalhin, Andrew R; Lee, Byong-Taek

2017-10-01

Studies have shown the technological and functional properties of ovomucin (OVN) in the food-agricultural industry. But research has yet to explore its potential as an implantable biomaterial for tissue engineering and regenerative medicine. In this study we isolated OVN from egg white by isoelectric precipitation and fabricated scaffolds with tunable porosity by utilizing its foaming property. Gelatin a known biocompatible material was introduced to stabilize the foams, wherein different ratios of OVN and gelatin had a significant effect on the degree of porosity, pore size and stability of the formed hydrogels. The porous scaffolds were crosslinked with EDC resulting in stable scaffolds with prolonged degradation. Improved cell proliferation and adhesion of rat bone marrow-derived mesenchymal stem cells were observed for OVN containing scaffolds. Although, scaffolds with 75% OVN showed decrease in cell proliferation for L929 fibroblast type of cells. Further biocompatibility assessment as implant material was determined by subcutaneous implantation in rats of selected scaffold. H&E staining showed reasonable vascularization over time and little evidence of severe fibrosis at the implant site. Persistent polarization of classically activated macrophage was not observed, potentially reducing inflammatory response, and showed increased expression of alternatively activated macrophage cells that is favorable for tissue repair. Analysis of IgE levels in rat serum after implantation indicated minimal and resolvable allergic response to the OVN implants. The results demonstrate OVN as an acceptable implant scaffold that could provide new opportunities as an alternative natural biocompatible and functional biomaterial in various biomedical applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2107-2117, 2017. © 2016 Wiley Periodicals, Inc.

High-strength, surface-porous polyether-ether-ketone for load-bearing orthopedic implants.

Science.gov (United States)

Evans, Nathan T; Torstrick, F Brennan; Lee, Christopher S D; Dupont, Kenneth M; Safranski, David L; Chang, W Allen; Macedo, Annie E; Lin, Angela S P; Boothby, Jennifer M; Whittingslow, Daniel C; Carson, Robert A; Guldberg, Robert E; Gall, Ken

2015-02-01

Despite its widespread clinical use in load-bearing orthopedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface-porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer was 399.6±63.3 μm thick and possessed a mean pore size of 279.9±31.6 μm, strut spacing of 186.8±55.5 μm, porosity of 67.3±3.1% and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection-molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection-molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via microcomputed tomography and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopedic applications. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Characteristics of porous zirconia coated with hydroxyapatite

Indian Academy of Sciences (India)

However, porous hydroxyapatite bodies are mechanically weak and brittle, which makes shaping and implantation difficult. One way to solve this problem is to introduce a strong porous network onto which hydroxyapatite coating is applied. In this study, porous zirconia and alumina-added zirconia ceramics were prepared ...

Functional outcome in subretinal electronic implants depends on foveal eccentricity.

Science.gov (United States)

Stingl, Katarina; Bartz-Schmidt, Karl-Ulrich; Gekeler, Florian; Kusnyerik, Akos; Sachs, Helmut; Zrenner, Eberhart

2013-11-19

An active microelectronic subretinal implant, developed to replace the photoreceptive function in hereditary degenerations of the outer retina, has been applied in a pilot and clinical study in patients with end-stage retinal degeneration. The study population comprised 20 blind patients, all of whom lost vision as result of a hereditary retinal disease. An active visual implant was placed surgically within the subretinal space of each patient: subfoveal placement in eight patients (group 1) and parafoveal placement in 12 (group 2). Standardized low-vision tests, including light perception, light localization, movement detection, grating acuity, and visual acuity by Landolt C-rings, were used under masked, randomized implant-OFF and implant-ON conditions. For the chip-mediated vision functional results of both subject groups were compared. Three of 20 patients were excluded from analysis because of surgical or technical implant issues. Among patients with nonfoveal placement of the implant, 80% could perceive light, 10% recognized location, and 10% correctly distinguished stripe patterns up to a resolution of 0.33 cycles/degree. No nonfoveal placement patient passed the motion or Landolt C-ring tests. When the implant was placed subfoveally, 100% of patients could perceive light and determine light localization, 75% could resolve motion up to 35°/s, 88% correctly distinguished stripe patterns up to a resolution of 3.3 cycles/degree, and 38% passed a Landolt C-ring test with a decimal visual acuity of up to 20/546 (logMAR 1.43). Subfoveal placement of active subretinal visual implants allows superior measurable outcomes compared to para- or nonfoveal placement locations. (ClinicalTrials.gov numbers, NCT01024803, NCT00515814.).

Effects of Untreated Periodontitis on Osseointegration of Dental Implants in a Beagle Dog Model.

Science.gov (United States)

Lee, Daehyun; Sohn, Byungjin; Kim, Kyoung Hwa; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Rhyu, In-Chul; Ku, Young

2016-10-01

There have been previous studies on the relationship between periodontitis and peri-implantitis, but limited information is available on how periodontitis affects osseointegration and wound healing of newly placed dental implants adjacent to natural teeth. The objective of the present experiment is to evaluate healing around dental implants adjacent to teeth with untreated experimental periodontitis. The study included six male beagle dogs. Scaling and plaque control procedures were performed on three dogs (control group). In the other three dogs (experimental group), retraction cords and ligature wires were placed subgingivally around all premolars and the first molars. Induced experimental periodontitis was confirmed after 3 months. Each control or experimental group was divided into two subgroups depending on the timing of implant placement (immediate/delayed). Twelve dental implants (two implants for each dog) were placed immediately, and the other 12 dental implants (two implants for each dog) were placed 2 months after extraction. The animals were sacrificed 2 months after implant placement. Histologic and histometric analyses were performed. Four implants (three from the immediate placement group and one from the delayed placement group) failed in the experimental group. There were significant differences in the percentage of bone-to-implant contact and marginal bone volume density between the control and experimental groups. Both parameters were significantly lower in the experimental group than in the control group (P implants is associated with a higher failure rate compared with delayed placement. Untreated experimental periodontitis was correlated with compromised osseointegration in the implants with delayed placement.

Printing of Titanium implant prototype

International Nuclear Information System (INIS)

Wiria, Florencia Edith; Shyan, John Yong Ming; Lim, Poon Nian; Wen, Francis Goh Chung; Yeo, Jin Fei; Cao, Tong

2010-01-01

Dental implant plays an important role as a conduit of force and stress to flow from the tooth to the related bone. In the load sharing between an implant and its related bone, the amount of stress carried by each of them directly related to their stiffness or modulus. Hence, it is a crucial issue for the implant to have matching mechanical properties, in particular modulus, between the implant and its related bone. Titanium is a metallic material that has good biocompatibility and corrosion resistance. Whilst the modulus of the bulk material is still higher than that of bone, it is the lowest among all other commonly used metallic implant materials, such as stainless steel or cobalt alloy. Hence it is potential to further reduce the modulus of pure Titanium by engineering its processing method to obtain porous structure. In this project, porous Titanium implant prototype is fabricated using 3-dimensional printing. This technique allows the flexibility of design customization, which is beneficial for implant fabrication as tailoring of implant size and shape helps to ensure the implant would fit nicely to the patient. The fabricated Titanium prototype had a modulus of 4.8-13.2 GPa, which is in the range of natural bone modulus. The compressive strength achieved was between 167 to 455 MPa. Subsequent cell culture study indicated that the porous Titanium prototype had good biocompatibility and is suitable for bone cell attachment and proliferation.

Partial lateralization of the nasopalatine nerve at the incisive foramen for ridge augmentation in the anterior maxilla prior to placement of dental implants: a retrospective case series evaluating self-reported data and neurosensory testing.

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Urban, Istvan; Jovanovic, Sascha A; Buser, Daniel; Bornstein, Michael M

2015-01-01

The objective of this study was to assess implant therapy after a staged guided bone regeneration procedure in the anterior maxilla by lateralization of the nasopalatine nerve and vessel bundle. Neurosensory function following augmentative procedures and implant placement, assessed using a standardized questionnaire and clinical examination, were the primary outcome variables measured. This retrospective study included patients with a bone defect in the anterior maxilla in need of horizontal and/or vertical ridge augmentation prior to dental implant placement. The surgical sites were allowed to heal for at least 6 months before placement of dental implants. All patients received fixed implant-supported restorations and entered into a tightly scheduled maintenance program. In addition to the maintenance program, patients were recalled for a clinical examination and to fill out a questionnaire to assess any changes in the neurosensory function of the nasopalatine nerve at least 6 months after function. Twenty patients were included in the study from February 2001 to December 2010. They received a total of 51 implants after augmentation of the alveolar crest and lateralization of the nasopalatine nerve. The follow-up examination for questionnaire and neurosensory assessment was scheduled after a mean period of 4.18 years of function. None of the patients examined reported any pain, they did not have less or an altered sensation, and they did not experience a "foreign body" feeling in the area of surgery. Overall, 6 patients out of 20 (30%) showed palatal sensibility alterations of the soft tissues in the region of the maxillary canines and incisors resulting in a risk for a neurosensory change of 0.45 mucosal teeth regions per patient after ridge augmentation with lateralization of the nasopalatine nerve. Regeneration of bone defects in the anterior maxilla by horizontal and/or vertical ridge augmentation and lateralization of the nasopalatine nerve prior to dental

Single perineal incision placement of artificial urinary sphincter with cadaveric correlation of sub-dartos pump placement

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Cooper R. Benson

Full Text Available ABSTRACT Purpose We present a novel AUS implantation technique using a single perineal incision for single device placement or in combination with an inflatable penile prosthesis (IPP. Urinary and sexual dysfunction following the management of prostate cancer has a significant impact on the quality of life of our patients. While there are marginal changes in the prosthetic devices, we strive to reduce post-operative morbidity while maximizing efficacy. Materials and Methods We retrospectively reviewed the outcomes of 6 patients who underwent single perineal incision placement of a virgin AUS in 2014, 3 with simultaneous IPP placement. In all cases, the pressure regulating balloons (PRB were placed in a high sub-muscular ectopic position and the pumps were placed into a sub-dartos pouch through the perineal incision, which was also validated using a cadaveric model. Results The mean patient age was 61 (SD, 7.5 years with mean body mass index of 31 (SD, 5.9. The average pre-operative pad usage was 7.7 (SD 1.63 pads per day. The mean follow-up was 13.9 months (SD 9.45. Four out of the six patients reported utilizing ≤1 pad daily at follow-up. The one patient who was not initially dry required downsizing of his cuff to 3.5cm; the remaining patient was lost to follow-up. There were no identifiable perioperative or post-operative complications. Conclusions We present our initial report of using a single perineal incision for AUS implantation with a validated sub-dartos pump location, which is safe and effective for implantation of an AUS as a single or double implantation in well-selected patients.

Ridge expansion and immediate placement with piezosurgery and screw expanders in atrophic maxillary sites: two case reports.

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Kelly, Andrew; Flanagan, Dennis

2013-02-01

Endosseous dental implants may require bone augmentation before implant placement. Herein is described an approach to edentulous ridge expansion with the use of piezosurgery and immediate placement of implants. This may allow for a shortened treatment time and the elimination of donor-site morbidity. Two cases are reported. This technique uses a piezoelectric device to cut the crestal and proximal facial cortices. Space is then created with motorized osteotomes to widen the split ridge. This technique allows for expansion of narrow, anatomically limiting, atrophic ridges, creating space for immediate implant placement. The facial and lingual cortices provide support with vital osteocytes for osteogenesis. The 2 patients presented had adequate bone height for implant placement but narrow edentulous ridges. In patient 1 at site #11, the ridge crest was 3.12 mm thick and was expanded to accept a 4.3 mm × 13 mm implant. The resulting ridge width was 8.88 mm, which was verified using cone beam computerized tomography (CBCT). In patient 2 at site #8 and site #9, the narrow ridge was expanded using the same technique to accept 2 adjacent 3.5 mm × 14 mm implants. The implants were restored to a functional and esthetic outcome.

Marginal Bone Remodeling around healing Abutment vs Final Abutment Placement at Second Stage Implant Surgery: A 12-month Randomized Clinical Trial.

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Nader, Nabih; Aboulhosn, Maissa; Berberi, Antoine; Manal, Cordahi; Younes, Ronald

2016-01-01

The periimplant bone level has been used as one of the criteria to assess the success of dental implants. It has been documented that the bone supporting two-piece implants undergoes resorption first following the second-stage surgery and later on further to abutment connection and delivery of the final prosthesis. The aim of this multicentric randomized clinical trial was to evaluate the crestal bone resorption around internal connection dental implants using a new surgical protocol that aims to respect the biological distance, relying on the benefit of a friction fit connection abutment (test group) compared with implants receiving conventional healing abutments at second-stage surgery (control group). A total of partially edentulous patients were consecutively treated at two private clinics, with two adjacent two-stage implants. Three months after the first surgery, one of the implants was randomly allocated to the control group and was uncovered using a healing abutment, while the other implant received a standard final abutment and was seated and tightened to 30 Ncm. At each step of the prosthetic try-in, the abutment in the test group was removed and then retightened to 30 Ncm. Horizontal bone changes were assessed using periapical radiographs immediately after implant placement and at 3 (second-stage surgery), 6, 9 and 12 months follow-up examinations. At 12 months follow-up, no implant failure was reported in both groups. In the control group, the mean periimplant bone resorption was 0.249 ± 0.362 at M3, 0.773 ± 0.413 at M6, 0.904 ± 0.36 at M9 and 1.047 ± 0.395 at M12. The test group revealed a statistically significant lower marginal bone loss of 20.88% at M3 (0.197 ± 0.262), 22.25% at M6 (0.601 ± 0.386), 24.23% at M9 (0.685 ± 0.341) and 19.2% at M9 (0.846 ± 0.454). The results revealed that bone loss increased over time, with the greatest change in bone loss occurring between 3 and 6 months. Alveolar bone loss was significantly greater in the

A rare case report of peri-implant bone necrosis: Mapping the distance of initial peri-implant complication toward a path of success

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S K Salaria

2011-01-01

Full Text Available In the past decade, science of implant placement has greatly advanced and at the same time much success has been experienced with the endosseous implant. Despite the long-term predictability of the implants, however, biological, technical and esthetic complications do occur. The use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has been highly predictable, but still at present, there is no consensus of how to best manage the complications occurring after implant placement. In this report, we discuss post-insertion complication of bone necrosis and its successful management.

Safety and Biocompatibility of a New High-Density Polyethylene-Based Spherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits

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Ivan Fernandez-Bueno

2015-01-01

Full Text Available Purpose. To evaluate clinically and histologically the safety and biocompatibility of a new HDPE-based spherical porous orbital implants in rabbits. Methods. MEDPOR (Porex Surgical, Inc., Fairburn, GA, USA, OCULFIT I, and OCULFIT II (AJL Ophthalmic S.A., Vitoria, Spain implants were implanted in eviscerated rabbis. Animals were randomly divided into 6 groups (n=4 each according to the 3 implant materials tested and 2 follow-up times of 90 or 180 days. Signs of regional pain and presence of eyelid swelling, conjunctival hyperemia, and amount of exudate were semiquantitatively evaluated. After animals sacrifice, the implants and surrounding ocular tissues were processed for histological staining and polarized light evaluation. Statistical study was performed by ANOVA and Kaplan-Meier analysis. Results. No statistically significant differences in regional pain, eyelid swelling, or conjunctival hyperemia were shown between implants and/or time points evaluated. However, amount of exudate differed, with OCULFIT I causing the smallest amount. No remarkable clinical complications were observed. Histological findings were similar in all three types of implants and agree with minor inflammatory response. Conclusions. OCULFIT ophthalmic tolerance and biocompatibility in rabbits were comparable to the clinically used MEDPOR. Clinical studies are needed to determine if OCULFIT is superior to the orbital implants commercially available.

Safety and Biocompatibility of a New High-Density Polyethylene-Based Spherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits

Science.gov (United States)

Fernandez-Bueno, Ivan; Di Lauro, Salvatore; Alvarez, Ivan; Lopez, Jose Carlos; Garcia-Gutierrez, Maria Teresa; Fernandez, Itziar; Larra, Eva; Pastor, Jose Carlos

2015-01-01

Purpose. To evaluate clinically and histologically the safety and biocompatibility of a new HDPE-based spherical porous orbital implants in rabbits. Methods. MEDPOR (Porex Surgical, Inc., Fairburn, GA, USA), OCULFIT I, and OCULFIT II (AJL Ophthalmic S.A., Vitoria, Spain) implants were implanted in eviscerated rabbis. Animals were randomly divided into 6 groups (n = 4 each) according to the 3 implant materials tested and 2 follow-up times of 90 or 180 days. Signs of regional pain and presence of eyelid swelling, conjunctival hyperemia, and amount of exudate were semiquantitatively evaluated. After animals sacrifice, the implants and surrounding ocular tissues were processed for histological staining and polarized light evaluation. Statistical study was performed by ANOVA and Kaplan-Meier analysis. Results. No statistically significant differences in regional pain, eyelid swelling, or conjunctival hyperemia were shown between implants and/or time points evaluated. However, amount of exudate differed, with OCULFIT I causing the smallest amount. No remarkable clinical complications were observed. Histological findings were similar in all three types of implants and agree with minor inflammatory response. Conclusions. OCULFIT ophthalmic tolerance and biocompatibility in rabbits were comparable to the clinically used MEDPOR. Clinical studies are needed to determine if OCULFIT is superior to the orbital implants commercially available. PMID:26689343

Continuous functionally graded porous titanium scaffolds manufactured by selective laser melting for bone implants.

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Han, Changjun; Li, Yan; Wang, Qian; Wen, Shifeng; Wei, Qingsong; Yan, Chunze; Hao, Liang; Liu, Jie; Shi, Yusheng

2018-04-01

A significant requirement for a bone implant is to replicate the functional gradient across the bone to mimic the localization change in stiffness. In this work, continuous functionally graded porous scaffolds (FGPSs) based on the Schwartz diamond unit cell with a wide range of graded volume fraction were manufactured by selective laser melting (SLM). The micro-topology, strut dimension characterization and effect of graded volume fraction on the mechanical properties of SLM-processed FGPSs were systematically investigated. The micro-topology observations indicate that diamond FGPSs with a wide range of graded volume fraction from 7.97% to 19.99% were fabricated without any defects, showing a good geometric reproduction of the original designs. The dimensional characterization demonstrates the capability of SLM in manufacturing titanium diamond FGPSs with the strut size of 483-905µm. The elastic modulus and yield strength of the titanium diamond FGPSs can be tailored in the range of 0.28-0.59GPa and 3.79-17.75MPa respectively by adjusting the graded volume fraction, which are comparable to those of the cancellous bone. The mathematical relationship between the graded porosity and compression properties of a FGPS was revealed. Furthermore, two equations based on the Gibson and Ashby model have been established to predict the modulus and yield strength of SLM-processed diamond FGPSs. Compared to homogeneous diamond porous scaffolds, FGPSs provide a wide range of mutative pore size and porosity, which are potential to be tailored to optimize the pore space for bone tissue growth. The findings provide a basis of new methodologies to design and manufacture superior graded scaffolds for bone implant applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

Additively manufactured porous tantalum implants

NARCIS (Netherlands)

Wauthle, Ruben; Van Der Stok, Johan; Yavari, Saber Amin; Van Humbeeck, Jan; Kruth, Jean Pierre; Zadpoor, Amir Abbas; Weinans, Harrie; Mulier, Michiel; Schrooten, Jan

2015-01-01

The medical device industry's interest in open porous, metallic biomaterials has increased in response to additive manufacturing techniques enabling the production of complex shapes that cannot be produced with conventional techniques. Tantalum is an important metal for medical devices because of

Porous biomorphic silicon carbide ceramics coated with hydroxyapatite as prospective materials for bone implants

Energy Technology Data Exchange (ETDEWEB)

Gryshkov, Oleksandr, E-mail: gryshkov@imp.uni-hannover.de [Institute for Multiphase Processes, Leibniz Universität Hannover, 30167 Hannover (Germany); Klyui, Nickolai I., E-mail: klyuini@ukr.net [College of Physics, Jilin University, 130012 Changchun (China); V. Lashkaryov Institute of Semiconductor Physics, National Academy of Science of Ukraine, 03028 Kyiv (Ukraine); Temchenko, Volodymyr P., E-mail: tvp@isp.kiev.ua [V. Lashkaryov Institute of Semiconductor Physics, National Academy of Science of Ukraine, 03028 Kyiv (Ukraine); Kyselov, Vitalii S., E-mail: kyselov@isp.kiev.ua [V. Lashkaryov Institute of Semiconductor Physics, National Academy of Science of Ukraine, 03028 Kyiv (Ukraine); Chatterjee, Anamika, E-mail: chatterjee@imp.uni-hannover.de [Institute for Multiphase Processes, Leibniz Universität Hannover, 30167 Hannover (Germany); Belyaev, Alexander E., E-mail: belyaev@isp.kiev.ua [V. Lashkaryov Institute of Semiconductor Physics, National Academy of Science of Ukraine, 03028 Kyiv (Ukraine); Lauterboeck, Lothar, E-mail: lauterboeck@imp.uni-hannover.de [Institute for Multiphase Processes, Leibniz Universität Hannover, 30167 Hannover (Germany); Iarmolenko, Dmytro, E-mail: iarmolenko.dmytro@isp.kiev.ua [V. Lashkaryov Institute of Semiconductor Physics, National Academy of Science of Ukraine, 03028 Kyiv (Ukraine); Glasmacher, Birgit, E-mail: glasmacher@imp.uni-hannover.de [Institute for Multiphase Processes, Leibniz Universität Hannover, 30167 Hannover (Germany)

2016-11-01

Porous and cytocompatible silicon carbide (SiC) ceramics derived from wood precursors and coated with bioactive hydroxyapatite (HA) and HA-zirconium dioxide (HA/ZrO{sub 2}) composite are materials with promising application in engineering of bone implants due to their excellent mechanical and structural properties. Biomorphic SiC ceramics have been synthesized from wood (Hornbeam, Sapele, Tilia and Pear) using a forced impregnation method. The SiC ceramics have been coated with bioactive HA and HA/ZrO{sub 2} using effective gas detonation deposition approach (GDD). The surface morphology and cytotoxicity of SiC ceramics as well as phase composition and crystallinity of deposited coatings were analyzed. It has been shown that the porosity and pore size of SiC ceramics depend on initial wood source. The XRD and FTIR studies revealed the preservation of crystal structure and phase composition of in the HA coating, while addition of ZrO{sub 2} to the initial HA powder resulted in significant decomposition of the final HA/ZrO{sub 2} coating and formation of other calcium phosphate phases. In turn, NIH 3T3 cells cultured in medium exposed to coated and uncoated SiC ceramics showed high re-cultivation efficiency as well as metabolic activity. The recultivation efficiency of cells was the highest for HA-coated ceramics, whereas HA/ZrO{sub 2} coating improved the recultivation efficiency of cells as compared to uncoated SiC ceramics. The GDD method allowed generating homogeneous HA coatings with no change in calcium to phosphorus ratio. In summary, porous and cytocompatible bio-SiC ceramics with bioactive coatings show a great promise in construction of light, robust, inexpensive and patient-specific bone implants for clinical application. - Highlights: • Synthesis and characterization of porous biomorphic SiC ceramics derived from wood • Successful deposition of bioactive calcium phosphate coatings using gas detonation deposition • Porosity and pore size of Si

Porous biomorphic silicon carbide ceramics coated with hydroxyapatite as prospective materials for bone implants

International Nuclear Information System (INIS)

Gryshkov, Oleksandr; Klyui, Nickolai I.; Temchenko, Volodymyr P.; Kyselov, Vitalii S.; Chatterjee, Anamika; Belyaev, Alexander E.; Lauterboeck, Lothar; Iarmolenko, Dmytro; Glasmacher, Birgit

2016-01-01

Porous and cytocompatible silicon carbide (SiC) ceramics derived from wood precursors and coated with bioactive hydroxyapatite (HA) and HA-zirconium dioxide (HA/ZrO 2 ) composite are materials with promising application in engineering of bone implants due to their excellent mechanical and structural properties. Biomorphic SiC ceramics have been synthesized from wood (Hornbeam, Sapele, Tilia and Pear) using a forced impregnation method. The SiC ceramics have been coated with bioactive HA and HA/ZrO 2 using effective gas detonation deposition approach (GDD). The surface morphology and cytotoxicity of SiC ceramics as well as phase composition and crystallinity of deposited coatings were analyzed. It has been shown that the porosity and pore size of SiC ceramics depend on initial wood source. The XRD and FTIR studies revealed the preservation of crystal structure and phase composition of in the HA coating, while addition of ZrO 2 to the initial HA powder resulted in significant decomposition of the final HA/ZrO 2 coating and formation of other calcium phosphate phases. In turn, NIH 3T3 cells cultured in medium exposed to coated and uncoated SiC ceramics showed high re-cultivation efficiency as well as metabolic activity. The recultivation efficiency of cells was the highest for HA-coated ceramics, whereas HA/ZrO 2 coating improved the recultivation efficiency of cells as compared to uncoated SiC ceramics. The GDD method allowed generating homogeneous HA coatings with no change in calcium to phosphorus ratio. In summary, porous and cytocompatible bio-SiC ceramics with bioactive coatings show a great promise in construction of light, robust, inexpensive and patient-specific bone implants for clinical application. - Highlights: • Synthesis and characterization of porous biomorphic SiC ceramics derived from wood • Successful deposition of bioactive calcium phosphate coatings using gas detonation deposition • Porosity and pore size of SiC ceramics depend on wood

Implante de filtro em veia cava inferior dupla: relato de caso e revisão da literatura Filter placement in duplicated inferior vena cava: case report and review of the literature

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Rafael Demarchi Malgor

2008-06-01

Full Text Available Veia cava inferior dupla é uma variação anatômica rara cuja prevalência é de 0,2-3%. O implante de filtro de veia cava, quando indicado em casos com duplicidade da veia cava inferior, pode ser realizado de diferentes formas: em ambas as veias cavas; em uma delas, embolizando a anastomose entre ambas; em somente uma delas; ou por implante supra-renal. Relatamos um caso de trombose venosa profunda no pós-operatório de implante de prótese de quadril com contra-indicação para tratamento anticoagulante e cuja cavografia evidenciou duplicidade de veia cava inferior. O implante de filtro de veia cava inferior realizado em posição supra-renal mostrou-se opção adequada e segura.Double inferior vena cava is a rare anatomic variation with prevalence ranging between 0.2-3.0%. In cases of duplication, inferior vena cava filter placement options include placing it in both vena cava, coil-embolization of the intervenous segment plus placing a filter in the right inferior vena cava, or suprarenal filter placement. We report a case of deep venous thrombosis after unilateral primary total hip replacement, presenting with contraindications for anticoagulant therapy, in which cavography showed inferior vena cava duplication. Inferior vena cava filter placement was performed in the supra-renal portion and was proved to be an adequate and safe procedure.

Simultaneous malaroplasty with porous polyethylene implants and orthognathic surgery for correction of malar deficiency.

Science.gov (United States)

Robiony, M; Costa, F; Demitri, V; Politi, M

1998-06-01

Patients with skeletal malrelationships caused by maxillary anteroposterior defect and midface hypoplasia may present with an alteration of cheekbone contour. High osteotomies, segmental osteotomies of the zygomatic complex, and malar expansion with alloplastic materials can be performed to improve facial aesthetics. This article describes the restoration of cheekbone-nasal base-lip contour by performing a malaroplasty using an alloplastic implant in addition to orthognathic surgery. From 1995 to 1996, 17 patients with maxillomandibular malrelationships and deficient cheekbone contour were tested by malar augmentation with porous high-density polyethylene in association with maxillary advancement and mandibular setback. The diagnosis of cheekbone contour alteration was made after observing the patient from a lateral, frontal, and oblique point of view. The position of the implant was determined by using Mladick's point, with lateral or medial extension in relation to the depressed area. By the restoration of normal cheekbone-nasal base-upper lip contour produced excellent aesthetic results in all patients. Malaroplasty in association with bimaxillary orthognathic surgery seems to be an effective procedure for treating midface skeletal deficiencies.

Azygos Vein Lead Implantation For High Defibrillation Thresholds In Implantable Cardioverter Defibrillator Placement

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Naga VA Kommuri

2010-01-01

Full Text Available Evaluation of defibrillation threshold is a standard of care during implantation of implantable cardioverter defibrillator. High defibrillation thresholds are often encountered and pose a challenge to electrophysiologists to improve the defibrillation threshold. We describe a case series where defibrillation thresholds were improved after implanting a defibrillation lead in the azygos vein.

Implant experience with an implantable hemodynamic monitor for the management of symptomatic heart failure.

Science.gov (United States)

Steinhaus, David; Reynolds, Dwight W; Gadler, Fredrik; Kay, G Neal; Hess, Mike F; Bennett, Tom

2005-08-01

Management of congestive heart failure is a serious public health problem. The use of implantable hemodynamic monitors (IHMs) may assist in this management by providing continuous ambulatory filling pressure status for optimal volume management. The Chronicle system includes an implanted monitor, a pressure sensor lead with passive fixation, an external pressure reference (EPR), and data retrieval and viewing components. The tip of the lead is placed near the right ventricular outflow tract to minimize risk of sensor tissue encapsulation. Implant technique and lead placement is similar to that of a permanent pacemaker. After the system had been successfully implanted in 148 patients, the type and frequency of implant-related adverse events were similar to a single-chamber pacemaker implant. R-wave amplitude was 15.2 +/- 6.7 mV and the pressure waveform signal was acceptable in all but two patients in whom presence of artifacts required lead repositioning. Implant procedure time was not influenced by experience, remaining constant throughout the study. Based on this evaluation, permanent placement of an IHM in symptomatic heart failure patients is technically feasible. Further investigation is warranted to evaluate the use of the continuous hemodynamic data in management of heart failure patients.

Immediate occlusal loading of Osseotite implants in mandibular edentulous patients: a prospective observational report with 18-month data.

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Drago, Carl J; Lazzara, Richard J

2006-01-01

To evaluate the efficacy of treatment consisting of placement and immediate occlusal loading of implants in 27 patients with edentulous mandibles. Twenty-seven patients were treated in two private practice settings. One hundred fifty-one implants were placed and immediately occlusally loaded with fixed implant prostheses (15 cement-retained, 12 screw-retained) on the day of implant placement. The implant-retained prostheses were inserted within 5 hours of implant placement. Patients were followed for at least 18 months. The required criteria for immediate occlusal loading was primary implant stability of at least 30 Ncm of insertion torque. The implant prostheses were removed at least 12 months post-placement and the implants were evaluated for primary clinical stability and radiographic bone apposition to implants. At the 12-month follow-up appointments, cumulative survival rates of 98.0% and 100% were recorded for implants and prostheses, respectively. Three implants failed within 3 months. All other implants were clinically successful. Immediate occlusal loading of multiple, splinted mandibular implants is an effective treatment when implants are stable at insertion and are rigidly splinted with implant-retained prostheses.

Maintenance of class III trifurcated molars versus implant placement in regenerated extraction sockets: long-term results of 2 cases.

Science.gov (United States)

Zafiropoulos, Gregory-George K; di Prisco, Manuela Occipite; Deli, Giorgio; Hoffmann, Oliver

2011-03-01

Studies to date have reached differing conclusions regarding the long-term prognosis of teeth with class III furcation involvement. Replacement of such teeth with implants could be an alternative. This report compares the treatment outcomes of 2 cases with similar disease progression: 1 treated by implant therapy and 1 maintained with nonsurgical periodontal treatment. Two patients with advanced chronic periodontitis and class III furcation involvement of all molars were treated. Case 1 received a conservative periodontal and antibiotic treatment, followed by 15 years of maintenance. In case 2, the molars were extracted and replaced with implants, and the implants were observed for 7 years. Clinical attachment level (CAL), probing attachment level (PAL), bleeding on probing, plaque index, and periodontal pathogens were recorded. Despite good compliance of case 1, periodontal pathogens were not eliminated and tissue destruction was not halted. The PAL outcomes of case 2 improved over time; mean PAL loss reached 0.35 mm/y in the first 3 years and then decreased to 0.01 mm/y. While CAL outcomes did not change in case 2, case 1 showed increased CAL loss after 8 years. Based on the limited findings of this case report, extraction of molars with class III furcation involvement and subsequent implant placement may render a better predictability of treatment outcomes than nonsurgical periodontal therapy in the cases of infection with periodontal pathogens.

Implantable porous gelatin microspheres sustained release of bFGF and improved its neuroprotective effect on rats after spinal cord injury.

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Li Lan

Full Text Available In this study, porous gelatin microspheres (GMSs were constructed to improve the neuroprotective effect of basic fibroblast growth factor (bFGF on spinal cord injury. GMSs were prepared by a W/O emulsion template, followed by cross-linking, washing and drying. The particle sizes and surface porosity of the blank GMSs were carefully characterized by scan electronic microscopy. The blank GMSs have a mean particle size of 35μm and theirs surface was coarse and porous. bFGF was easily encapsulated inside the bulk GMSs through diffusion along the porous channel. 200μg of bFGF was completely encapsulated in 100mg of GMSs. The bFGF-loaded GMSs displayed a continuous drug release pattern without an obvious burst release over two weeks in vitro. Moreover, the therapeutic effects of bFGF-loaded GMSs were also evaluated in spinal cord injury rat model. After implantation of bFGF-loaded GMSs, the recovery of the motor function of SCI rats were evaluated by behavioral score and foot print experiment. The motor function of SCI rats treated with bFGF-loaded GMSs was more obvious than that treated with free bFGF solution (P<0.05. At the 28th days after treatment, rats were sacrificed and the injured spinal were removed for histopathological and apoptosis examination. Compared with treatment with free bFGF solution, treatment with bFGF-loaded GMSs resulted in a less necrosis, less infiltration of leukocytes, and a reduced the cavity ratio and less apoptotic cells in injured spinal(P<0.01, indicating its better therapeutic effect. Implantable porous GMSs may be a potential carrier to deliver bFGF for therapy of spinal cord injury.

Fabrication and characterization of porous hydroxyapatite ocular ...

Indian Academy of Sciences (India)

Unknown

risk of life or risk to the other eye of the patient. The lost eye can be ... fibrovascular growth are termed as integrated implants. Porous implants have the .... They were maintained under identical environment, management and standard diet with ...

Porous biomorphic silicon carbide ceramics coated with hydroxyapatite as prospective materials for bone implants.

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Gryshkov, Oleksandr; Klyui, Nickolai I; Temchenko, Volodymyr P; Kyselov, Vitalii S; Chatterjee, Anamika; Belyaev, Alexander E; Lauterboeck, Lothar; Iarmolenko, Dmytro; Glasmacher, Birgit

2016-11-01

Porous and cytocompatible silicon carbide (SiC) ceramics derived from wood precursors and coated with bioactive hydroxyapatite (HA) and HA-zirconium dioxide (HA/ZrO2) composite are materials with promising application in engineering of bone implants due to their excellent mechanical and structural properties. Biomorphic SiC ceramics have been synthesized from wood (Hornbeam, Sapele, Tilia and Pear) using a forced impregnation method. The SiC ceramics have been coated with bioactive HA and HA/ZrO2 using effective gas detonation deposition approach (GDD). The surface morphology and cytotoxicity of SiC ceramics as well as phase composition and crystallinity of deposited coatings were analyzed. It has been shown that the porosity and pore size of SiC ceramics depend on initial wood source. The XRD and FTIR studies revealed the preservation of crystal structure and phase composition of in the HA coating, while addition of ZrO2 to the initial HA powder resulted in significant decomposition of the final HA/ZrO2 coating and formation of other calcium phosphate phases. In turn, NIH 3T3 cells cultured in medium exposed to coated and uncoated SiC ceramics showed high re-cultivation efficiency as well as metabolic activity. The recultivation efficiency of cells was the highest for HA-coated ceramics, whereas HA/ZrO2 coating improved the recultivation efficiency of cells as compared to uncoated SiC ceramics. The GDD method allowed generating homogeneous HA coatings with no change in calcium to phosphorus ratio. In summary, porous and cytocompatible bio-SiC ceramics with bioactive coatings show a great promise in construction of light, robust, inexpensive and patient-specific bone implants for clinical application. Copyright © 2016 Elsevier B.V. All rights reserved.

Subgingival Microbiome Colonization and Cytokine Production during Early Dental Implant Healing.

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Payne, Jeffrey B; Johnson, Paul G; Kok, Car Reen; Gomes-Neto, João C; Ramer-Tait, Amanda E; Schmid, Marian J; Hutkins, Robert W

2017-01-01

Little is known about longitudinal development of the peri-implant subgingival microbiome and cytokine production as a new sulcus forms after dental implant placement. Therefore, the purpose of this observational study was to evaluate simultaneous longitudinal changes in the oral microbiome and cytokine production in the developing peri-implant sulcus compared to control natural teeth. Four and 12 weeks after implant placement and abutment connection, a dental implant and a natural tooth were sampled in 25 patients for subgingival plaque and gingival crevicular fluid (GCF [around teeth] and peri-implant crevicular fluid [PICF] around implants). DNA from plaque samples was extracted and sequenced using Illumina-based 16S rRNA sequencing. GCF and PICF samples were analyzed using a customized Milliplex human cytokine and chemokine magnetic bead panel. Beta diversity analysis revealed that natural teeth and implants had similar subgingival microbiomes, while teeth had greater alpha diversity than implants. At the genus level, however, few differences were noted between teeth and dental implants over 12 weeks. Specifically, Actinomyces and Selenomonas were significantly elevated around teeth versus dental implants at both 4 weeks and 12 weeks, while Corynebacterium and Campylobacter were significantly elevated only at 4 weeks around teeth. The only difference between PICF and GCF biomarkers was significantly elevated granulocyte-macrophage colony-stimulating factor levels around teeth versus dental implants at the 4-week visit. The subgingival microbiome and cytokine production were similar between teeth and implants during early healing, suggesting that these profiles are driven by the patient following dental implant placement and are not determined by anatomical niche. IMPORTANCE Dental implants are a common treatment option offered to patients for tooth replacement. However, little is known regarding initial colonization of the subgingival microbiome and

Immediately loaded implants supporting fixed prostheses in the edentulous maxilla: a preliminary clinical and radiologic report.

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Bergkvist, Göran; Sahlholm, Sten; Karlsson, Ulf; Nilner, Krister; Lindh, Christina

2005-01-01

To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.

Multilayer porous UHMWPE scaffolds for bone defects replacement

International Nuclear Information System (INIS)

Maksimkin, A.V.; Senatov, F.S.; Anisimova, N.Yu.; Kiselevskiy, M.V.; Zalepugin, D.Yu.; Chernyshova, I.V.; Tilkunova, N.A.; Kaloshkin, S.D.

2017-01-01

Reconstruction of the structural integrity of the damaged bone tissue is an urgent problem. UHMWPE may be potentially used for the manufacture of porous implants simulating as closely as possible the porous cancellous bone tissue. But the extremely high molecular weight of the polymer does not allow using traditional methods of foaming. Porous and multilayer UHMWPE scaffolds with nonporous bulk layer and porous layer that mimics cancellous bone architecture were obtained by solid-state mixing, thermopressing and washing in subcritical water. Structural and mechanical properties of the samples were studied. Porous UHMWPE samples were also studied in vitro and in vivo. The pores of UHMWPE scaffold are open and interconnected. Volume porosity of the obtained samples was 79 ± 2%; the pore size range was 80–700 μm. Strong connection of the two layers in multilayer UHMWPE scaffolds was observed with decreased number of fusion defects. Functionality of implants based on multilayer UHMWPE scaffolds is provided by the fixation of scaffolds in the bone defect through ingrowths of the connective tissue into the pores, which ensures the maintenance of the animals' mobility - Highlights: • Porous UHMWPE scaffold mimics cancellous bone architecture, maintaining its flexibility. • Multilayer UHMWPE scaffold is able to simulate different types of bone tissue. • Fixation of scaffolds in the bone provides through ingrowths of the connective tissue into pores. • Multilayer UHMWPE scaffolds can be used for the formation of bone implants.

Multilayer porous UHMWPE scaffolds for bone defects replacement

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Maksimkin, A.V. [National University of Science and Technology “MISIS”, Moscow (Russian Federation); Senatov, F.S., E-mail: senatov@misis.ru [National University of Science and Technology “MISIS”, Moscow (Russian Federation); Anisimova, N.Yu.; Kiselevskiy, M.V. [National University of Science and Technology “MISIS”, Moscow (Russian Federation); N.N. Blokhin Russian Cancer Research Center, Moscow (Russian Federation); Zalepugin, D.Yu.; Chernyshova, I.V.; Tilkunova, N.A. [State Plant of Medicinal Drugs, Moscow (Russian Federation); Kaloshkin, S.D. [National University of Science and Technology “MISIS”, Moscow (Russian Federation)

2017-04-01

Reconstruction of the structural integrity of the damaged bone tissue is an urgent problem. UHMWPE may be potentially used for the manufacture of porous implants simulating as closely as possible the porous cancellous bone tissue. But the extremely high molecular weight of the polymer does not allow using traditional methods of foaming. Porous and multilayer UHMWPE scaffolds with nonporous bulk layer and porous layer that mimics cancellous bone architecture were obtained by solid-state mixing, thermopressing and washing in subcritical water. Structural and mechanical properties of the samples were studied. Porous UHMWPE samples were also studied in vitro and in vivo. The pores of UHMWPE scaffold are open and interconnected. Volume porosity of the obtained samples was 79 ± 2%; the pore size range was 80–700 μm. Strong connection of the two layers in multilayer UHMWPE scaffolds was observed with decreased number of fusion defects. Functionality of implants based on multilayer UHMWPE scaffolds is provided by the fixation of scaffolds in the bone defect through ingrowths of the connective tissue into the pores, which ensures the maintenance of the animals' mobility - Highlights: • Porous UHMWPE scaffold mimics cancellous bone architecture, maintaining its flexibility. • Multilayer UHMWPE scaffold is able to simulate different types of bone tissue. • Fixation of scaffolds in the bone provides through ingrowths of the connective tissue into pores. • Multilayer UHMWPE scaffolds can be used for the formation of bone implants.

Single Sitting Surgical Treatment of Generalized Aggressive Periodontitis Using GTR Technique and Immediate Implant Placement with 10-Year Follow-Up

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Fatme Mouchref Hamasni

2018-01-01

Full Text Available This case report exhibits a patient with generalized aggressive periodontitis who has been under maintenance for the past 12 years after being surgically treated in a single sitting and restored with dental implants. A 41-year-old systemically healthy male patient presented complaining of lower anterior teeth mobility and pain in the upper right quadrant. After clinical and radiographic examination, the upper right molars and lower anterior incisors were deemed unrestorable. Covered by doxycycline, the patient received a nonsurgical periodontal treatment. Three weeks later, teeth extraction, immediate implant placement, immediate nonloading provisional prosthesis, and a guided tissue regeneration were performed at indicated areas in a single sitting. The clinical decisions were based on patient compliance, the status of the existing periodontal tissues, and the prognosis of the remaining teeth. During the 12-year follow-up period, no residual pockets were observed and there was no exacerbation of the inflammatory condition. Marginal bone stability is present on all implants. For aggressive periodontal disease, a high risk of relapse as well as limited success and survival of dental implants should be considered. This case shows proper containment of the disease based on appropriate treatment planning and a strict maintenance program.

Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse.

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Ohba, Seigo; Nakatani, Yuya; Kawasaki, Takako; Tajima, Nobutaka; Tobita, Takayoshi; Yoshida, Noriaki; Sawase, Takashi; Asahina, Izumi

2015-08-01

Increasing numbers of older patients are seeking orthognathic surgery to treat jaw deformity. However, orthodontic and orthognathic surgical treatment is difficult in cases without occlusal vertical stop. A 55-year-old man presented with Class III malocclusion and mandibular protrusion including esthetic problems and posterior bite collapse. He underwent dental implant treatment to reconstruct an occlusal vertical stop before orthognathic surgery. His occlusal function and esthetic problems improved after surgery, and his skeletal and occlusal stability has been maintained for 6 years. Dental implant placement at appropriate positions could help to determine the position of the proximal segment at orthognathic surgery and could shorten the time required to restore esthetic and occlusal function. This case demonstrates how skeletal and dental stability can be maintained long after surgery in a patient with jaw deformity and posterior bite collapse.

Clinical evaluation of the stability of implants placed at different supracrestal levels.

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Gultekin, B Alper; Sirali, Ali; Gultekin, Pinar; Ersanli, Selim

2016-01-01

The aim of this study was to evaluate the stability during healing and before loading of implants placed at two different supracrestal levels according to their collar texture. This retrospective study included patients who received posterior implants with the same macro design. Implants with a machined collar were placed 0.3 mm above the crestal bone (M group), while those with a laser-microtextured collar were placed 1 mm above the crestal bone (L group). All implants healed in a single stage with healing abutments. Implant stability quotient (ISQ) values were determined using resonance frequency analysis immediately after implant placement during surgery and after 1, 4, 8, and 12 weeks after surgery. Other evaluated factors for stability included the implant diameter and length and the site of placement (maxilla or mandible). In total, 103 implants (47 L, 56 M) were evaluated. The median ISQ values at baseline and 1 week after placement were significantly higher for the M group than for the L group (p=0.006 and p=0.031, respectively). There were no differences at the subsequent observation points. The ISQ value was higher for wide-diameter than regular diameter (p=0.001) and mandibular implants than maxillary implants (p=0.001 at 0-8. weeks; p=0.012 at 12 weeks) at all observation points. When diameter data were neglected, the implant length did not influence the ISQ value at all observation points. Our results suggest that submerging implant more inside bone may only influence primary stability. Moreover, the implant diameter and site of placement influence primary and secondary stability before loading, whereas the implant length does not when its diameter is not accounted for.

Unusual Etiology and Diagnosis of Oroantral Communication due to Late Implant Failure

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Rabah Nedir

2017-01-01

Full Text Available Oroantral communication (OAC rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure. This case report supports the need for sinus check-up during a routine implant examination.

CLINICAL CONSIDERATIONS OF DENTAL IMPLANT SYSTEM IN IMMEDIATE LOADING IMPLANT CASES

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Carolina Damayanti Marpaung

2015-06-01

Full Text Available Immediate loading of dental implant has been researched intensively in the development of Branemark’s early concept of 2 stages implant placement. This was embarked from both patients and practiitioner’s convenience towards a simpler protocol and shorter time frame. Many recent researchers later found that micromotions derived from occlusal loading for a certain degree, instead of resulting a fibrous tissue encapsulation, can enhance the osseointegration process. Dental Implant system enhancement towards maximizing the primary stability held a key factor in Branemark’s concept development. Surgical protocol and implant design was found to give a significant contribution to the prognosis of immediate-loading implants.

Human bone ingrowth into a porous tantalum acetabular cup

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Gregory N. Haidemenopoulos

2017-11-01

Full Text Available Porous Tantalum is increasingly used as a structural scaffold in orthopaedic applications. Information on the mechanisms of human bone ingrowth into trabecular metal implants is rather limited. In this work we have studied, qualitatively, human bone ingrowth into a retrieved porous tantalum monoblock acetabular cup using optical microscopy, scanning electron microscopy and energy dispersive X-ray analysis. According to the results and taking into account the short operational life (4 years of the implant, bone ingrowth on the acetabular cup took place in the first two-rows of porous tantalum cells to an estimated depth of 1.5 to 2 mm. The bone material, grown inside the first raw of cells, had almost identical composition with the attached bone on the cup surface, as verified by the same Ca:P ratio. Bone ingrowth has been a gradual process starting with Ca deposition on the tantalum struts, followed by bone formation into the tantalum cells, with gradual densification of the bone tissue into hydroxyapatite. A critical step in this process has been the attachment of bone material to the tantalum struts following the topology of the porous tantalum scaffold. These results provide insight to the human bone ingrowth process into porous tantalum implants.

The evaluation of hydroxyapatite (HA) coated and uncoated porous tantalum for biomedical material applications

International Nuclear Information System (INIS)

Safuan, Nadia; Sukmana, Irza; Kadir, Mohammed Rafiq Abdul; Noviana, Deni

2014-01-01

Porous tantalum has been used as an orthopedic implant for bone defects as it has a good corrosion resistance and fatigue behaviour properties. However, there are some reports on the rejection of porous Ta after the implantation. Those clinical cases refer to the less bioactivity of metallic-based materials. This study aims to evaluate hydroxyapatite coated and uncoated porous Tantalum in order to improve the biocompatibility of porous tantalum implant and osseointegration. Porous tantalum was used as metallic-base substrate and hydroxyapatite coating has been done using plasma-spraying technique. Scanning Electron Microscopy (SEM) and Field Emission Scanning Electron Microscopy (FESEM) techniques were utilizes to investigate the coating characteristics while Confocal Raman Microscopy to investigate the interface and image. The effect of coating to the corrosion behaviour was assessed by employing potentiodynamic polarization tests in simulated body fluid at 37±1 °C. Based on SEM and FESEM results, the morphologies as well the weight element consists in the uncoated and hydroxyapatite coated porous tantalum were revealed. The results indicated that the decrease in corrosion current density for HA coated porous Ta compared to the uncoated porous Ta. This study concluded that by coating porous tantalum with HA supports to decrease the corrosion rate of pure porous.

The Evaluation of Hydroxyapatite (HA) Coated and Uncoated Porous Tantalum for Biomedical Material Applications

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Safuan, Nadia; Sukmana, Irza; Kadir, Mohammed Rafiq Abdul; Noviana, Deni

2014-04-01

Porous tantalum has been used as an orthopedic implant for bone defects as it has a good corrosion resistance and fatigue behaviour properties. However, there are some reports on the rejection of porous Ta after the implantation. Those clinical cases refer to the less bioactivity of metallic-based materials. This study aims to evaluate hydroxyapatite coated and uncoated porous Tantalum in order to improve the biocompatibility of porous tantalum implant and osseointegration. Porous tantalum was used as metallic-base substrate and hydroxyapatite coating has been done using plasma-spraying technique. Scanning Electron Microscopy (SEM) and Field Emission Scanning Electron Microscopy (FESEM) techniques were utilizes to investigate the coating characteristics while Confocal Raman Microscopy to investigate the interface and image. The effect of coating to the corrosion behaviour was assessed by employing potentiodynamic polarization tests in simulated body fluid at 37±1 °C. Based on SEM and FESEM results, the morphologies as well the weight element consists in the uncoated and hydroxyapatite coated porous tantalum were revealed. The results indicated that the decrease in corrosion current density for HA coated porous Ta compared to the uncoated porous Ta. This study concluded that by coating porous tantalum with HA supports to decrease the corrosion rate of pure porous.

Maintenance in dental implants

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Giselle Póvoa Gomes

2008-01-01

Full Text Available In implants, maintenance is a decisive factor for obtaining success when implant supported overdentures and dentures are used. The present stud presents, a clinical case of a patient, a 70 year-old white man, with a completely edentulous mandibular alveolar ridge, severe bone resorption with presence of basal bone only, and absence of vestibule. Initially, treatment consisted of the placement of a mandibular overdenture, supported on three implants in the anterior inter-foramen region, as the left implant was transfixed in the basal bone of 2 to 3 millimeters. Eleven years later, another two implants were placed in the anterior area and an immediate load was performed up to the first molars, for the placement of an implant supported fixed. Throughout the entire treatment, meticulous maintenance was carried out, with follow-up for fourteen years, interrupted by the patient’s death. From the third month after the opening the three implants initially placed, the presence of keratinized mucosa, definition of the vestibule, maturation of the alveolar ridge and bone formation in the mento region were observed. It was concluded that good planning, allied to mastery of the technique and adequate maintenance were the prerequisites necessary for obtaining favorable results, success of the present case, and for the patient to have a better quality of life.

Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part II: a Systematic Review of Neurosensory Complications

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Boris Abayev

2015-03-01

Full Text Available Objectives: This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of this article is to review the scientific literature and clinical reports in order to analyse the neurosensory complications, risks and disadvantages of lateralization/transposition of the inferior alveolar nerve followed by implant placement in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC databases, as well as academic sites and books. The articles were searched from January 1997 to July 2014. Articles in English language, which included adult patients between 18 - 80 years of age who had minimal residual bone above the mandibular canal and had undergone inferior alveolar nerve (IAN repositioning, with minimum 6 months of follow-up, were included. Results: A total of 21 studies were included in this review. Ten were related to IAN transposition, 7 to IAN lateralization and 4 to both transposition and lateralization. The IAN neurosensory disturbance function was present in most patients (99.47% [376/378] for 1 to 6 months. In total, 0.53% (2/378 of procedures the disturbances were permanent. Conclusions: Inferior alveolar nerve repositioning is related to initial transient change in sensation in the majority of cases. The most popular causes of nerve damage are spatula-caused traction in the mucoperiosteal flap, pressure due to severe inflammation or retention of fluid around the nerve and subsequent development of transient ischemia, and mandibular body fracture.

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

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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.

Quantitative analysis of alveolar bone change following implant placement using intraoral radiographic subtraction

International Nuclear Information System (INIS)

Kimura, Hiroyuki; Kanda, Shigenobu; Tanaka, Takemasa

2002-01-01

The purpose of this study was to develop a procedure for quantitative analysis using intraoral radiographs of alveolar bone after placement of dental implants and to consider the validity of the method. We evaluated the ten patients (2 males and 8 females, average age: 48.4 years-old), who were treated with dental implant operation in the site of mandibular molar region, since October of 1999 until September of 2000 in Kimura Dental Clinic (Kumamoto, Japan). We evaluated the intraoral radiographs taken pre- and post- operatively and at follow-up examination. To detect alveolar bone change on radiograph, we adopted the digital subtraction method. Although the radiographs were taken under an ordinary technique with cone indicator, we did not apply the standardized technique with fixing material customized for each patient. Therefore, we used geometric correction and density compensation before subtraction. We assessed the basic statistical values (mean, variance, kurtosis and skewness) of the region of interest (ROI) of the subtracted images. Also, we noted PPD (probing pocket depth) and BOP (bleeding on probing) at each site as indicators of clinical findings and all implanted sites were classified according to the PPD or BOP, i.e. PPD increased group ''PPD (+)'' and PPD stable group ''PPD (-)'', likewise BOP positive group ''BOP (+)'' and negative group ''BOP (-)''. We considered the statistical values of ROI in each group and compared these findings. Mean and variance values of PPD (+) were higher than those of PPD (-) and there was a significant difference in mean value (p=0.031). Similarly, mean and variance values of BOP (+) were statistically higher than those of BOP (-) (p=0.041 and p=0.0087, respectively). Concerning kurtosis and skewness, there was no difference between PPD (+) and PPD (-), or between BOP (+) and BOP (-). Using our method, the radiographs taken for follow-up examination could be assessed quantitatively. It is suggested that geometric

The History of Nontraditional or Ectopic Placement of Reservoirs in Prosthetic Urology.

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Perito, Paul; Wilson, Steven

2016-04-01

Reservoir placement during implantation of prosthetic urology devices has been problematic throughout the history of the surgical treatment of erectile dysfunction and urinary incontinence. We thought it would be interesting to review the history of reservoir placement leading up to current surgical techniques. To provide an overview of the past and present techniques for reservoir placement and discuss the evolutionary process leading to safe and effective placement of prosthetic reservoirs. We reviewed data pertaining to inflatable penile prosthesis (IPP) reservoirs and pressure-regulating balloons (PRB) in a chronological fashion, spanning 25 years. Main outcomes included a historical review of techniques for IPP reservoir and PRB placement leading to the subsequent incremental improvements in safety and efficacy when performing penile implants and artificial urinary sphincters. Prosthetic urologic reservoirs have traditionally been placed in the retropubic space. Over the years, urologists have attempted use of alternative spaces including peritoneal, epigastric, "ectopic," posterior to transversalis, and high submuscular. Current advances in prosthetic urologic reservoir placement allow safe and effective abdominal wall placement of reservoirs. These novel approaches appear to be so effective that urologists may now be able to cease using the traditional retropubic space for reservoir placement, even in the case of virgin pelves. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Gene expression of inflammation and bone healing in peri-implant crevicular fluid after placement and loading of dental implants. A kinetic clinical pilot study using quantitative real-time PCR.

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Slotte, Christer; Lennerås, Maria; Göthberg, Catharina; Suska, Felicia; Zoric, Neven; Thomsen, Peter; Nannmark, Ulf

2012-10-01

Early detection of healing complications after placement of dental implants is a pressing but elusive goal. This paper proposes a non-invasive diagnostic tool for monitoring healing- and peri-implant disease specific genes, complementary to clinical evaluations. Eighteen partially edentulous patients were recruited to this pilot study. Three Brånemark TiUnite® implants/patient (Nobel Biocare) were placed in a one-stage procedure. Abutments with smooth or rough (TiUnite®) surface were placed. The test group (n = 9) received fixed bridges (immediate loading), whereas the control group (n = 9) implants were loaded 3 months after surgery. In addition to clinical measurements, crevicular fluid was collected using paper strips at the implant abutments 2, 14, 28, and 90 days postoperative. mRNA was extracted, purified, and converted to cDNA. Quantitative PCR assays for IL-1β, TNF-α, Osteocalcin (OC), Alkaline Phosphatase (ALP), Cathepsin K, Tartrate Resistant Acid Phosphatase, and 18S ribosomal RNA were designed and validated. Relative gene expression levels were calculated. One implant was lost in the control group and three in the test group. In one test patient, one implant showed lowered stability after 2 to 4 weeks and was unloaded. Later implant stability improved which allowed for loading after 3 to 4 months. TNF-α and ALP most commonly showed correlation with clinical parameters followed by IL-1β and OC. The strongest correlation was found for TNF-α with clinical complications at 2 and 14 days (p = .01/r = -048, and p = .0004/r = -0.56, respectively; test and control groups together). In some cases, gene expression predicted clinical complications (TNF-α, ALP, CK). This study is based on samples from few individuals; still, some genes showed correlation with clinical findings. Further studies are needed to refine and optimize the sampling process, to find the appropriate panel, and to validate gene expression for monitoring implant healing. © 2010 Wiley

Evaluation of porous vitreous carbon or silicon implants by radiology in rat's skull; Avaliacao radiologica de implantes de carbono vitreo poroso ou silicone em cranio de ratos

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Vaccari-Mazzetti, Marcelo Paulo; Kobata, Celio Toshiro [Lusiada University of Santos, SP (Brazil). Hospital Defeitos da Face. Dept. of Surgery]. E-mail: mmgvaccari@ig.com.br; Fabiani, Paulo [Lusiada University of Santos, SP (Brazil). Dept. of Radiology; Martins, Dulce Maria Fonseca Soares [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. of Surgery. Div. of Plastic Surgery; Gomes, Paulo de Oliveira [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. of Surgery. Div. of Operatory Technique and Experimental Surgery; Martins, Jose Luiz [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. of Surgery. Div. of Pediatric Surgery

2008-07-01

Purpose: Evaluate by CT the use of porous vitreous carbon (PVC) and silicon (S) implants as the replacement bone in the craniofacial skeleton of rats. Methods: 40 rats divided in: Group A (n=20) PVC submitted to the implant of a fragment in skull. After the euthanasia, the animals were divided into two subgroups: A I: 10 animals, studied in the 7th postoperative day (P.O) and AII: 10 animals, studied in the 28th P.O. In group B, S, 20 rats were submitted to S implant in the skull. All other steps were identical to group A, with designation of subgroups BI and BII. CT with beams in axial cuts of 1 mm thickness to obtain 3-D information It was used Hounsfield scale for evaluate the radio density of the implant. They were used non parametric tests to analyze the results. Results: The 7th PO boss remained in the two groups, but for 28th PO, observed reduction in the volume of the implant in Group A, not observed in group B. CT studies noticed different radio densities around all of S prostheses (pseudo capsule), that do not appeared in CPV implants. The S has remained unchanged in the CT, but the CPV has had a modification in its radio density (p{<=}0,05), in all implants. Conclusion: In CT evaluation the implants of CPV have greater deformation that the S, which makes them not suitable for replacement of membranous bone in the rat skull. (author)

Implantable cardioverter defibrillator implantation in children in The Netherlands

NARCIS (Netherlands)

Ten Harkel, ADJ; Blom, NA; Reimer, AG; Tukkie, R; Sreeram, N; Bink-Boelkens, MTE

To evaluate the indications, underlying cardiac disorders, efficacy and complications involved with implantable cardioverter-defibrillators (ICDs) in paediatric patients in The Netherlands, the records of all patients aged 18 years or younger who underwent ICD placement were reviewed

Implantable cardioverter defibrillator implantation in children in The Netherlands

NARCIS (Netherlands)

ten Harkel, A. Derk Jan; Blom, Nico A.; Reimer, Annette G.; Tukkie, Raymond; Sreeram, Narayanswami; Bink-Boelkens, Margreet T. E.

2005-01-01

To evaluate the indications, underlying cardiac disorders, efficacy and complications involved with implantable cardioverter-defibrillators (ICDs) in paediatric patients in The Netherlands, the records of all patients aged 18 years or younger who underwent ICD placement were reviewed

Titanium implants with modified surfaces: Meta-analysis of in vivo osteointegration

Energy Technology Data Exchange (ETDEWEB)

Gasik, Michael, E-mail: michael.gasik@aalto.fi [Aalto University Foundation, School of Chemical Technology, P.O. Box 16200, FIN-00076 AALTO (Finland); Braem, Annabel [Department of Metallurgy and Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee (Belgium); Chaudhari, Amol; Duyck, Joke [Department of Prosthetic Dentistry, BIOMAT Research Cluster, KU Leuven, Kapucijnenvoer 7a, B-3000 Leuven (Belgium); Vleugels, Jozef [Department of Metallurgy and Materials Engineering, KU Leuven, Kasteelpark Arenberg 44, B-3001 Heverlee (Belgium)

2015-04-01

Titanium-based implants are widely used in modern clinical practice, but their “optimal” properties in terms of porosity and topology, roughness and hydrophilic parameters are being a subject of intensive discussions. Recent in vitro results have shown a possibility to optimize the surface of an implant with maximal repelling of bacteria (Staphylococcus aureus, Staphylococcus epidermidis) and improvement in human osteogenic and endothelial cell adhesion, proliferation and differentiation. In this work, these different grades titanium implants were tested in vivo using the same analytical methodology. In addition to material parameters, key histomorphometrical parameters such a regeneration area, bone adaptation area and bone-to-implant contact were determined after 2 and 4 weeks of implantation in rabbit animal model. Porous implants have more clear differences than non-porous ones, with the best optimum values obtained on hydrothermally treated electrophoretically deposited titanium. These in vivo data correlate well with the optimal prediction made by in vitro tests. - Highlights: • Various titanium specimens were studied in vivo on osteointegration vs their properties. • Non-porous implants had a better performance when coated with bioactive glass. • Porous implants have shown the best results for hydrothermally treated specimens. • Good correlation was found with the previous in vitro tests. • New analysis of the in vivo data has shown benefits to assess biomaterials performance.

Titanium implants with modified surfaces: Meta-analysis of in vivo osteointegration

International Nuclear Information System (INIS)

Gasik, Michael; Braem, Annabel; Chaudhari, Amol; Duyck, Joke; Vleugels, Jozef

2015-01-01

Titanium-based implants are widely used in modern clinical practice, but their “optimal” properties in terms of porosity and topology, roughness and hydrophilic parameters are being a subject of intensive discussions. Recent in vitro results have shown a possibility to optimize the surface of an implant with maximal repelling of bacteria (Staphylococcus aureus, Staphylococcus epidermidis) and improvement in human osteogenic and endothelial cell adhesion, proliferation and differentiation. In this work, these different grades titanium implants were tested in vivo using the same analytical methodology. In addition to material parameters, key histomorphometrical parameters such a regeneration area, bone adaptation area and bone-to-implant contact were determined after 2 and 4 weeks of implantation in rabbit animal model. Porous implants have more clear differences than non-porous ones, with the best optimum values obtained on hydrothermally treated electrophoretically deposited titanium. These in vivo data correlate well with the optimal prediction made by in vitro tests. - Highlights: • Various titanium specimens were studied in vivo on osteointegration vs their properties. • Non-porous implants had a better performance when coated with bioactive glass. • Porous implants have shown the best results for hydrothermally treated specimens. • Good correlation was found with the previous in vitro tests. • New analysis of the in vivo data has shown benefits to assess biomaterials performance

Fatigue crack propagation in additively manufactured porous biomaterials

NARCIS (Netherlands)

Hedayati, R.; Amin Yavari, S.; Zadpoor, A.A.

2017-01-01

Additively manufactured porous titanium implants, in addition to preserving the excellent biocompatible properties of titanium, have very small stiffness values comparable to those of natural bones. Although usually loaded in compression, biomedical implants can also be under tensional, shear,

Graded/Gradient Porous Biomaterials

Directory of Open Access Journals (Sweden)

Xigeng Miao

2009-12-01

Full Text Available Biomaterials include bioceramics, biometals, biopolymers and biocomposites and they play important roles in the replacement and regeneration of human tissues. However, dense bioceramics and dense biometals pose the problem of stress shielding due to their high Young’s moduli compared to those of bones. On the other hand, porous biomaterials exhibit the potential of bone ingrowth, which will depend on porous parameters such as pore size, pore interconnectivity, and porosity. Unfortunately, a highly porous biomaterial results in poor mechanical properties. To optimise the mechanical and the biological properties, porous biomaterials with graded/gradient porosity, pores size, and/or composition have been developed. Graded/gradient porous biomaterials have many advantages over graded/gradient dense biomaterials and uniform or homogenous porous biomaterials. The internal pore surfaces of graded/gradient porous biomaterials can be modified with organic, inorganic, or biological coatings and the internal pores themselves can also be filled with biocompatible and biodegradable materials or living cells. However, graded/gradient porous biomaterials are generally more difficult to fabricate than uniform or homogenous porous biomaterials. With the development of cost-effective processing techniques, graded/gradient porous biomaterials can find wide applications in bone defect filling, implant fixation, bone replacement, drug delivery, and tissue engineering.

CLINICAL EVALUATION OF THE STABILITY OF IMPLANTS PLACED AT DIFFERENT SUPRACRESTAL LEVELS

Directory of Open Access Journals (Sweden)

B. Alper GÜLTEKIN

2016-10-01

Full Text Available Purpose: The aim of this study was to evaluate the stability during healing and before loading of implants placed at two different supracrestal levels according to their collar texture. Materials and Methods: This retrospective study included patients who received posterior implants with the same macro design. Implants with a machined collar were placed 0.3 mm above the crestal bone (M group, while those with a laser-microtextured collar were placed 1 mm above the crestal bone (L group. All implants healed in a single stage with healing abutments. Implant stability quotient (ISQ values were determined using resonance frequency analysis immediately after implant placement during surgery and after 1, 4, 8, and 12 weeks after surgery. Other evaluated factors for stability included the implant diameter and length and the site of placement (maxilla or mandible. Results: In total, 103 implants (47 L, 56 M were evaluated. The median ISQ values at baseline and 1 week after placement were significantly higher for the M group than for the L group (p=0.006 and p=0.031, respectively. There were no differences at the subsequent observation points. The ISQ value was higher for wide-diameter than regular diameter (p=0.001 and mandibular implants than maxillary implants (p=0.001 at 0-8. weeks; p=0.012 at 12 weeks at all observation points. When diameter data were neglected, the implant length did not influence the ISQ value at all observation points. Conclusion: Our results suggest that submerging implant more inside bone may only influence primary stability. Moreover, the implant diameter and site of placement influence primary and secondary stability before loading, whereas the implant length does not when its diameter is not accounted for.

A New Detection Method for Submerged Implants: Oral Tattoo.

Science.gov (United States)

Soylu, Emrah; Gönen, Zeynep Burçin; Alkan, Alper

2018-04-01

To evaluate the marking potential of tattoo ink in determining the definitive locations of submerged implants at the time of surgical exposure of the implants. In total, 104 implants in 32 patients were included in this study. After placement of the implants, cover screws were inserted. Overlying mucosa was marked with tattoo ink using a 20 g needle through the center of the cover screw. At the time of surgical exposure the tattoo marks were evaluated relative to visibility. At the time of the surgical exposures, tattoo ink was clearly visible at 91 implants, slightly visible at 8 implants, and not visible at 5 implants. After detection and classification of tattoo ink, the overlying mucosa was gently removed by tissue punch under local anesthesia. The results of this study seemed to indicate that marking the location of implants with tattoos at the time of implant placement can be an inexpensive, easy, healthy, and practical way to identify the location of marked submerged dental implants. © 2016 by the American College of Prosthodontists.

The Austrian breast implant register: recent trends in implant-based breast surgery.

Science.gov (United States)

Wurzer, Paul; Rappl, Thomas; Friedl, Herwig; Kamolz, Lars-Peter; Spendel, Stephan; Hoflehner, Helmut; Parvizi, Daryousch

2014-12-01

Due to the fact that the number of breast implant surgeries for cosmetic and medical purposes is rising yearly, a discussion about the quality of service for both patients and physicians is more important than ever. To this end, we reviewed the Austrian Breast Implant Register with one specific question in mind: What are the trends? In the statistical analysis of the Austrian Breast Implant Register, we were able to identify 13,112 registered breast implants between 2004 and 2012. The whole dataset was then divided into medical and cosmetic groups. We focused on device size, surface characteristics, filling material, device placement and incision site. All factors were considered for all examined years. In summary, the most used device had a textured surface (97 %) and silicone gel as the filling material (93 %). The mean size of implants for the cosmetic group was 240 cc, placement was submuscular (58 %) and the incision site was inframammary (67 %). In the medical group, the mean size was 250 cc. Yearly registrations had their peak in 2008 (1,898 registered devices); from this year on, registrations decreased annually. A slight trend away from subglandular placement in the cosmetic group was noted. Also, the usage of implants with polyurethane surface characteristics has increased since 2008. The smooth surface implants had a peak usage in 2006 and their usage decreased steadily from then on whereas the textured surface was steady over the years. Keeping the problems related to the quality of breast implants in mind, we could recommend an obligatory national register. Organisations of surgeons and governments should develop and establish these registers. Furthermore, an all-encompassing international register should be established by the European Union and the American FDA (Food and Drug Administration); this might be useful in comparing the individual country registers and also would help in delivering "evidence based" medicine in cosmetic and medical procedures

Surgical Templates for Dental Implant Positioning; Current ...

African Journals Online (AJOL)

Since the mid‑20th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark ... Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is ...

Peri-implant esthetics assessment and management

Science.gov (United States)

Balasubramaniam, Aarthi S.; Raja, Sunitha V.; Thomas, Libby John

2013-01-01

Providing an esthetic restoration in the anterior region of the mouth has been the basis of peri-implant esthetics. To achieve optimal esthetics, in implant supported restorations, various patient and tooth related factors have to be taken into consideration. Peri-implant plastic surgery has been adopted to improve the soft tissue and hard tissue profiles, during and after implant placement. The various factors and the procedures related to enhancement of peri-implant esthetics have been discussed in this review article. PMID:23878557

Primary prevention of peri-implantitis: managing peri-implant mucositis.

Science.gov (United States)

Jepsen, Søren; Berglundh, Tord; Genco, Robert; Aass, Anne Merete; Demirel, Korkud; Derks, Jan; Figuero, Elena; Giovannoli, Jean Louis; Goldstein, Moshe; Lambert, France; Ortiz-Vigon, Alberto; Polyzois, Ioannis; Salvi, Giovanni E; Schwarz, Frank; Serino, Giovanni; Tomasi, Cristiano; Zitzmann, Nicola U

2015-04-01

Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis. Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants. Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis.

Science.gov (United States)

Sarmast, Nima D; Wang, Howard H; Soldatos, Nikolaos K; Angelov, Nikola; Dorn, Samuel; Yukna, Raymond; Iacono, Vincent J

2016-12-01

Although retrograde peri-implantitis (RPI) is not a common sequela of dental implant surgery, its prevalence has been reported in the literature to be 0.26%. Incidence of RPI is reported to increase to 7.8% when teeth adjacent to the implant site have a previous history of root canal therapy, and it is correlated with distance between implant and adjacent tooth and/or with time from endodontic treatment of adjacent tooth to implant placement. Minimum 2 mm space between implant and adjacent tooth is needed to decrease incidence of apical RPI, with minimum 4 weeks between completion of endodontic treatment and actual implant placement. The purpose of this study is to compile all available treatment modalities and to provide a decision tree as a general guide for clinicians to aid in diagnosis and treatment of RPI. Literature search was performed for articles published in English on the topic of RPI. Articles selected were case reports with study populations ranging from 1 to 32 patients. Any case report or clinical trial that attempted to treat or rescue an implant diagnosed with RPI was included. Predominant diagnostic presentation of a lesion was presence of sinus tract at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated a radiolucent lesion. On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement. Twelve of 20 studies reported that RPI lesions were diagnosed within 6 months after implant placement. A step-by-step decision tree is provided to allow clinicians to triage and properly manage cases of RPI on the basis of recommendations and successful treatments provided in analyzed case reports. It is divided between symptomatic and asymptomatic implants and adjacent teeth with vital and necrotic pulps. Most common etiology of apical RPI is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Most

[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

Expanded polytetrafluoroethylene membrane alters tissue response to implanted Ahmed glaucoma valve.

Science.gov (United States)

DeCroos, Francis Char; Ahmad, Sameer; Kondo, Yuji; Chow, Jessica; Mordes, Daniel; Lee, Maria Regina; Asrani, Sanjay; Allingham, R Rand; Olbrich, Kevin C; Klitzman, Bruce

2009-07-01

Long-term intraocular pressure control by glaucoma drainage implants is compromised by the formation of an avascular fibrous capsule that surrounds the glaucoma implant and increases aqueous outflow resistance. It is possible to alter this fibrotic tissue reaction and produce a more vascularized and potentially more permeable capsule around implanted devices by enclosing them in a porous membrane. Ahmed glaucoma implants modified with an outer 5-microm pore size membrane (termed porous retrofitted implant with modified enclosure or PRIME-Ahmed) and unmodified glaucoma implants were implanted into paired rabbit eyes. After 6 weeks, the devices were explanted and subject to histological analysis. A tissue response containing minimal vascularization, negligible immune response, and a thick fibrous capsule surrounded the unmodified Ahmed glaucoma implant. In comparison, the tissue response around the PRIME-Ahmed demonstrated a thinner fibrous capsule (46.4 +/- 10.8 microm for PRIME-Ahmed versus 94.9 +/- 21.2 microm for control, p vascularized near the tissue-material interface. A prominent chronic inflammatory response was noted as well. Encapsulating the aqueous outflow pathway with a porous membrane produces a more vascular tissue response and thinner fibrous capsule compared with a standard glaucoma implant plate. Enhanced vascularity and a thinner fibrous capsule may reduce aqueous outflow resistance and improve long-term glaucoma implant performance.

[Esthetic analysis on immediate single-tooth implant restoration in anterior maxilla].

Science.gov (United States)

Li, Shao-wei; Wang, Guo-shi; Sha, Yan-zhi

2015-10-01

To evaluate the esthetic outcomes of immediate single-tooth implant restoration in anterior maxilla with the pink esthetic score (PES). Nine patients were treated with 9 Straumann implants by immediate single-tooth implant restoration in anterior maxilla. Assessment of PES after crown placement at 1 week (baseline) and 6 months after implantation was conducted. Statistical analysis was performed using SPSS 16.0 software package. Nine implants achieved a retention rate of 100%. PES for single-tooth implant was 10.33 ± 1.50 at 1 week and 11.44 ± 0.88 at 6 months after crown placement. The difference was significant(P=0.021). This study indicates that immediate single-tooth implant restoration in anterior maxilla is predictable. Immediate single-tooth implantation can result in good clinical esthetic results in most patients with single-tooth missing in anterior maxilla.

Fully porous 3D printed titanium femoral stem to reduce stress-shielding following total hip arthroplasty.

Science.gov (United States)

Arabnejad, Sajad; Johnston, Burnett; Tanzer, Michael; Pasini, Damiano

2017-08-01

Current hip replacement femoral implants are made of fully solid materials which all have stiffness considerably higher than that of bone. This mechanical mismatch can cause significant bone resorption secondary to stress shielding, which can lead to serious complications such as peri-prosthetic fracture during or after revision surgery. In this work, a high strength fully porous material with tunable mechanical properties is introduced for use in hip replacement design. The implant macro geometry is based off of a short stem taper-wedge implant compatible with minimally invasive hip replacement surgery. The implant micro-architecture is fine-tuned to locally mimic bone tissue properties which results in minimum bone resorption secondary to stress shielding. We present a systematic approach for the design of a 3D printed fully porous hip implant that encompasses the whole activity spectrum of implant development, from concept generation, multiscale mechanics of porous materials, material architecture tailoring, to additive manufacturing, and performance assessment via in vitro experiments in composite femurs. We show that the fully porous implant with an optimized material micro-structure can reduce the amount of bone loss secondary to stress shielding by 75% compared to a fully solid implant. This result also agrees with those of the in vitro quasi-physiological experimental model and the corresponding finite element model for both the optimized fully porous and fully solid implant. These studies demonstrate the merit and the potential of tuning material architecture to achieve a substantial reduction of bone resorption secondary to stress shielding. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1774-1783, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh extraction sockets.

Science.gov (United States)

Berberi, Antoine N; Tehini, Georges E; Noujeim, Ziad F; Khairallah, Alexandre A; Abousehlib, Moustafa N; Salameh, Ziad A

2014-10-01

Delayed placement of implant abutments has been associated with peri-implant marginal bone loss; however, long-term results obtained by modifying surgical and prosthetic techniques after implant placement are still lacking. This study aimed to evaluate the marginal bone loss around titanium implants placed in fresh extraction sockets using two loading protocols after a 5-year follow-up period. A total of 36 patients received 40 titanium implants (Astra Tech) intended for single-tooth replacement. Implants were immediately placed into fresh extraction sockets using either a one-stage (immediate loading by placing an interim prosthesis into functional occlusion) or a two-stage prosthetic loading protocol (insertion of abutments after 8 weeks of healing time). Marginal bone levels relative to the implant reference point were evaluated at four time intervals using intraoral radiographs: at time of implant placement, and 1, 3, and 5 years after implant placement. Measurements were obtained from mesial and distal surfaces of each implant (α = 0.05). One-stage immediate implant placement into fresh extraction sockets resulted in a significant reduction in marginal bone loss (p sockets reduced marginal bone loss and did not compromise the success rate of the restorations. © 2014 by the American College of Prosthodontists.

Two-stage implant systems.

Science.gov (United States)

Fritz, M E

1999-06-01

Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

Influence of Palatal Coverage and Implant Distribution on Implant Strain in Maxillary Implant Overdentures.

Science.gov (United States)

Takahashi, Toshihito; Gonda, Tomoya; Mizuno, Yoko; Fujinami, Yozo; Maeda, Yoshinobu

2016-01-01

Maxillary implant overdentures are often used in clinical practice. However, there is no agreement or established guidelines regarding prosthetic design or optimal implant placement configuration. The purpose of this study was to examine the influence of palatal coverage and implant number and distribution in relation to impact strain under maxillary implant overdentures. A maxillary edentulous model with implants and experimental overdentures with and without palatal coverage was fabricated. Four strain gauges were attached to each implant, and they were positioned in the anterior, premolar, and molar areas. A vertical occlusal load of 98 N was applied through a mandibular complete denture, and the implant strains were compared using one-way analysis of variance (P = .05). The palatolabial strain was much higher on anterior implants than on other implants in both denture types. Although there was no significant difference between the strain under dentures with and without palatal coverage, palateless dentures tended to result in higher implant strain than dentures with palatal coverage. Dentures supported by only two implants registered higher strain than those supported by four or six implants. Implants under palateless dentures registered higher strain than those under dentures with palatal coverage. Anterior implants exhibited higher palatolabial strain than other implants regardless of palatal coverage and implant configuration; it is therefore recommended that maxillary implant overdentures should be supported by six implants with support extending to the distal end of the arch.

Bone growth into a revised porous-coated patellar implant

DEFF Research Database (Denmark)

Jensen, L N; Lund, B; Gotfredsen, K

1990-01-01

A noncemented and clinically stable porous-coated patellar component (PCA) was removed from a patient after 11 months because of infection. It was sectioned and examined histologically in undecalcified, thin-ground sections. The bone ingrowth into the porous space was measured at eight levels. Ea...

Multilayer porous UHMWPE scaffolds for bone defects replacement.

Science.gov (United States)

Maksimkin, A V; Senatov, F S; Anisimova, N Yu; Kiselevskiy, M V; Zalepugin, D Yu; Chernyshova, I V; Tilkunova, N A; Kaloshkin, S D

2017-04-01

Reconstruction of the structural integrity of the damaged bone tissue is an urgent problem. UHMWPE may be potentially used for the manufacture of porous implants simulating as closely as possible the porous cancellous bone tissue. But the extremely high molecular weight of the polymer does not allow using traditional methods of foaming. Porous and multilayer UHMWPE scaffolds with nonporous bulk layer and porous layer that mimics cancellous bone architecture were obtained by solid-state mixing, thermopressing and washing in subcritical water. Structural and mechanical properties of the samples were studied. Porous UHMWPE samples were also studied in vitro and in vivo. The pores of UHMWPE scaffold are open and interconnected. Volume porosity of the obtained samples was 79±2%; the pore size range was 80-700μm. Strong connection of the two layers in multilayer UHMWPE scaffolds was observed with decreased number of fusion defects. Functionality of implants based on multilayer UHMWPE scaffolds is provided by the fixation of scaffolds in the bone defect through ingrowths of the connective tissue into the pores, which ensures the maintenance of the animals' mobility. Copyright © 2016 Elsevier B.V. All rights reserved.

Percutaneous implantation of endoprostheses in the carotid arteries

Directory of Open Access Journals (Sweden)

Costa Jr. José Ribamar

2003-01-01

Full Text Available OBJECTIVE: To assess the in-hospital evolution of patients undergoing percutaneous stent placement in the carotid arteries. METHODS: From August 1996 to April 2001, we studied 86 patients with carotid arterial obliterative lesions > 70% who were treated with percutaneous stent placement in the carotid arteries. We assessed the rate of success of the implantation and of the procedure, the types of stents used, mortality rate, and neurological complications. RESULTS: Successful implantation was obtained in 98.9% of the cases, and the procedure was successful in 91.8%. The Wallstent was the most frequently used stent (73 patients - 77%. Cerebral strokes occurred as follows: 3 (3.2% transient ischemic attacks, 1 (1.1% minor stroke, and 3 (3.1% major strokes. One (1.1% patient died during hospitalization. CONCLUSION: The high rate of success of stent implantation (98.9% in addition to the low rate of cerebral stroke/death (4.2% showed the efficiency and safety of percutaneous stent placement in carotid arteries.

Immediate Loading of Single Implants in the Anterior Maxilla: A 1-Year Prospective Clinical Study on 34 Patients

Directory of Open Access Journals (Sweden)

Miguel Stanley

2017-01-01

Full Text Available Purpose. To present the outcomes of immediately loaded single implants placed in the anterior maxilla. Methods. Over a 2-year period, all patients referred to a private clinic were considered for enrolment in this study. Inclusion criteria were single-tooth placement in postextraction sockets or healed sites of the anterior maxilla. All implants were immediately loaded and followed for a period of 1 year after the placement of definitive crowns. The outcome measures were implant stability, survival, and success. Results. 34 patients were selected and 43 tapered implants with a knife-edge thread design and a nanostructured, calcium-incorporated surface (Anyridge®, Megagen, Gyeongsang, Korea were installed. Two implants were not sufficiently stable at placement (ISQ < 60 and were considered failed for immediate loading; 41 implants had an ISQ ≥ 60 at placement and were immediately loaded. One year after the placement of definitive crowns, no implant failures were reported, for a survival rate of 100%. No biological complications were found, but 2 implants had their prosthetic abutments loosened: the implant success rate was 95.2%. Conclusions. In the present study on the immediate loading of single implants in the anterior maxilla, positive outcomes were reported, with high survival (100% and success (95.2% rates (the present study has been registered in the ISRCTN registry, a publicly available trial register recognized by WHO and ICMJE, with number ISRCTN12935478.

Self-Consolidation Mechanism Of Porous Ti-6Al-4V Implant Prototypes Produced By Electro-Discharge-Sintering Of Spherical Ti-6Al-4V Powders

Directory of Open Access Journals (Sweden)

Lee W.H.

2015-06-01

Full Text Available Electro-Discharge-Sintering (EDS was employed to fabricate Ti-6Al-4V porous implant prototypes from atomized powders (100 – 150 μm, that were subjected to discharges of 0.75 to 2.0 kJ/0.7g-powder from 150, 300, and 450 μF capacitors. Both fully porous and porous-surfaced Ti-6Al-4V compacts with various solid core sizes were self-consolidated in less than 86 – 155 μsec. It is known that EDS can simultaneously produce the pinch pressure to squeeze and deform powder particles and the heat to weld them together. The formation of a solid core in these prototypes depends on the amounts of both the pinch pressure and heat generated during a discharge. The size of the solid core and the thickness of the porous layer can be successfully controlled by manipulating the discharge conditions such as input energy and capacitance.

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-aided implant placement. Part II: reliability of mucosa-supported stereolithographic guides.

Science.gov (United States)

Arisan, Volkan; Karabuda, Zihni Cüneyt; Pişkin, Bülent; Özdemir, Tayfun

2013-12-01

Deviations of implants that were placed by conventional computed tomography (CT)- or cone beam CT (CBCT)-derived mucosa-supported stereolithographic (SLA) surgical guides were analyzed in this study. Eleven patients were randomly scanned by a multi-slice CT (CT group) or a CBCT scanner (CBCT group). A total of 108 implants were planned on the software and placed using SLA guides. A new CT or CBCT scan was obtained and merged with the planning data to identify the deviations between the planned and placed implants. Results were analyzed by Mann-Whitney U test and multiple regressions (p < .05). Mean angular and linear deviations in the CT group were 3.30° (SD 0.36), and 0.75 (SD 0.32) and 0.80 mm (SD 0.35) at the implant shoulder and tip, respectively. In the CBCT group, mean angular and linear deviations were 3.47° (SD 0.37), and 0.81 (SD 0.32) and 0.87 mm (SD 0.32) at the implant shoulder and tip, respectively. No statistically significant differences were detected between the CT and CBCT groups (p = .169 and p = .551, p = .113 for angular and linear deviations, respectively). Implant placement via CT- or CBCT-derived mucosa-supported SLA guides yielded similar deviation values. Results should be confirmed on alternative CBCT scanners. © 2012 Wiley Periodicals, Inc.

[A scanning electron microscopy study of the surface of porous-textured breast implants and their capsules. Description of the "velcro" effect of porous-textured breast prostheses].

Science.gov (United States)

Danino, A; Rocher, F; Blanchet-Bardon, C; Revol, M; Servant, J M

2001-02-01

The efficacy of breast prosthesis texturing in the prevention of capsular contracture has been established for about 20 years. This successful procedure has led to the development and marketing of a number of different models. In the present study, four porous-textured breast prostheses have been examined: the Arion monoblock implant, the CUI (McGahn), the Biocell (Mcgahn), and the Sebbin LS21. Scanning electron microscopic (SEM) investigation of the implant surfaces of the different prostheses was carried out on new samples received from the manufacturers. During a prospective study on eight patients, capsule samples corresponding to the four above-mentioned prostheses were taken to determine whether a secondary intervention was necessary for correction of asymmetry or malpositioning. These samples were analyzed by SEM to investigate whether there could be a correlation between prosthesis texturing and the aspect of the corresponding capsules. Significant ultrastructural differences were found between the various prostheses examined: the results showed that only the CUI and Biocell prostheses presented a mirror image of the capsule texturing, with a correspondence between the depressions on the prosthesis and the contacts on the capsule. This finding seems to be linked to the existence of a critical size for the pores that constitute the implant surface. This observation led to the hypothesis of an adhesive "velcro" effect between the prosthesis and its capsule. Although the latter may not be directly linked to the prevention of capsular contracture it can, however, have a major effect on implant stabilization in cases of primary breast reconstruction and in possible secondary adjustments of asymmetry and malpositioning.

Hollow mandrin facilitates external ventricular drainage placement.

Science.gov (United States)

Heese, O; Regelsberger, J; Kehler, U; Westphal, M

2005-07-01

Placement of ventricular catheters is a routine procedure in neurosurgery. Ventricle puncture is done using a flexible ventricular catheter stabilised by a solid steel mandrin in order to improve stability during brain penetration. A correct catheter placement is confirmed after removing the solid steel mandrin by observation of cerebrospinal fluid (CSF) flow out of the flexible catheter. Incorrect placement makes further punctures necessary. The newly developed device allows CSF flow observation during the puncture procedure and in addition precise intracranial pressure (ICP) measurement. The developed mandrin is hollow with a blunt tip. On one side 4-5 small holes with a diameter of 0.8 mm are drilled corresponding exactly with the holes in the ventricular catheter, allowing CSF to pass into the hollow mandrin as soon as the ventricle is reached. By connecting a small translucent tube at the distal portion of the hollow mandrin ICP can be measured without loss of CSF. The system has been used in 15 patients with subarachnoid haemorrhage (SAH) or intraventricular haemeorrhage (IVH) and subsequent hydrocephalus. The new system improved the external ventricular drainage implantation procedure. In all 15 patients catheter placement was correct. ICP measurement was easy to perform immediately at ventricle puncture. In 4 patients at puncture no spontaneous CSF flow was observed, therefore by connecting a syringe and gentle aspiration of CSF correct placement was confirmed in this unexpected low pressure hydrocephalus. Otherwise by using the conventional technique further punctures would have been necessary. Advantages of the new technique are less puncture procedures with a lower risk of damage to neural structures and reduced risk of intracranial haemorrhages. Implantation of the ventricular catheter to far into the brain can be monitored and this complication can be overcome. Using the connected pressure monitoring tube an exact measurement of the opening

Porous Polymer Drug-Eluting Coating Prepared by Radiation Induced Polymerization

International Nuclear Information System (INIS)

Veres, M.; Beiler, B.; Himics, L.; Tóth, S.; Koós, M.

2010-01-01

Many areas of modern medicine are almost unimaginable without the use of different kinds of implants. They used as replacements, supports, auxiliary devices etc. for various parts or functions of the body. Their use has many advantages, however there could be some drawbacks too, like the possibility of rejection, inflammation and other side-effects. Many of these drawbacks are directly related to the materials used for the implant fabrication. Coatings are widely used to eliminate the unwanted effects appearing after the implantation. In addition to the protection and separation of tissues from the implant material they could also enhance the functionality and the acceptance of the artificial device and also promote the regeneration of the tissues after the intervention. Drug-eluting coatings are a good example for the latter. By delivery and controlled elution of drugs they could actively suppress inflammatory reactions, allergy and rejection of the implant, and their activity is localized to the place where these effects could mainly occur – to the region of the implant. This project is aimed to develop a drug-eluting porous polymer coating by radiation induced polymerization that can be used in different medical implants. The primary objects for this research are coronary stents however these porous layers could have perspective in other types of medical devices too. The main objectives are to develop a method for coating the surface of medical grade metallic alloy wires, plates and tubes with a porous polymer nanocomposite layer prepared by radiation induced polymerization and to characterize the obtained coatings

Porous Polymer Drug-Eluting Coating Prepared by Radiation Induced Polymerization

Energy Technology Data Exchange (ETDEWEB)

Veres, M.; Beiler, B.; Himics, L.; Tóth, S.; Koós, M., E-mail: vm@szfki.hu [Hungarian Academy of Sciences, Research Institute for Solid State Physics and Optics, Department of Laser Applications, Konkoly Thege Miklós ut 29-33, 1121 Budapest, P.O. Box 49, 1525 Budapest (Hungary)

2010-07-01

Many areas of modern medicine are almost unimaginable without the use of different kinds of implants. They used as replacements, supports, auxiliary devices etc. for various parts or functions of the body. Their use has many advantages, however there could be some drawbacks too, like the possibility of rejection, inflammation and other side-effects. Many of these drawbacks are directly related to the materials used for the implant fabrication. Coatings are widely used to eliminate the unwanted effects appearing after the implantation. In addition to the protection and separation of tissues from the implant material they could also enhance the functionality and the acceptance of the artificial device and also promote the regeneration of the tissues after the intervention. Drug-eluting coatings are a good example for the latter. By delivery and controlled elution of drugs they could actively suppress inflammatory reactions, allergy and rejection of the implant, and their activity is localized to the place where these effects could mainly occur – to the region of the implant. This project is aimed to develop a drug-eluting porous polymer coating by radiation induced polymerization that can be used in different medical implants. The primary objects for this research are coronary stents however these porous layers could have perspective in other types of medical devices too. The main objectives are to develop a method for coating the surface of medical grade metallic alloy wires, plates and tubes with a porous polymer nanocomposite layer prepared by radiation induced polymerization and to characterize the obtained coatings.

Immediate Loading of Tapered Implants Placed in Postextraction Sockets and Healed Sites.

Science.gov (United States)

Han, Chang-Hun; Mangano, Francesco; Mortellaro, Carmen; Park, Kwang-Bum

2016-07-01

The aim of the present study was to compare the survival, stability, and complications of immediately loaded implants placed in postextraction sockets and healed sites. Over a 2-year period, all patients presenting with partial or complete edentulism of the maxilla and/or mandible (healed site group, at least 4 months of healing after tooth extraction) or in need of replacement of nonrecoverable failing teeth (postextraction group) were considered for inclusion in this study. Tapered implants featuring a nanostructured calcium-incorporated surface were placed and loaded immediately. The prosthetic restorations comprised single crowns, fixed partial dentures, and fixed full arches. Primary outcomes were implant survival, stability, and complications. Implant stability was assessed at placement and at each follow-up evaluation (1 week, 3 months, and 1 year after placement): implants with an insertion torque (IT) sockets of 17 patients, and 32 implants were placed in healed sites of 22 patients. There were no statistically significant differences in ISQ values between the 2 groups, at each assessment. In total, 60 implants (96.8%) had an IT ≥45 and an ISQ ≥70 at placement and at each follow-up control: all these implants were successfully loaded. Only 2 implants (1 in a postextraction socket and 1 in a healed site, 3.2%) could not achieve an IT ≥45 N·cm and/or an ISQ ≥70 at placement or over time: accordingly, these were considered failed for stability, as they could not be subjected to immediate loading. One of these 2 implants, in a healed site of a posterior maxilla, had to be removed, yielding an overall 1-year implant survival rate of 98.4%. No complications were reported. No significant differences were reported between the 2 groups with respect to implant failures and complications. Immediately loaded implants placed in postextraction sockets and healed sites had similar high survival and stability, with no reported complications. Further long

A novel approach to fabrication of three-dimensional porous titanium with controllable structure

Energy Technology Data Exchange (ETDEWEB)

Wang, Dong; Li, Qiuyan; Xu, Mingqin; Jiang, Guofeng; Zhang, Yunxia [Shanghai Key Laboratory of Materials Laser Processing and Modification, and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240 (China); He, Guo, E-mail: ghe@sjtu.edu.cn [Shanghai Key Laboratory of Materials Laser Processing and Modification, and State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240 (China); Collaborative Innovation Center for Advanced Ship and Deep-Sea Exploration, Shanghai 200240 (China)

2017-02-01

A new approach to fabrication of porous titanium by using the molybdenum wire as space holder was developed, in which titanium liquid was cast into the entangled molybdenum wires in a vacuum environment, and followed by etching off the space holder material in an aqua regia solution. This infiltration casting and acid corrosion method fabricated the porous titanium with different porosities with a pore diameter of 0.4 mm. The porous titanium with the porosity of 32–47% exhibited the Young's modulus in the range of 23–62 GPa and the yielding strength in the range of 76–192 MPa. The adhesion and spreadability of the bovine osteoblast cells on the porous titanium were also evaluated in vitro. The porous titanium with 47% porosity has great potential for implant applications. - Highlights: • A new approach to fabrication of porous titanium was developed. • The 3D morphology of the interconnected porous structure can be exactly controlled. • The as-prepared porous titanium exhibits adequate yielding strength. • The elastic modulus of the porous titanium matches well with that of cortical bone. • The as-prepared porous titanium has great potential for implant applications.

Implantation and Stability of Metallic Fiducials Within Pulmonary Lesions

International Nuclear Information System (INIS)

Kupelian, Patrick A.; Forbes, Alan; Willoughby, Twyla R. M.S.; Wallace, Karen; Manon, Rafael R.; Meeks, Sanford L.; Herrera, Luis; Johnston, Alan; Herran, Juan J.

2007-01-01

Purpose: To report and describe implantation techniques and stability of metallic fiducials in lung lesions to be treated with external beam radiotherapy. Methods and Materials: Patients undergoing radiation therapy for small early-stage lung cancer underwent implantation with small metallic markers. Implantation was either transcutaneous under computed tomographic (CT) or fluoroscopic guidance or transbronchial with the superDimension/Bronchus system (radiofrequency signal-based bronchoscopy guidance related to CT images). Results: Implantation was performed transcutaneously in 15 patients and transbronchially in 8 patients. Pneumothorax occurred with eight of the 15 transcutaneous implants, six of which required chest tube placement. None of the patients who underwent transbronchial implantation developed pneumothorax. Successfully inserted markers were all usable during gated image-guided radiotherapy. Marker stability was determined by observing the variation in gross target volume (GTV) centroid relative to the marker on repeated CT scans. Average three-dimensional variation in the GTV center relative to the marker was 2.6 ± 1.3 (SD) mm, and the largest variation along any anatomic axis for any patient was <5 mm. Average GTV volume decrease during the observation period was 34% ± 23%. Gross tumor volumes do not appear to shrink uniformly about the center of the tumor, but rather the tumor shapes deform substantially throughout treatment. Conclusions: Transbronchial marker placement is less invasive than transcutaneous placement, which is associated with high pneumothorax rates. Although marker geometry can be affected by tumor shrinkage, implanted markers are stable within tumors throughout the treatment duration regardless of implantation method

Aligned ion implantation using scanning probes

International Nuclear Information System (INIS)

Persaud, A.

2006-01-01

A new technique for precision ion implantation has been developed. A scanning probe has been equipped with a small aperture and incorporated into an ion beamline, so that ions can be implanted through the aperture into a sample. By using a scanning probe the target can be imaged in a non-destructive way prior to implantation and the probe together with the aperture can be placed at the desired location with nanometer precision. In this work first results of a scanning probe integrated into an ion beamline are presented. A placement resolution of about 120 nm is reported. The final placement accuracy is determined by the size of the aperture hole and by the straggle of the implanted ion inside the target material. The limits of this technology are expected to be set by the latter, which is of the order of 10 nm for low energy ions. This research has been carried out in the context of a larger program concerned with the development of quantum computer test structures. For that the placement accuracy needs to be increased and a detector for single ion detection has to be integrated into the setup. Both issues are discussed in this thesis. To achieve single ion detection highly charged ions are used for the implantation, as in addition to their kinetic energy they also deposit their potential energy in the target material, therefore making detection easier. A special ion source for producing these highly charged ions was used and their creation and interactions with solids of are discussed in detail. (orig.)

Evaluation of biological properties of electron beam melted Ti6Al4V implant with biomimetic coating in vitro and in vivo.

Directory of Open Access Journals (Sweden)

Xiang Li

Full Text Available BACKGROUND: High strength porous titanium implants are widely used for the reconstruction of craniofacial defects because of their similar mechanical properties to those of bone. The recent introduction of electron beam melting (EBM technique allows a direct digitally enabled fabrication of patient specific porous titanium implants, whereas both their in vitro and in vivo biological performance need further investigation. METHODS: In the present study, we fabricated porous Ti6Al4V implants with controlled porous structure by EBM process, analyzed their mechanical properties, and conducted the surface modification with biomimetic approach. The bioactivities of EBM porous titanium in vitro and in vivo were evaluated between implants with and without biomimetic apatite coating. RESULTS: The physical property of the porous implants, containing the compressive strength being 163 - 286 MPa and the Young's modulus being 14.5-38.5 GPa, is similar to cortical bone. The in vitro culture of osteoblasts on the porous Ti6Al4V implants has shown a favorable circumstance for cell attachment and proliferation as well as cell morphology and spreading, which were comparable with the implants coating with bone-like apatite. In vivo, histological analysis has obtained a rapid ingrowth of bone tissue from calvarial margins toward the center of bone defect in 12 weeks. We observed similar increasing rate of bone ingrowth and percentage of bone formation within coated and uncoated implants, all of which achieved a successful bridging of the defect in 12 weeks after the implantation. CONCLUSIONS: This study demonstrated that the EBM porous Ti6Al4V implant not only reduced the stress-shielding but also exerted appropriate osteoconductive properties, as well as the apatite coated group. The results opened up the possibility of using purely porous titanium alloy scaffolds to reconstruct specific bone defects in the maxillofacial and orthopedic fields.

Nasopalatine duct cyst associated with dental implant treatment: A case report

Directory of Open Access Journals (Sweden)

Shintaro Sukegawa, DDS, PhD

2015-09-01

Full Text Available Maxillary anterior implants are associated with the risk of nasopalatine canal damage. Here we present the case of a 37-year-old man who developed a nasopalatine duct cyst after maxillary implant placement. The patient received an implant 3 months after the extraction of a fractured maxillary right central incisor. At a maintenance visit 9 years after the procedure, he complained of swelling and mild pain in the palatal region of the implant. A panoramic radiograph and computed tomography (CT scan revealed a large, well-circumscribed, periapical radiolucency surrounding the apical portion of the implant and extending to the nasopalatine duct. We removed the entire lesion without removing the implant. Histopathologic examination of the resected specimen revealed a nasopalatine duct cyst. Accidental contact with the nasopalatine canal during implant surgery may have led to the development of the nasopalatine duct cyst. Careful planning using a preoperative CT scan prior to implant placement may prevent such complications.

3D Printing Guide Implant Placement: A Case Report

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Vlahović Zoran

2017-03-01

Full Text Available Background: Cone Beam Computer Tomography (CBCT is representing a new concept of radiological diagnostics and its application occupies a special place in implantology. Today, preoperative planning, and quantitative and qualitative jaw bone analysis cannot be done without the use of these techniques. The latest in a series of achievements in this field is a method of making a guide for implant using a 3D printing technique. This way pre implantology planning reduces the chance of surgical complications to a minimum and allows installation of dental implants in the most optimal position for future prosthetic work. Aim: To show benefits of guide implantation in clinical practice.

When is an implant ready for a tooth?

Science.gov (United States)

Tupac, Robert G

2003-12-01

The capability of placing an osseointegrated implant at the time of tooth extraction and immediately placing a restoration on the implant depends upon a number of factors. This paper describes the traditional Brånemark protocol, the evolution of single-stage surgery, the guidelines for immediate placement, the measurement of implant stability, and the considerations critical to immediately loading.

Injectable loop recorder implantation in an ambulatory setting by advanced practice providers: Analysis of outcomes.

Science.gov (United States)

Kipp, Ryan; Young, Natasha; Barnett, Anne; Kopp, Douglas; Leal, Miguel A; Eckhardt, Lee L; Teelin, Thomas; Hoffmayer, Kurt S; Wright, Jennifer; Field, Michael

2017-09-01

Implantable loop recorder (ILR) insertion has historically been performed in a surgical environment such as the electrophysiology (EP) lab. The newest generation loop recorder (Medtronic Reveal LINQ™, Minneapolis, MN, USA) is injectable with potential for implantation in a non-EP lab setting by advanced practice providers (APPs) facilitating improved workflow and resource utilization. We report the safety and efficacy of injectable ILR placement in the ambulatory care setting by APPs. A retrospective review was performed including all patients referred for injectable ILR placement from March 2014 to November 2015. All device placement procedures were performed in an ambulatory care setting using the standard manufacturer deployment kit with sterile technique and local anesthetic following a single dose of intravenous antibiotics. Acute procedural success and complication rates following injectable ILR placement in the ambulatory setting were reviewed. During the study period, 125 injectable ILRs were implanted. Acute procedural success with adequate sensing (R-waves ≥ 0.2 mV) occurred in 100% of patients. There were no acute procedural complications. Subacute complications occurred in two patients (1.6% of implantations), including one possible infection treated with oral antibiotics and one device removal due to pain at the implant site. In this retrospective single-center study, implantation of injectable ILR in an ambulatory care setting by APPs following a single dose of intravenous antibiotics and standard manufacturer technique yielded a low complication rate with high acute procedural success. Use of this implantation strategy may improve EP lab workflow while providing a safe and effective technique for device placement. © 2017 Wiley Periodicals, Inc.

Tooth Retained Implant: No More an Oxymoron

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Divya Bhat

2011-03-01

Full Text Available Introduction: Periodontally af-fected teeth are treated in one of the two ways. (1 Tooth retention after periodontal surgery, in which the degree of regeneration achieved is unpredictable. (2 Tooth extrac-tion and implant placement. Implants have an osseointegrated surface which does not provide adequate shock absorption. Regeneration can be achieved by resecting the crown of the affected tooth and submerging the root. This technique has not had a clinical application so far as the tooth becomes difficult to restore. Placing an implant within the root can make the retained root restorable. At the same time, as the implant is placed within the root surface it achieves a periodontal integration which dampens occlusal forces better than osseointegration. Therefore, such a “tooth retained implant” may serve as an additional treatment option with significant benefits over tooth retention and implant placement alone. The hypothesis: Implants placed within retained roots have shown cementum deposition and attachment of periodontal ligament fibers over their surface. This periodontal attachment may be able to dam-pen forces better than in an osseointegrated implant. Moreover, since an implant is being placed, the crown of the tooth can be resected and submerged. This prevents epithelial migration, allows for the periodontal ligament cells to populate the wound and favors regeneration.Evaluation of the hypothesis: The technique of placing implants within cavities prepared in the root and then submerging them are simple for any practitioner placing implants routinely.

Use of platelet rich fibrin in a fenestration defect around an implant

Directory of Open Access Journals (Sweden)

R Vijayalakshmi

2012-01-01

Full Text Available Guided bone regeneration (GBR in implant therapy is especially useful for implant placement with dehiscence defects or fenestration defects. In alveolar ridges with marked facial/buccal depressions or in knifeedge alveolar crests, the position and direction of fixture placement is restricted. Improvement of alveolar ridge morphology becomes possible with GBR. This article describes a case in which the fenestration defect around an implant was treated by the application of platelet rich fibrin, a second generation platelet concentrate along with bone graft, and guided tissue regeneration membrane.

Surface modification of porous titanium with rice husk as space holder

Science.gov (United States)

Wang, Xinsheng; Hou, Junjian; Liu, Yanpei

2018-06-01

Porous titanium was characterized after its surface modification by acid and alkali solution immersion. The results show that the acid surface treatment caused the emergence of flocculent sodium titanate and induced apatite formation. The surface modification of porous titanium promotes biological activation, and the application of porous titanium is also improved as an implant material because of the existence of C and Si.

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.

Comparison of a novel porous titanium construct (Regenerex®) to a well proven porous coated tibial surface in cementless total knee arthroplasty - A prospective randomized RSA study with two-year follow-up

DEFF Research Database (Denmark)

Winther, Nikolaj Sebastian; Jensen, Claus Lindkær; Jensen, Claus Munk

2016-01-01

BACKGROUND: Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biomechanical characteristics close to that of normal trabecular bone. The aim of this study was to compare this novel construct to a well-proven porous plasma sprayed tibial (PPS) implant aft...

Maxillary Three-Implant Overdentures Opposing Mandibular Two-Implant Overdentures: 10-Year Surgical Outcomes of a Randomized Controlled Trial.

Science.gov (United States)

Ma, Sunyoung; Tawse-Smith, Andrew; De Silva, Rohana K; Atieh, Momen A; Alsabeeha, Nabeel H M; Payne, Alan G T

2016-06-01

The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years. Implant stability quotients were 56.05, 57.54, 60.88, 58.80, 61.17 at surgery, 12 weeks, 1 year, 5 years, and 10 years. Four-field tables by implant showed success rates of 82% at 1 year; 69.2% at 2 years; 66.7% at 5 years; 61.5% at 7 years; 51.3% at 10 years. Data showed no differences between surgical technique, systems, or prosthodontic designs. Surgical placement with osteotomes of three narrow diameter implants for maxillary overdentures, opposing mandibular two-implant overdentures, is an acceptable approach, subject to strict patient selection. Implant success is independent of prosthodontic design. © 2015 Wiley Periodicals, Inc.

Computer-Aided Process Planning for the Layered Fabrication of Porous Scaffold Matrices

Science.gov (United States)

Starly, Binil

Rapid Prototyping (RP) technology promises to have a tremendous impact on the design and fabrication of porous tissue replacement structures for applications in tissue engineering and regenerative medicine. The layer-by-layer fabrication technology enables the design of patient-specific medical implants and complex structures for diseased tissue replacement strategies. Combined with advancements in imaging modalities and bio-modeling software, physicians can engage themselves in advanced solutions for craniofacial and mandibular reconstruction. For example, prior to the advancement of RP technologies, solid titanium parts used as implants for mandibular reconstruction were fashioned out of molding or CNC-based machining processes (Fig. 3.1). Titanium implants built using this process are often heavy, leading to increased patient discomfort. In addition, the Young's modulus of titanium is almost five times that of healthy cortical bone resulting in stress shielding effects [1,2]. With the advent of CAD/CAM-based tools, the virtual reconstruction of the implants has resulted in significant design improvements. The new generation of implants can be porous, enabling the in-growth of healthy bone tissue for additional implant fixation and stabilization. Newer implants would conform to the external shape of the defect site that is intended to be filled in. More importantly, the effective elastic modulus of the implant can be designed to match that of surrounding tissue. Ideally, the weight of the implant can be designed to equal the weight of the tissue that is being replaced resulting in increased patient comfort. Currently, such porous structures for reconstruction can only be fabricated using RP-based metal fabrication technologies such as Electron Beam Melting (EBM), Selective Laser Sintering (SLS®), and 3D™ Printing processes.

A Novel Surgical Template Design in Staged Dental Implant Rehabilitations

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Michael Patras

2012-05-01

Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.

In Vitro Evaluation of PCL and P(3HB) as Coating Materials for Selective Laser Melted Porous Titanium Implants.

Science.gov (United States)

Grau, Michael; Matena, Julia; Teske, Michael; Petersen, Svea; Aliuos, Pooyan; Roland, Laura; Grabow, Niels; Murua Escobar, Hugo; Gellrich, Nils-Claudius; Haferkamp, Heinz; Nolte, Ingo

2017-11-23

Titanium is widely used as a bone implant material due to its biocompatibility and high resilience. Since its Young's modulus differs from bone tissue, the resulting "stress shielding" could lead to scaffold loosening. However, by using a scaffold-shaped geometry, the Young's modulus can be adjusted. Also, a porous geometry enables vascularisation and bone ingrowth inside the implant itself. Additionally, growth factors can improve these effects. In order to create a deposit and release system for these factors, the titanium scaffolds could be coated with degradable polymers. Therefore, in the present study, synthetic poly-ε-caprolactone (PCL) and the biopolymer poly(3-hydroxybutyrate) (P(3HB)) were tested for coating efficiency, cell adhesion, and biocompatibility to find a suitable coating material. The underlying scaffold was created from titanium by Selective Laser Melting (SLM) and coated with PCL or P(3HB) via dip coating. To test the biocompatibility, Live Cell Imaging (LCI) as well as vitality and proliferation assays were performed. In addition, cell adhesion forces were detected via Single Cell Force Spectroscopy, while the coating efficiency was observed using environmental scanning electron microscopy (ESEM) and energy-dispersive X-ray (EDX) analyses. Regarding the coating efficiency, PCL showed higher values in comparison to P(3HB). Vitality assays revealed decent vitality values for both polymers, while values for PCL were significantly lower than those for blank titanium. No significant differences could be observed between PCL and P(3HB) in proliferation and cell adhesion studies. Although LCI observations revealed decreasing values in cell number and populated area over time on both polymer-coated scaffolds, these outcomes could be explained by the possibility of coating diluent residues accumulating in the culture medium. Overall, both polymers fulfill the requirements regarding biocompatibility. Nonetheless, since only PCL coating ensured the

In Vitro Evaluation of PCL and P(3HB as Coating Materials for Selective Laser Melted Porous Titanium Implants

Directory of Open Access Journals (Sweden)

Michael Grau

2017-11-01

Full Text Available Titanium is widely used as a bone implant material due to its biocompatibility and high resilience. Since its Young’s modulus differs from bone tissue, the resulting “stress shielding” could lead to scaffold loosening. However, by using a scaffold-shaped geometry, the Young’s modulus can be adjusted. Also, a porous geometry enables vascularisation and bone ingrowth inside the implant itself. Additionally, growth factors can improve these effects. In order to create a deposit and release system for these factors, the titanium scaffolds could be coated with degradable polymers. Therefore, in the present study, synthetic poly-ε-caprolactone (PCL and the biopolymer poly(3-hydroxybutyrate (P(3HB were tested for coating efficiency, cell adhesion, and biocompatibility to find a suitable coating material. The underlying scaffold was created from titanium by Selective Laser Melting (SLM and coated with PCL or P(3HB via dip coating. To test the biocompatibility, Live Cell Imaging (LCI as well as vitality and proliferation assays were performed. In addition, cell adhesion forces were detected via Single Cell Force Spectroscopy, while the coating efficiency was observed using environmental scanning electron microscopy (ESEM and energy-dispersive X-ray (EDX analyses. Regarding the coating efficiency, PCL showed higher values in comparison to P(3HB. Vitality assays revealed decent vitality values for both polymers, while values for PCL were significantly lower than those for blank titanium. No significant differences could be observed between PCL and P(3HB in proliferation and cell adhesion studies. Although LCI observations revealed decreasing values in cell number and populated area over time on both polymer-coated scaffolds, these outcomes could be explained by the possibility of coating diluent residues accumulating in the culture medium. Overall, both polymers fulfill the requirements regarding biocompatibility. Nonetheless, since only PCL

Progressive immediate loading of a perforated maxillary sinus dental implant: a case report

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Al-Juboori MJ

2015-01-01

Full Text Available Mohammed Jasim Al-Juboori Department of Oral Surgery, MAHSA University, Kuala Lumpur, Malaysia Abstract: The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement. Keywords: progressive implant loading, resonance frequency analysis, implant stability, provisional crown, bone density, maxillary sinus

Spiral Computed Tomography Based Maxillary Sinus Imaging in Relation to Tooth Loss, Implant Placement and Potential Grafting Procedure

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Reinhilde Jacobs

2010-01-01

Full Text Available Objectives: The purpose of the present study was to explore the maxillary sinus anatomy, its variations and volume in patients with a need for maxillary implant placement.Materials and Methods: Maxillary sinus data of 101 consecutive patients who underwent spiral computed tomography (CT scans for preoperative implant planning in the maxilla at the Department of Periodontology, University Hospital, Catholic University of Leuven, Leuven, Belgium were retrospectively evaluated. The alveolar bone height was measured on serial cross-sectional images between alveolar crest and sinus floor, parallel to the tooth axis. In order to describe the size of the maxillary sinus anteroposterior (AP and mediolateral (ML diameters of the sinus were measured.Results: The results indicated that the alveolar bone height was significantly higher in the premolar regions in comparison to the molar region (n = 46, P 4 mm mucosal thickening mostly at the level of the sinus floor. The present sample did not allow revealing any significant difference (P > 0.05 in maxillary sinus dimensions for partially dentate and edentulous subjects.Conclusions: Cross-sectional imaging can be used in order to obtain more accurate information on the morphology, variation, and the amount of maxillary bone adjacent to the maxillary sinus.

Osteonecrosis of the jaw after dental implant placement. A case report

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J.L. Calvo-Guirado

2014-03-01

Full Text Available Background: In the past few years, the occurrence of an oral lesion, called osteonecrosis of the jaw, has increasingly been reported in patients undergoing treatment with systemic bisphosphonates (BPs; however, few papers dealing with oral biphosphonates related osteonecrosis of the jaws (BRONJ can be found in the literature. The purpose of the present case was to report an occurrence of BRONJ after implant insertion. Case report: Ten years ago, eight dental implants were inserted in the jaw of a 65-year-old female. After 5 years of treatment with alendronic acid, a breakdown of the oral mucosa covering the implants occurred with a purulent discharge in the left side of the jaw; periapical radiolucency was present around both distal implants. An en-block resection of the alveolar bone including the two implants was performed. Thirthy-five hyperbaric sessions were taken and no signs of recurrence of the lesion were observed after a follow-up of 20 months. Before the new implant insertion, the patient had suspended the treatment with alendronic acid for 6 months. At the interface of one of the implants, a gap was observed between bone and implant. This bone was non vital, and many osteocyte lacunae were empty. Moreover, this bone appeared to be partially demineralized. Conclusion: There is certainly a temporal association between oral BPs use and development of BRONJ, but a correlation does not necessarily mean causation. In patients undergoing oraltreatment, clinicians must be aware of the increased risk of implant failure.

Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

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Peter Magnusson

2017-04-01

Full Text Available BackgroundA pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket.MethodsIn October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device.ConclusionsPOCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

Placement Of Cardiac PacemaKEr Trial (POCKET – rationale and design: a randomized controlled trial

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Peter Magnusson

2017-04-01

Full Text Available Background: A pacemaker system consists of one or two leads connected to a device that is implanted into a pocket formed just below the collarbone. This pocket is typically subcutaneous, that is, located just above the pectoral fascia. Even though the size of pacemakers has decreased markedly, complications due to superficial implants do occur. An alternative technique would be intramuscular placement of the pacemaker device, but there are no randomized controlled trials (RCTs to support this approach, which is the rationale for the Placement Of Cardiac PacemaKEr Trial (POCKET. The aim is to study if intramuscular is superior to subcutaneous placement of a pacemaker pocket. Methods: In October 2016, we started to enroll 200 consecutive patients with an indication for bradycardia pacemaker implantation. Patients are randomized to random block sizes, stratified by age group (cut-off: 65 years and sex, and then randomized to either subcutaneous or intramuscular implant. A concealed allocation procedure is employed, using sequentially numbered, sealed envelopes. Pocket site is blinded to the patient and in all subsequent care. The primary endpoint is patient overall satisfaction with the pocket location at 24 months as measured using a visual analog scale (VAS 0-10. Secondary endpoints are: complications, patient-reported satisfaction at 1, 12, and 24 months (overall satisfaction, pain, discomfort, degree of unsightly appearance, movement problems, and sleep problems due to device. Conclusions: POCKET is a prospective interventional RCT designed to evaluate if intramuscular is superior to subcutaneous placement of a bradycardia pacemaker during a two-year follow-up.

Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

International Nuclear Information System (INIS)

Ko, Gi Young; Lee, Im Sick; Choi, Won Chan

2004-01-01

To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications

Placement of an implantable port catheter in the biliary stent: an experimental study in dogs

Energy Technology Data Exchange (ETDEWEB)

Ko, Gi Young; Lee, Im Sick; Choi, Won Chan [Asan Medical Center, Seoul (Korea, Republic of)

2004-04-01

To investigate the feasibility of port catheter placement following a biliary stent placement. We employed 14 mongrel dogs as test subject and after the puncture of their gaIl bladders using sonographic guidance, a 10-mm in diameter metallic stent was placed at the common duct. In 12 dogs, a 6.3 F port catheter was placed into the duodenum through the common duct and a port was secured at the subcutaneous space following stent placement. As a control group, an 8.5 F drain tube was placed into the gallbladder without port catheter placement in the remaining two dogs. Irrigation of the bile duct was performed every week by injection of saline into the port, and the port catheter was replaced three weeks later in two dogs. Information relating to the success of the procedure, complications and the five-week follow-up cholangiographic findings were obtained. Placement of a biliary stent and a port catheter was technically successful in 13 (93%) dogs, while stent migration (n=3), gallbladder rupture (n=1) and death (n=5) due to subcutaneous abscess and peritonitis also occurred. The follow-up was achieved in eight dogs (seven dogs with a port catheter placement and one dog with a drain tube placement). Irrigation of the bile duct and port catheter replacement were successfully achieved without any complications. Cholangiograms obtained five weeks after stent placement showed diffuse biliary dilation with granulation tissue formation. However, focal biliary stricture was seen in one dog with stent placement alone. Placement of a port catheter following biliary stent placement seems to be feasible. However, further investigation is necessary to reduce the current complications.

21 CFR 878.3500 - Polytetrafluoroethylene with carbon fibers composite implant material.

Science.gov (United States)

2010-04-01

... composite implant material. 878.3500 Section 878.3500 Food and Drugs FOOD AND DRUG ADMINISTRATION... Prosthetic Devices § 878.3500 Polytetrafluoroethylene with carbon fibers composite implant material. (a) Identification. A polytetrafluoroethylene with carbon fibers composite implant material is a porous device...

Surface characterization of titanium based dental implants; Caracterizacao de implantes odontologicos a base de titanio

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Castilho, Guilherme Augusto Alcaraz

2006-07-01

Dental implantology uses metallic devices made of commercially pure titanium in order to replace lost teeth. Titanium presents favorable characteristics as bio material and modern implants are capable of integrate, witch is the union between bone and implant without fibrous tissue development. Three of the major Brazilian implant manufacturers were chosen to join the study. A foreign manufacturer participated as standard. The manufacturers had three specimens of each implant with two different surface finishing, as machined and porous, submitted to analysis. Surface chemical composition and implant morphology were analyzed by X-ray photoelectron spectroscopy (XP S), scanning electron microscopy (SEM) and microprobe. Implant surface is mainly composed of titanium, oxygen and carbon. Few contaminants commonly present on implant surface were found on samples. Superficial oxide layer is basically composed of titanium dioxide (TiO{sub 2}), another oxides as Ti O and Ti{sub 2}O{sub 3} were also found in small amount. Carbon on implant surface was attributed to manufacturing process. Nitrogen, Phosphorous and Silicon appeared in smaller concentration on surface. There was no surface discrepancy among foreign and Brazilian made implants. SEM images were made on different magnification, 35 X to 3500 X, and showed similarity among as machined implants. Porous surface finishing implants presented distinct morphology. This result was attributed to differences on manufacturing process. Implant bioactivity was accessed through immersion on simulated body solution (SBF) in order to verify formation of an hydroxyapatite (HA) layer on surface. Samples were divided on three groups according to immersion time: G1 (7 days), G2 (14 days), G3 (21 days), and deep in SBF solution at 37 deg C. After being removed from solution, XPS analyses were made and then implants have been submitted to microprobe analysis. XPS showed some components of SBF solution on sample surface but microprobe

Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture

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Meleşcanu Imre, M; Preoteasa, E; Țâncu, AM; Preoteasa, CT

2013-01-01

Rationale. The imaging methods are more and more used in the clinical process of modern dentistry. Once the implant based treatment alternatives are nowadays seen as being the standard of care in edentulous patients, these techniques must be integrated in the complete denture treatment. Aim. The study presents some evaluation techniques for the edentulous patient treated by conventional dentures or mini dental implants (mini SKY Bredent) overdentures, using the profile teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide that allows the prosthetically driven implants placement. Material and method. Clinical case reports were made, highlighting the importance of cephalometric evaluation on lateral teleradiographs in complete edentulous patients. A clinical case that gradually reports the surgical guide preparation (Bredent silicon radio opaque), in order to place the mini dental implants in the best prosthetic and anatomic conditions, was presented. Conclusions. The profile teleradiograph is a useful tool for the practitioner. It allows establishing the optimal site for implant placement, in a good relation with the overdenture. The conventional denture can be easily and relatively costless transformed in a surgical guide used during implant placement. PMID:23599828

Making Porous Luminescent Regions In Silicon Wafers

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Fathauer, Robert W.; Jones, Eric W.

1994-01-01

Regions damaged by ion implantation stain-etched. Porous regions within single-crystal silicon wafers fabricated by straightforward stain-etching process. Regions exhibit visible photoluminescence at room temperature and might constitute basis of novel class of optoelectronic devices. Stain-etching process has advantages over recently investigated anodic-etching process. Process works on both n-doped and p-doped silicon wafers. Related development reported in article, "Porous Si(x)Ge(1-x) Layers Within Single Crystals of Si," (NPO-18836).

Straightforward Case of Dental Implant in General Dentistry

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Aji P. Tjikman

2013-07-01

Full Text Available Dental implant has become a fast developing and dynamic field in dental practice. It is acknowledged as a predictable treatment modality with high clinical success rates. Conventional fixed prostheses are no longer considered to be the first choice of treatment for replacing a missing tooth. Despite the increasing number of patients requesting dental implant treatments, there are only some clinicians who are offering implant therapy in their daily practice. The International team for Implantology described a straightforward case as a simple case such as implant placements in adquate soft and hard tissue conditions and single-tooth restorations in a non-aesthetic zone. A review of the current literature discussed the implementation of implant dentistry in universities worldwide into their curriculum for both undergraduate and postgraduate programs in general dentistry. The European consensus in implant dentistry education concluded that it is desirable to include the surgical technique for implant placement for straightforward cases into the dental curriculum. The levels and limitations to which the various aspects of implant dentistry and related skills are taught to be determined by the academic community. This review aimed at promoting awareness amongst dental practitioners and institutions in Indonesia of the shifting treatment paradigm in the maangement of a missing tooth. Hence clinicians will be able to include implant dentistry in the treatment planning of their patients and also undertake a significant part in the execution of such treatments.

Management of Retrograde Peri-Implantitis Using an Air-Abrasive Device, Er,Cr:YSGG Laser, and Guided Bone Regeneration

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Nikolaos Soldatos

2018-01-01

Full Text Available Background. The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR. Case Description. A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions. The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.

Percutaneous placement of peritoneal port-catheter in oncologic patients

International Nuclear Information System (INIS)

Orsi, Franco; Vigna, Paolo Della; Bonomo, Guido; Penco, Silvia; Lovati, Elena; Bellomi, Massimo

2004-01-01

The aim of this paper is to describe the technique of percutaneous ultrasound (US)-guided placement of a peritoneal port-catheter in an interventional radiological setting. Nineteen patients with peritoneal carcinomatosis were selected for intraperitoneal port-catheter placement in order to perform intracavitary receptor-immuno- or radio-immunotherapy with Ytrium-90. All the procedures were performed percutaneously under US and fluoro guidance; the insertion site for catheters was chosen according to abdominal conditions and US findings: all devices were implanted at the lower abdominal quadrants. All patients were followed up with CT and US according to the therapy protocol. The procedure was successfully completed in 15/19 patients, in 4 being contraindicated by peritoneal adhesions. No procedure-related complications and device occlusions during therapy were observed; one catheter displaced 7 months later the placement. In our experience, this procedure was feasible, reliable and easy to perform, allowing the correct administration of the planned intracavitary therapy. Peritoneal adhesions are the main limitation of peritoneal port placement. (orig.)

Viability of dental implants in head and neck irradiated patients: A systematic review.

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Zen Filho, Edson Virgílio; Tolentino, Elen de Souza; Santos, Paulo Sérgio Silva

2016-04-01

The purpose of this systematic review was to evaluate the safety of dental implants placed in irradiated bone and to discuss their viability when placed post-radiotherapy (RT). A systematic review was performed to answer the questions: "Are dental implants in irradiated bone viable?" and "What are the main factors that influence the loss of implants in irradiated patients?" The search strategy resulted in 8 publications. A total of 331 patients received 1237 implants, with an overall failure rate of 9.53%. The osseointegration success rates ranged between 62.5% and 100%. The optimal time interval between irradiation and dental implantation varied from 6 to 15 months. The interval time between RT and implant placement and the radiation doses are not associated with significant implant failure rates. The placement of implants in irradiated bone is viable, and head and neck RT should not be considered as a contraindication for dental rehabilitation with implants. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2229-E2240, 2016. © 2015 Wiley Periodicals, Inc.

A multicenter randomized clinical trial of etonogestrel- and levonorgestrel- contraceptive implants with nonrandomized copper-IUD controls: effect on weight variations up to three years after placement.

Science.gov (United States)

Bahamondes, Luis; Brache, Vivian; Ali, Moazzam; Habib, Ndema

2018-05-16

To evaluate weight changes in women randomized to either the etonogestrel (ENG)- or the levonorgestrel (LNG)-releasing contraceptive implants and to compare with users of the TCu380A intrauterine device (IUD). A multi-center randomized trial with 1:1 allocation ratio of the ENG- and the LNG- implants with non-randomized, age-matched control group of women choosing TCu380A IUD. The primary objective was to assess contraceptive efficacy and method continuation rates, and secondarily the incidence of common complaints and side effects (including weight changes) associated with use of the three contraceptives. All women were enrolled in nine centers at seven countries. Weight change was evaluated from time at device(s) placement. Confounders were socio-demographic, baseline weight and body mass index, center, and time from insertion. We used a linear mixed effects regression modeling with random intercept and slope. Weight was compared between the two implants groups and between the implants and the IUD-groups, through linear mixed multivariable regression model. A total of 995, 997 and 971 users in the ENG-, LNG-implant and IUD-groups respectively, were included. At 36months of use, ENG- and LNG-implants users had similar significant mean weight increase of 3.0 kg (95% CI 2.5-3.5) and 2.9 kg (95% CI 2.4-3.4), respectively (p than 50 kg. These findings must be useful for clinicians to counsel implant-users which could improve method continuation. Copyright © 2018. Published by Elsevier Inc.

Functional benefits of implants placed during ablative surgery: A 5-year prospective study on the prosthodontic rehabilitation of 56 edentulous oral cancer patients.

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Wetzels, Jan Willem; Koole, Ron; Meijer, Gert J; de Haan, Anton F J; Merkx, Matthias A W; Speksnijder, Caroline M

2016-04-01

The timing of placement as well as the functional benefit of interforaminal implants in edentulous patients treated for oral cancer is unclear. Fifty-six patients were recruited at 2 institutions. In 1 institution, interforaminal implants were placed during ablative surgery, the other institution used conventional prosthodontics with optional placement of implants postsurgery (postponed-placement). Masticatory performance, bite force, and subjective masticatory function were assessed before and 6 months, 1 year, and 5 years after surgery. Implant-retained overdentures (IODs) demonstrated the highest bite force and the least problems with solid food and food choice. Masticatory performance was equal for IODs and conventional dentures. After 5 years, IODs from patients in the during-ablative-surgery cohort tend to have higher bite force and masticatory performance than those from patients in the postponed-placement cohort. IODs produce the highest overall masticatory function. Implant placement during ablative surgery seems to be functionally beneficial. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2103-E2111, 2016. © 2016 Wiley Periodicals, Inc.

Porous γ-TiAl Structures Fabricated by Electron Beam Melting Process

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Ashfaq Mohammad

2016-01-01

Full Text Available Porous metal structures have many benefits over fully dense structures for use in bio-implants. The designs of porous structures can be made more sophisticated by altering their pore volume and strut orientation. Porous structures made from biocompatible materials such as titanium and its alloys can be produced using electron-beam melting, and recent reports have shown the biocompatibility of titanium aluminide (γ-TiAl. In the present work, we produced porous γ-TiAl structures by electron-beam melting, incorporating varying pore volumes. To achieve this, the individual pore dimensions were kept constant, and only the strut thickness was altered. Thus, for the highest pore volume of ~77%, the struts had to be as thin as half a millimeter. To accomplish such fine struts, we used various beam currents and scan strategies. Microscopy showed that selecting a proper scan strategy was most important in producing these fine struts. Microcomputed tomography revealed no major gaps in the struts, and the fine struts displayed compressive stiffness similar to that of natural bone. The characteristics of these highly-porous structures suggest their promise for use in bio-implants.

Drug delivery via porous silicon: a focused patent review.

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Kulyavtsev, Paulina A; Spencer, Roxanne P

2017-03-01

Although silicon is more commonly associated with computer chips than with drug delivery, with the discovery that porous silicon is a viable biocompatible material, mesoporous silicon with pores between 2 and 50 nm has been loaded with small molecule and biomolecule therapeutics and safely implanted for controlled release. As porous silicon is readily oxidized, porous silica must also be considered for drug delivery applications. Since 2010, only a limited number of US patents have been granted, primarily for ophthalmologic and immunotherapy applications, in contrast to the growing body of technical literature in this area.

Assessment of the Survival of Dental Implants in Irradiated Jaws ...

African Journals Online (AJOL)

frequency of dental implant placement in irradiated jaws from. 2002 to 2008 in India. Table 2 ..... Linsen SS, Martini M, Stark H. Long-term results of endosteal implants following radical oral ... Oral Health 2015:5;1-6. 21. Visch LL, van Waas MA ...

Osseointegration of Plateau Root Form Implants: Unique Healing Pathway Leading to Haversian-Like Long-Term Morphology.

Science.gov (United States)

Coelho, Paulo G; Suzuki, Marcelo; Marin, Charles; Granato, Rodrigo; Gil, Luis F; Tovar, Nick; Jimbo, Ryo; Neiva, Rodrigo; Bonfante, Estevam A

2015-01-01

Endosteal dental implants have been utilized as anchors for dental and orthopedic rehabilitations for decades with one of the highest treatment success rates in medicine. Such success is due to the phenomenon of osseointegration where after the implant surgical placement, bone healing results into an intimate contact between bone and implant surface. While osseointegration is an established phenomenon, the route which osseointegration occurs around endosteal implants is related to various implant design factors including surgical instrumentation and implant macro, micro, and nanometer scale geometry. In an implant system where void spaces (healing chambers) are present between the implant and bone immediately after placement, its inherent bone healing pathway results in unique opportunities to accelerate the osseointegration phenomenon at the short-term and its maintenance on the long-term through a haversian-like bone morphology and mechanical properties.

Successful Rehabilitation of Partial Edentulous Maxilla and Mandible with New Type of Implants: Molecular Precision Implants

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Matteo Danza

2014-01-01

Full Text Available The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. Atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. The immediate load of implants is a universally practiced procedure; nevertheless a successful procedure requires expertise in both the clinical and the reconstructive stages using a solid implant system. Excellent primary stability and high bone-implant contact are only minimal requirements for any type of implant procedure. In this paper we present a case report using a new type of implants. The new type of implants, due to its sophisticated control system of production, provides to the implantologist a safe and reliable implant, with a macromorphology designed to ensure a close contact with the surrounding bone.

Immediate provisional restoration of a single-tooth implant in the esthetic zone: A case report

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Po-Sung Fu

2011-02-01

Full Text Available Immediate implant restoration of single implants may demonstrate a positive effect on peri-implant soft tissue. Placement of a provisional restoration following implant surgery can create soft tissue contours that resemble normal gingival topography before placement of the definitive prosthesis. This article describes a staged approach of the mandibular permanent right central incisor, which was congenital missing. The proper space for restoration of the missing incisor was created through orthodontic treatment. The scheduled implant site was reconstructed using autogenous bone harvested from the chin region. After a healing period of four months, an implant was installed with the connection of a fixed provisional crown to a prefabricated temporary abutment. The soft tissue around the implant healed according to the contours of the provisional restoration and the emergence profile was used to duplicate the definitive restoration. Peri-implant esthetics was achieved through the staged approach and immediate restoration of the implant.

Effect of Flapless Immediate Implantation and Filling the Buccal Gap with Xenograft Material on the Buccal Bone Level: A Randomized Clinical Trial

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Mojgan Paknejad

2017-12-01

Full Text Available Objectives: Following tooth extraction, soft and hard tissue alterations occur; Different factors can affect this process. The objective of this study was to determine the effect of gap filling on buccal alveolar crestal bone level after immediate implant placement after 4- to 6-month observation period.Materials and Methods: This   randomized clinical trial was performed on 20 patients (mean age of 38.8 years requiring tooth extraction in a total of 27 areas in the anterior maxilla. The treatment strategy was as follows: atraumatic flapless tooth extraction, implant placement, insertion of a graft (test group or no material (control group between the implant and the socket wall, connection healing abutment placement and suturing the area. Clinical and cone beam computed tomographic examinations were performed before implant placement (baseline, 24 hours after surgery and 4-6 months (T2 after implant placement, to assess the buccal plate height (BH and implant complications.Results: After 4 months of healing, a reduction in different bone measurements was noticed in the two groups. No statistically significant differences were assessed in bone height measurements between the test and control groups at different time points. The study demonstrated that immediate implantation resulted in 1.30 and 1.66 mm reduction in buccal bone plate in the test and control groups, respectively.Conclusions: The study demonstrated that immediate implantation in the extraction socket together with xenograft failed to prevent bone resorption.

Survival of dental implants placed in sites of previously failed implants.

Science.gov (United States)

Chrcanovic, Bruno R; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

2017-11-01

To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Unilateral placement of the Adiana device after failed bilateral placement of the Essure device for hysteroscopic sterilization.

Science.gov (United States)

Gimpelson, Richard J; Wagner, Corey A

2010-01-01

This case report outlines the successful completion of hysteroscopic sterilization using the Adiana Permanent Contraception device (Hologic, Inc., Bedford, MA) after failure of multiple attempts to bilaterally place the Essure Permanent Birth Control system (Conceptus Inc., Mountain View, CA). The patient desired hysteroscopic sterilization using the Essure system. Although the first coil was easily placed in the right ostium, the second coil could not be passed beyond 2.4 cm into the left ostium. Inasmuch as the Adiana system needs to be passed only 1.4 cm into the ostium, this was found to be adequate for appropriate placement of the implant. Adiana may be an effective alternative to Essure, especially in patients in whom tubal stricture or spasm prevents Essure placement. Copyright © 2010 AAGL. Published by Elsevier Inc. All rights reserved.

Pterygoid implants for maxillofacial rehabilitation of a patient with a bilateral maxillectomy defect.

Science.gov (United States)

Bidra, Avinash S; May, George W; Tharp, Greggory E; Chambers, Mark S

2013-02-01

Bilateral maxillectomy is known to have serious esthetic and functional consequences. The retention and support of a maxillary obturator prosthesis in these patients is particularly challenging. Surgical placement of implants is also challenging because of the lack of available bone. Therefore, implant placement into remote sites such as zygoma has been advocated. Very few articles in the literature have discussed the use of pterygoid/pterygomaxillary implants in patients undergoing maxillectomy. This case report describes the maxillofacial rehabilitation of an elderly man who underwent a bilateral subtotal maxillectomy due to basaloid squamous cell carcinoma of the hard palate. After initial healing, the patient had a pterygoid implant placed on each side of the oral cavity. Zygomatic implants were also attempted, but they failed to osseointegrate. Both pterygoid implants showed successful osseointegration. These 2 implants significantly helped to retain a hollow maxillary obturator prosthesis that aided in improved swallowing, speech, and esthetics. To the authors' knowledge, this is the first report in the literature that describes usage of pterygoid implants for rehabilitation of a patient undergoing bilateral maxillectomy.

Increased crown-to-implant ratio may not be a risk factor for dental implant failure under appropriate plaque control.

Science.gov (United States)

Okada, Shinsuke; Koretake, Katsunori; Miyamoto, Yasunari; Oue, Hiroshi; Akagawa, Yasumasa

2013-01-01

The aim of this study was to evaluate whether increased crown-to-implant (C/I) ratio influences implant stability or not under proper healthy control of peri-implant mucosa. The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control. Five male Beagle-Labrador hybrid dogs (2 years old) were used. Their bilateral mandibular premolar extraction was performed. After allowing 12 weeks for bone healing, 3 types of vertical marginal bone loss were simultaneously prepared randomly. Then, 30 titanium implants were placed in the edentulous areas and defined as High C/I, Mid C/I and Low C/I groups. This time point was designated as the baseline (0 Week). Twelve weeks after implant placement, metal superstructures were cemented to the implants and an occlusal plate was set at the opposite side. At the same time, Calcein green was injected for remodeling evaluation. Implants were loaded by feeding the dogs a hard pellet diet. Tooth brushing was performed 5 days per week during the study to maintain healthy peri-implant mucosa. Twenty-four weeks following implant placement, the interface structure was evaluated clinically, radiologically, and histologically. Implant stability quotient (ISQ) increased with time in all 3 groups, without any significant correlation with the C/I value (p >0.05). Moreover, mean marginal bone loss adjacent around implants in all 3 groups ranged between 0.11 and 0.19 mm, with no significant difference (p >0.05). Many fluorescence-labeled bones are shown in the High C/I group. It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control. These findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model.

Increased crown-to-implant ratio may not be a risk factor for dental implant failure under appropriate plaque control.

Directory of Open Access Journals (Sweden)

Shinsuke Okada

Full Text Available OBJECTIVE: The aim of this study was to evaluate whether increased crown-to-implant (C/I ratio influences implant stability or not under proper healthy control of peri-implant mucosa. The hypothesis of this study is that implant stability can be maintained despite High C/I, under appropriate plaque control. MATERIALS AND METHODS: Five male Beagle-Labrador hybrid dogs (2 years old were used. Their bilateral mandibular premolar extraction was performed. After allowing 12 weeks for bone healing, 3 types of vertical marginal bone loss were simultaneously prepared randomly. Then, 30 titanium implants were placed in the edentulous areas and defined as High C/I, Mid C/I and Low C/I groups. This time point was designated as the baseline (0 Week. Twelve weeks after implant placement, metal superstructures were cemented to the implants and an occlusal plate was set at the opposite side. At the same time, Calcein green was injected for remodeling evaluation. Implants were loaded by feeding the dogs a hard pellet diet. Tooth brushing was performed 5 days per week during the study to maintain healthy peri-implant mucosa. Twenty-four weeks following implant placement, the interface structure was evaluated clinically, radiologically, and histologically. RESULT: Implant stability quotient (ISQ increased with time in all 3 groups, without any significant correlation with the C/I value (p >0.05. Moreover, mean marginal bone loss adjacent around implants in all 3 groups ranged between 0.11 and 0.19 mm, with no significant difference (p >0.05. Many fluorescence-labeled bones are shown in the High C/I group. It is considered that high remodeling activity prevent marginal bone loss in the High C/I group and this may provide favorable implant stability under proper plaque control. CONCLUSION: These findings suggest that increased C/I may not be a risk factor for implant failure if the peri-implant mucosa is kept healthy, as was the case in this animal model.

Prepectoral Implant-Based Breast Reconstruction

Directory of Open Access Journals (Sweden)

Lyndsey Highton, BMBCh, MA, FRCS(Plast

2017-09-01

Conclusion:. Prepectoral implant placement with ADM cover is emerging as an alternative approach for IBR. This method facilitates breast reconstruction with a good cosmetic outcome for patients who want a quick recovery without potential compromise of pectoral muscle function and associated problems.

An unusual case of coronary artery compression that did not preclude successful transcatheter pulmonary valve placement.

Science.gov (United States)

Schwartz, Matthew C; Felix, Donald; Iacono, Karen; Nykanen, David

2018-04-16

During transcatheter pulmonary valve placement, coronary compression observed during simultaneous right ventricular outflow tract angioplasty and coronary angiography typically contraindicates valve implantation. We present a unique patient with tetralogy of Fallot who underwent successful transcatheter Melody valve placement despite coronary compression observed during right ventricular outflow tract balloon angioplasty. © 2018 Wiley Periodicals, Inc.

Principles of subcutaneous port placement.

Science.gov (United States)

Gonda, Shaun J; Li, Ruizong

2011-12-01

The introduction of totally implantable subcutaneous devices in the early 1980s provided patients with secure, reliable venous access and also gave them the ability to move more freely and have a more normal lifestyle with these devices in place. The most common totally implantable device used today is the subcutaneous port. These ports consist of an injection port connected to a catheter. Ports provide a number of advantages compared with other venous catheters; the most important is the reduced risk of infection. These devices have significantly lower rates of infection than nontunneled and tunneled catheters. Additional advantages include less frequent irrigation and minimal home care, and they are less prone to environmental or cutaneous contamination when not being accessed. This article will focus on the placement of these ports. Copyright © 2011 Elsevier Inc. All rights reserved.

The efficacy of short (6 mm) dental implants with a novel thread design.

Science.gov (United States)

Bechara, Soheil; Nimčenko, Tatjana; Kubilius, Ričardas

2017-01-01

To assess efficacy of short (6 mm) implants with a novel macrostructure and thread design placed in a compromised bone situations of edentulous posterior regions of maxilla (3-4 mm of bone height under sinus floor) as compared to results of clinical situations treated with simultaneous maxillary sinus grafting and placement of long (≥10 mm) implants of the same company. Clinical cases of conducted clinical study. Patients with compromised bone height in edentulous posterior regions of maxilla were randomly divided into two groups. Short (6mm length) implant treatment conducted in the test group and simultaneous sinus lift with standard length implant placement treatment in the control group. In general implant stability quotient (ISQ) and marginal bone level (MBL) changes values in both groups were comparable. However, significant negative correlation was found between implant's diameter and MBL changes. Implant's length has little if none impact on initial implant anchorage, especially in greatly compromised residual bone situations. Results have confirmed that implant initial stability mainly depends on implant's macro-design and further its development on implant's micro-design: namely, implant diameter rather than length, tapered shape and improved thread design determines primarily acquired mechanical anchorage, while bioactive surface treatment ensures development of biological stability.

A new testing protocol for zirconia dental implants.

Science.gov (United States)

Sanon, Clarisse; Chevalier, Jérôme; Douillard, Thierry; Cattani-Lorente, Maria; Scherrer, Susanne S; Gremillard, Laurent

2015-01-01

Based on the current lack of standards concerning zirconia dental implants, we aim at developing a protocol to validate their functionality and safety prior their clinical use. The protocol is designed to account for the specific brittle nature of ceramics and the specific behavior of zirconia in terms of phase transformation. Several types of zirconia dental implants with different surface textures (porous, alveolar, rough) were assessed. The implants were first characterized in their as-received state by Scanning Electron Microscopy (SEM), Focused Ion Beam (FIB), X-Ray Diffraction (XRD). Fracture tests following a method adapted from ISO 14801 were conducted to evaluate their initial mechanical properties. Accelerated aging was performed on the implants, and XRD monoclinic content measured directly at their surface instead of using polished samples as in ISO 13356. The implants were then characterized again after aging. Implants with an alveolar surface presented large defects. The protocol shows that such defects compromise the long-term mechanical properties. Implants with a porous surface exhibited sufficient strength but a significant sensitivity to aging. Even if associated to micro cracking clearly observed by FIB, aging did not decrease mechanical strength of the implants. As each dental implant company has its own process, all zirconia implants may behave differently, even if the starting powder is the same. Especially, surface modifications have a large influence on strength and aging resistance, which is not taken into account by the current standards. Protocols adapted from this work could be useful. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis.

Science.gov (United States)

Mello, C C; Lemos, C A A; Verri, F R; Dos Santos, D M; Goiato, M C; Pellizzer, E P

2017-09-01

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) (p=.001). For the marginal bone loss (p=.32), implant stability quotients values (p=.44), and pocket probing depth (p=.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Immediate implants placed in fresh sockets associated to periapical infectious processes. A systematic review

Science.gov (United States)

Álvarez-Camino, Juan C.; Valmaseda-Castellón, Eduard

2013-01-01

Objetives: The development of treated implant surfaces, added to the increase of the aesthetic requirements by the patients has led to a change in the treatment protocols as well as the development of techniques such as the one-fase implants and the immediate prosthetic loading. One of the usual contraindications of the implant treatment is the presence of periapical disease associated to the tooth to be replaced. The aim of this paper is to review the published literature on immediate implant placement in extraction sockets of teeth with periapical pathology, considering the level of scientific evidence, and following the principles of medicine and evidence-based Dentistry. Material and Methods: A search of articles published between 1982 and 2012 was conducted. The search terms immediate, dental implant, extraction, infected, periapical pathology were used. Search was limited to studies in animals and humans, published in english language. Results: 16 articles were selected from a total of 438, which were stratified according to their level of scientific evidence using the SORT criteria (Strength of Recommendation Taxonomy). Studies in both animals and humans presented high rates of implant survival, but human studies are limited to a small number of cases. Discussion and Conclusions: There is a limited evidence regarding implant placement immediately to the extraction of teeth affected by chronic periapical pathology. Following analysis of the articles, and in function of their scientific quality, a type B recommendation is given in favor of the immediate implant placement in fresh sockets associated to periapical infectious processes. Key words:Immediate implant, periapical pathology. PMID:23722139

Reliability of implant surgical guides based on soft-tissue models.

Science.gov (United States)

Maney, Pooja; Simmons, David E; Palaiologou, Archontia; Kee, Edwin

2012-12-01

The purpose of this study was to determine the accuracy of implant surgical guides fabricated on diagnostic casts. Guides were fabricated with radiopaque rods representing implant positions. Cone beam computerized tomograms were taken with guides in place. Accuracy was evaluated using software to simulate implant placement. Twenty-two sites (47%) were considered accurate (13 of 24 maxillary and 9 of 23 mandibular sites). Soft-tissue models do not always provide sufficient accuracy for fabricating implant surgical guides.

The influence of surface porosity on gap-healing around intra-articular implants in the presence of migrating particles

DEFF Research Database (Denmark)

Rahbek, Ole; Kold, Soren; Zippor, Berit

2005-01-01

The aim of the present study was to compare the effect of two different porous coatings on bone ongrowth and on the peri-implant migration of polyethylene (PE) particles. Porous-coated cylindrical implants with an either plasma-sprayed closed-pore coating (Pl) or titanium fiber metal open-pore co...

Retrospective success and survival rates of dental implants placed after a ridge preservation procedure.

Science.gov (United States)

Apostolopoulos, Peter; Darby, Ivan

2017-04-01

Ridge preservation is any procedure that takes place at the time of, or shortly after an extraction, to minimise resorption of the ridge and maximise bone formation within the socket. The aim of this project is to investigate the outcome of implant treatment following ridge preservation and compare it to an ungrafted implant control group. Following ethics approval, an electronic and manual search of patient records was conducted, and appropriate cases of implant placement following a ridge preservation procedure were identified. Forty-two patients with 51 implants at ridge-preserved sites were examined by one author (PA) with the following parameters assessed at each implant: pocket probing depth, bleeding on probing, presence/absence of plaque and radiographic bone loss. Clinical and radiographic findings were compared to an ungrafted implant control group and analysed by years in function. There was a 100% survival rate of implants in ridge-preserved sites. In the majority of cases, ridge preservation was performed in the anterior maxilla with a flap raised and the use of deproteinised bovine bone mineral and collagen membrane materials. The mean time in function was 31 (±24) months with a range of 2-102 months. Differences in the mean PPD, BOP, plaque index and radiographic bone loss were not statistically significant between implants at ridge-preserved or ungrafted sites. The overall success rate was around 58% for ungrafted implants and around 51% for implants in ridge-preserved sites. However, this difference was not statistically significant. In this retrospective study, implant placement at ridge-preserved sites was a predictable procedure that led to very high survival rates and similar success rates to implant placement at ungrafted sites. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Spontaneous progression of ligature induced peri-implantitis at implants with different surface roughness: an experimental study in dogs

DEFF Research Database (Denmark)

Berglundh, T; Gotfredsen, K; Zitzmann, N U

2007-01-01

: The aim of the current experiment was to study the progression of peri-implantitis around implants with different surface roughness. MATERIAL AND METHODS: In five beagle dogs, three implants with either a sandblasted acid-etched surface (SLA) or a polished surface (P) were installed bilaterally......BACKGROUND: Peri-implantitis is associated with the presence of submarginal plaque, soft-tissue inflammation and advanced breakdown of the supporting bone. The progression of peri-implantitis following varying periods of continuing plaque accumulation has been studied in animal models. OBJECTIVE...... in the edentulous premolar regions. After 3 months on a plaque control regimen, experimental peri-implantitis was induced by ligature placement and plaque accumulation was allowed to progress until about 40% of the height of the supporting bone had been lost. After this 4-month period, ligatures were removed...

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.

Effects of gold coating on experimental implant fixation

DEFF Research Database (Denmark)

Zainali, Kasra; Danscher, Gorm; Jakobsen, Thomas

2009-01-01

Insertions of orthopedic implants are traumatic procedures that trigger an inflammatory response. Macrophages have been shown to liberate gold ions from metallic gold. Gold ions are known to act in an antiinflammatory manner by inhibiting cellular NF-kappa B-DNA binding and suppressing I-kappa B......-kinase activation. The present study investigated whether gilding implant Surfaces augmented early implant osseointegration and implant fixation by its modulatory effect on the local inflammatory response. Ion release was traced by autometallographic silver enhancement. Gold-coated cylindrical porous coated Ti6Al4V...

Tantalum coating of porous carbon scaffold supplemented with autologous bone marrow stromal stem cells for bone regeneration in vitro and in vivo.

Science.gov (United States)

Wei, Xiaowei; Zhao, Dewei; Wang, Benjie; Wang, Wei; Kang, Kai; Xie, Hui; Liu, Baoyi; Zhang, Xiuzhi; Zhang, Jinsong; Yang, Zhenming

2016-03-01

Porous tantalum metal with low elastic modulus is similar to cancellous bone. Reticulated vitreous carbon (RVC) can provide three-dimensional pore structure and serves as the ideal scaffold of tantalum coating. In this study, the biocompatibility of domestic porous tantalum was first successfully tested with bone marrow stromal stem cells (BMSCs) in vitro and for bone tissue repair in vivo. We evaluated cytotoxicity of RVC scaffold and tantalum coating using BMSCs. The morphology, adhesion, and proliferation of BMSCs were observed via laser scanning confocal microscope and scanning electron microscopy. In addition, porous tantalum rods with or without autologous BMSCs were implanted on hind legs in dogs, respectively. The osteogenic potential was observed by hard tissue slice examination. At three weeks and six weeks following implantation, new osteoblasts and new bone were observed at the tantalum-host bone interface and pores. At 12 weeks postporous tantalum with autologous BMSCs implantation, regenerated trabecular equivalent to mature bone was found in the pore of tantalum rods. Our results suggested that domestic porous tantalum had excellent biocompatibility and could promote new bone formation in vivo. Meanwhile, the osteogenesis of porous tantalum associated with autologous BMSCs was more excellent than only tantalum implantation. Future clinical studies are warranted to verify the clinical efficacy of combined implantation of this domestic porous tantalum associated with autologous BMSCs implantation and compare their efficacy with conventional autologous bone grafting carrying blood vessel in patients needing bone repairing. © 2016 by the Society for Experimental Biology and Medicine.

Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate

Energy Technology Data Exchange (ETDEWEB)

Gahleitner, Andre E-mail: andre.gahleitner@univie.ac.at; Podesser, Birgit; Schick, Susanne; Watzek, Georg; Imhof, Herwig

2004-09-01

Purpose: Palatal implants (PI) have been introduced for orthodontic treatment of dental and skeletal dysgnathia. Due to the restricted amount of bone in this region, precise preoperative anatomic information is necessary. The aim of this study was to determine whether dental CT could serve as a tool to locate the optimal size and position for orthodontic implant placement. Materials and methods: In 32 patients, where palatal implant placement was planned, axial CT scans of the maxillary bone were acquired. Using a standard dental software package (Easy Vision dental software package 2.1, Philips; Best, The Netherlands), paracoronal views were reconstructed and measurements of palatal bone height in 3 mm increments, dorsally from the incisive canal, were performed in the median and both paramedian regions. Results: The overall mean bone height was 5.01 mm (S.D. 2.60), ranging from 0 to 16.9 mm. The maximum palatal bone height was 6.17 mm (S.D. 2.81) at 6 mm dorsally from the incisive canal. Due to the lack of adequate bone (less than 4 mm), implant placement was not performed in 3 cases (7%). In the remaining 39 cases (93.0%), primary implant stability was achieved and complications, such as perforation of the palate, could be avoided. Conclusion: The results demonstrate that dental CT promises to be a valuable tool in evaluating the potential and optimal size and site for orthodontic implant placement.

Dental CT and orthodontic implants: imaging technique and assessment of available bone volume in the hard palate

International Nuclear Information System (INIS)

Gahleitner, Andre; Podesser, Birgit; Schick, Susanne; Watzek, Georg; Imhof, Herwig

2004-01-01

Purpose: Palatal implants (PI) have been introduced for orthodontic treatment of dental and skeletal dysgnathia. Due to the restricted amount of bone in this region, precise preoperative anatomic information is necessary. The aim of this study was to determine whether dental CT could serve as a tool to locate the optimal size and position for orthodontic implant placement. Materials and methods: In 32 patients, where palatal implant placement was planned, axial CT scans of the maxillary bone were acquired. Using a standard dental software package (Easy Vision dental software package 2.1, Philips; Best, The Netherlands), paracoronal views were reconstructed and measurements of palatal bone height in 3 mm increments, dorsally from the incisive canal, were performed in the median and both paramedian regions. Results: The overall mean bone height was 5.01 mm (S.D. 2.60), ranging from 0 to 16.9 mm. The maximum palatal bone height was 6.17 mm (S.D. 2.81) at 6 mm dorsally from the incisive canal. Due to the lack of adequate bone (less than 4 mm), implant placement was not performed in 3 cases (7%). In the remaining 39 cases (93.0%), primary implant stability was achieved and complications, such as perforation of the palate, could be avoided. Conclusion: The results demonstrate that dental CT promises to be a valuable tool in evaluating the potential and optimal size and site for orthodontic implant placement

Complications and results of subdural grid electrode implantation in epilepsy surgery.

Science.gov (United States)

Lee, W S; Lee, J K; Lee, S A; Kang, J K; Ko, T S

2000-11-01

We assessed the risk of delayed subdural hematoma and other complications associated with subdural grid implantation. Forty-nine patients underwent subdural grid implantation with/without subdural strips or depth electrodes from January 1994 to August 1998. To identify the risk associated with subdural grid implantation, a retrospective review of all patients' medical records and radiological studies was performed. The major complications of 50 subdural grid electrode implantations were as follows: four cases (7.8%) of delayed subdural hematoma at the site of the subdural grid, requiring emergency operation; two cases (3.9%) of infection; one case (2.0%) of epidural hematoma; and one case (2.0%) of brain swelling. After subdural hematoma removal, the electrodes were left in place. CCTV monitoring and cortical stimulation studies were continued thereafter. No delayed subdural hematoma has occurred since routine placement of subdural drains was begun. In our experience the worst complication of subdural grid implantation has been delayed subdural hematoma. Placement of subdural drains and close observation may be helpful to prevent this serious complication.

Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results.

Science.gov (United States)

Rokn, A; Bassir, S H; Rasouli Ghahroudi, A A; Kharazifard, M J; Manesheof, R

2016-01-01

The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6-14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term.

The physicochemical/biological properties of porous tantalum and the potential surface modification techniques to improve its clinical application in dental implantology

Energy Technology Data Exchange (ETDEWEB)

Liu, Yindong [State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu (China); Bao, Chongyun, E-mail: cybao9933@scu.edu.cn [State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu (China); Wismeijer, Daniel [Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, VU University Amsterdam and University of Amsterdam, Amsterdam (Netherlands); Wu, Gang, E-mail: g.wu@acta.nl [Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, VU University Amsterdam and University of Amsterdam, Amsterdam (Netherlands)

2015-04-01

More rapid restoration and more rigid functionality have been pursued for decades in the field of dental implantology. Under such motivation, porous tantalum has been recently introduced to design a novel type of dental implant. Porous tantalum bears interconnected porous structure with pore size ranging from 300 to 600 μm and a porosity of 75–85%. Its elastic modulus (1.3–10 GPa) more closely approximates that of natural cortical (12–18 GPa) and cancellous bone (0.1–0.5 GPa) in comparison with the most commonly used dental materials, such as titanium and titanium alloy (106–115 GPa). Porous tantalum is highly corrosion-resistant and biocompatible. It can significantly enhance the proliferation and differentiation of primary osteoblasts derived from elderly people than titanium. Porous tantalum can allow bone ingrowth and establish not only osseointegration but also osseoincorporation, which will significantly enhance the secondary stability of implants in bone tissue. In this review, we summarize the physicochemical, mechanical and biological properties of porous tantalum. We further discuss the performance of current tantalum dental implants and present the methodologies of surface modifications in order to improve their biological performance.

The physicochemical/biological properties of porous tantalum and the potential surface modification techniques to improve its clinical application in dental implantology

International Nuclear Information System (INIS)

Liu, Yindong; Bao, Chongyun; Wismeijer, Daniel; Wu, Gang

2015-01-01

More rapid restoration and more rigid functionality have been pursued for decades in the field of dental implantology. Under such motivation, porous tantalum has been recently introduced to design a novel type of dental implant. Porous tantalum bears interconnected porous structure with pore size ranging from 300 to 600 μm and a porosity of 75–85%. Its elastic modulus (1.3–10 GPa) more closely approximates that of natural cortical (12–18 GPa) and cancellous bone (0.1–0.5 GPa) in comparison with the most commonly used dental materials, such as titanium and titanium alloy (106–115 GPa). Porous tantalum is highly corrosion-resistant and biocompatible. It can significantly enhance the proliferation and differentiation of primary osteoblasts derived from elderly people than titanium. Porous tantalum can allow bone ingrowth and establish not only osseointegration but also osseoincorporation, which will significantly enhance the secondary stability of implants in bone tissue. In this review, we summarize the physicochemical, mechanical and biological properties of porous tantalum. We further discuss the performance of current tantalum dental implants and present the methodologies of surface modifications in order to improve their biological performance

Osseointegrated implants and auricular defects: a case series study.

Science.gov (United States)

Wright, Robert F; Zemnick, Candice; Wazen, Jack J; Asher, Eric

2008-08-01

The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment. Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow-up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance. Thirty-nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction. The survival rate for bone-anchored titanium implants and prostheses was 100%. Bone-anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive-free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of

Porous hydroxyapatite and biphasic calcium phosphate ceramics promote ectopic osteoblast differentiation from mesenchymal stem cells

Energy Technology Data Exchange (ETDEWEB)

Zhang Lingli; Fan Hongsong; Zhang Xingdong [National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan 610064 (China); Hanagata, Nobutaka; Ikoma, Toshiyuki [Biomaterials Center, National Institute for Materials Science, Tsukuba, Ibaraki 305-0047 (Japan); Maeda, Megumi; Minowa, Takashi, E-mail: HANAGATA.Nobutaka@nims.go.j [Nanotechnology Innovation Center, National Institute for Materials Science, Tsukuba, Ibaraki 305-0047 (Japan)

2009-04-15

Because calcium phosphate (Ca-P) ceramics have been used as bone substitutes, it is necessary to investigate what effects the ceramics have on osteoblast maturation. We prepared three types of Ca-P ceramics with different Ca-P ratios, i.e. hydroxyapatite (HA), beta-tricalcium phosphate ({beta}-TCP), and biphasic calcium phosphate (BCP) ceramics with dense-smooth and porous structures. Comprehensive gene expression microarray analysis of mouse osteoblast-like cells cultured on these ceramics revealed that porous Ca-P ceramics considerably affected the gene expression profiles, having a higher potential for osteoblast maturation. In the in vivo study that followed, porous Ca-P ceramics were implanted into rat skeletal muscle. Sixteen weeks after the implantation, more alkaline-phosphatase-positive cells were observed in the pores of hydroxyapatite and BCP, and the expression of the osteocalcin gene (an osteoblast-specific marker) in tissue grown in pores was also higher in hydroxyapatite and BCP than in {beta}-TCP. In the pores of any Ca-P ceramics, 16 weeks after the implantation, we detected the expressions of marker genes of the early differentiation stage of chondrocytes and the complete differentiation stage of adipocytes, which originate from mesenchymal stem cells, as well as osteoblasts. These marker gene expressions were not observed in the muscle tissue surrounding the implanted Ca-P ceramics. These observations indicate that porous hydroxyapatite and BCP had a greater potential for promoting the differentiation of mesenchymal stem cells into osteoblasts than {beta}-TCP.

Reasons for mini-implants failure: choosing installation site should be valued!

Directory of Open Access Journals (Sweden)

Alberto Consolaro

2014-04-01

Full Text Available Mini-implant loss is often associated with physical and mechanical aspects that result from choosing an inappropriate placement site. It is worth highlighting that: a Interdental alveolar bone crests are flexible and deformable. For this reason, they may not offer the ideal absolute anchorage. The more cervical the structures, the more delicate they are, thus offering less physical support for mini-implant placement; b Alveolar bone crests of triangular shape are more deformable, whereas those of rectangular shape are more flexible; c The bases of the alveolar processes of the maxilla and the mandible are not flexible, for this reason, they are more likely to receive mini-implants; d The more cervical a mini-implant is placed, the higher the risk of loss; the more apical a mini-implant is placed, the better its prognosis will be; e 3D evaluations play a major role in planning the use of mini-implants. Based on the aforementioned considerations, the hypotheses about mini-implant loss are as follows: 1 Deflection of maxillary and mandibular alveolar processes when mini-implants are more cervically placed; 2 Mini-implants placed too near the periodontal ligament, with normal intra-alveolar tooth movement; 3 Low bone density, low thickness and low alveolar bone volume; 4 Low alveolar cortical bone thickness; 5 Excessive pressure inducing trabecular bone microfracture; 6 Sites of higher anatomical weakness in the mandible and the maxilla; 7 Thicker gingival tissue not considered when choosing the mini-implant.

Surgical templates for dental implant positioning; current knowledge and clinical perspectives

Directory of Open Access Journals (Sweden)

Mohammed Zaheer Kola

2015-01-01

Full Text Available Dental implants have been used in a variety of different forms for many years. Since the mid-20 th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

Immediate Loading of Implants in the Edentulous Maxilla with a Fixed Provisional Restoration without Bone Augmentation: A Report on 5-Year Outcomes Data Obtained from a Prospective Clinical Trial.

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Toljanic, Joseph A; Ekstrand, Karl; Baer, Russell A; Thor, Andreas

2016-01-01

Successful immediate loading of implants in the edentulous maxilla has been previously reported. The purpose of this 5-year prospective study was to further assess long-term outcomes following immediate loading of implants in the edentulous maxilla with fixed provisional restorations without the use of bone augmentation procedures. Subjects with edentulous maxillary arches each received six implants placed in native bone without augmentation. Where insufficient posterior bone volume existed, angled implant placement was employed. Fixed provisional restorations were delivered within 24 hours of implant placement. Implant placement locations, insertion torque values, and implant dimensions were recorded. Definitive fixed prostheses were placed within 24 weeks following implantation. Baseline implant site marginal bone levels were measured using periapical radiographs. Baseline peri-implant plaque and bleeding scores were obtained. Subjects were examined 6 months after implant placement and then annually for 5 years with follow-up periapical radiographs and plaque/bleeding scores obtained. Fifty-one subjects received a total of 306 implants. Forty subjects with 232 implants returned for the final follow-up appointment representing a 5-year implant survival proportion of 93% with a mean marginal bone loss of 0.44 ± 1.25 mm for this group. Thirty-nine of these 40 subjects continued to function with fixed restorations with the remaining subject functioning with a non-implant-retained removable prosthesis. Within the limitations of this study, predictable long-term implant rehabilitation outcomes were demonstrated for the edentulous maxilla using an immediate loading protocol without bone augmentation.

The status of undergraduate implant education in dental schools outside the United States.

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Seckinger, R J; Weintraub, A M; Berthold, P; Weintraub, G S

1995-01-01

Over the past 20 years the incorporation of implant dentistry into academia has been documented in some detail for North American dental schools but has not been pursued on an international level. In June of 1993, we surveyed 51 dental schools outside of the United States affiliated with the University of Pennsylvania School of Dental Medicine's Office of International Relations concerning their teaching involvement with implant dentistry. Results from the 44 (86 percent) responding schools suggest that implant dentistry is being incorporated into predoctoral curriculums. Industrialized countries were more inclined to provide implant education. Insufficient time and the thought that the predoctoral level was not the place for implant dentistry were cited as some of the reasons for not incorporating implant dentistry into the curriculum. Oral surgery, prosthodontics, and periodontics departments developed and administered the implant curriculum. Formats varied among schools with respect to allotted time, curricular placement, laboratory experience, and clinical participation. Didactic material most frequently presented included a historical overview, diagnosis and treatment planning, classification of dental implants, and surgical and prosthetic concepts. Clinical involvement varied from actual implant placement to observation of prosthodontic procedures. Results were categorized based on the TOEFL (Test of English as a Foreign Language) classification of countries in six regions.

Biocompatibility assessment of porous chitosan-Nafion and chitosan-PTFE composites in vivo.

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Liu, Bo-Ji; Ma, Li-Nan; Su, Juan; Jing, Wei-Wei; Wei, Min-Jie; Sha, Xian-Zheng

2014-06-01

Chitosan (CS) is widely used as a scaffold material in tissue engineering. The objective of this study was to test whether porous chitosan membrane (PCSM) coating for Nafion used in implantable sensor reduced fibrous capsule (FC) density and promoted superior vascularization compared with PCSM coating for polytetrafluoroethylene (PTFE). PCSM was fabricated with solvent casting/particulate leaching method using silica gel as porogen and characterized in vitro. Then, PCSM-Nafion and PCSM-PTFE composites were assembled with hydrated PCSM and implanted subcutaneously in rats. The histological analysis was performed in comparison with Nafion and PTFE. Implants were explanted 35, 65, and 100 days after the implantation. Histological assessments indicated that both composites achieved presumed effects of porous coatings on decreasing collagen deposition and promoting angiogenesis. PCSM-PTFE exerted higher collagen deposition by area ratio, both within and outside, compared with that of PCSM-Nafion. Angiogenesis within and outside the PCSM-Nafion both increased over time, but that of the PCSM-PTFE within decreased. Copyright © 2013 Wiley Periodicals, Inc.

[Application of a stand-alone interbody fusion cage based on a novel porous TiO2/glass composite. I. Implantation in the sheep cervical spine and radiological evaluation].

Science.gov (United States)

Korinth, M C; Hero, T; Mahnken, A H; Ragoss, C; Scherer, K

2004-12-01

Animals are becoming more and more common as in vitro and in vivo models for the human spine. Especially the sheep cervical spine is stated to be of good comparability and usefulness in the evaluation of in vivo radiological, biomechanical and histological behaviour of new bone replacement materials, implants and cages for cervical spine interbody fusion. In preceding biomechanical in vitro examination human cervical spine specimens were tested after fusion with either a cubical stand-alone interbody fusion cage manufactured from a new porous TiO/glass composite (Ecopore) or polymethyl-methacrylate (PMMA) after discectomy. First experience with the use of the new material and its influence on the primary stability after in vitro application were gained. After fusion of 10 sheep cervical spines in the levels C2/3 and C4/5 in each case with PMMA and with an Ecopore-cage, radiologic as well as computertomographic examinations were performed postoperatively and every 4 weeks during the following 2 and 4 months, respectively. Apart from establishing our animal model, we analysed the radiological changes and the degree of bony fusion of the operated segments during the course. In addition we performed measurements of the corresponding disc space heights (DSH) and intervertebral angles (IVA) for comparison among each other, during the course and with the initial values. Immediately after placement of both implants in the disc spaces the mean DSH and IVA increased (34.8% and 53.9%, respectively). During the following months DSH decreased to a greater extent in the Ecopore-segments than in the PMMA-segments, even to a value below the initial value (p>0.05). Similarly, the IVA decreased in both groups in the postoperative time lapse, but more distinct in the Ecopore-segments (pmodel of the sheep cervical spine. Distinct radiological changes regarding evident subsidence and detectable fusion of the segments, operated on with the new biomaterial, were seen. We demonstrated the

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.

Porous SiO_2 nanofiber grafted novel bioactive glass–ceramic coating: A structural scaffold for uniform apatite precipitation and oriented cell proliferation on inert implant

International Nuclear Information System (INIS)

Das, Indranee; De, Goutam; Hupa, Leena; Vallittu, Pekka K.

2016-01-01

A composite bioactive glass–ceramic coating grafted with porous silica nanofibers was fabricated on inert glass to provide a structural scaffold favoring uniform apatite precipitation and oriented cell proliferation. The coating surfaces were investigated thoroughly before and after immersion in simulated body fluid. In addition, the proliferation behavior of fibroblast cells on the surface was observed for several culture times. The nanofibrous exterior of this composite bioactive coating facilitated homogeneous growth of flake-like carbonated hydroxyapatite layer within a short period of immersion. Moreover, the embedded porous silica nanofibers enhanced hydrophilicity which is required for proper cell adhesion on the surface. The cells proliferated well following a particular orientation on the entire coating by the assistance of nanofibrous scaffold-like structural matrix. This newly engineered composite coating was effective in creating a biological structural matrix favorable for homogeneous precipitation of calcium phosphate, and organized cell growth on the inert glass surface. - Highlights: • Fabricated porous SiO_2 nanofibers grafted composite bioactive glass–ceramic coating on inert glass. • The newly engineered coating facilitates uniformly dense apatite precipitation. • Embedded porous silica nanofibers enhance hydrophilicity of the coated surface. • Cells proliferate well on the entire coating following a particular orientation by the assistance of nanofibers. • The coatings have potential to be used as biological scaffold on the surface of implants.

Survival Rate of Delayed Implants Placed in Healed Extraction Sockets is Significantly Higher Than That of Immediate Implants Placed in Fresh Extraction Sockets.

Science.gov (United States)

Antetomaso, Jordan; Kumar, Satish

2018-03-01

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: a systematic review and meta-analysis. Mello CC, Lemos CAA, Verri FR, Dos Santos DM, Goiato MC, Pellizzer EP. Int J Oral Maxillofac Surg 2017; 46(9):1162-77. None TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data. Copyright © 2017 Elsevier Inc. All rights reserved.

cancerous esophagotracheal fistula: treatment of placement with covered self-expanding metallic stent

International Nuclear Information System (INIS)

Han Xinwei; Li Tianxiao; Wang Ruilin; Fan Qingxia

1997-01-01

Purpose: To treat the esophagotracheal fistula that was the main cause of death in patients with esophageal carcinoma, the placement of the stent was studied. Materials and methods: Under the fluoroscopic guidance, 28 stents (5 stents made in USA and 23 in China) were successfully implanted in all the 28 patients with esophagotracheal fistula. Results: The aphagia of the patients was greatly improved and a normal diet could be swallowed at once after the placement of the stents. The 27 cases of inhalation pneumonia that caused by the fistula was recovered. Conclusion: The result indicated that the treatment with the placement of the covered self-expanding stent is simple, safe, and effective for most patients with aphagia and pneumonia due to esophagotracheal fistula

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.

Correlation between Initial BIC and the Insertion Torque/Depth Integral Recorded with an Instantaneous Torque-Measuring Implant Motor: An in vivo Study.

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Capparé, Paolo; Vinci, Raffaele; Di Stefano, Danilo Alessio; Traini, Tonino; Pantaleo, Giuseppe; Gherlone, Enrico Felice; Gastaldi, Giorgio

2015-10-01

Quantitative intraoperative evaluation of bone quality at implant placement site and postinsertion implant primary stability assessment are two key parameters to perform implant-supported rehabilitation properly. A novel micromotor has been recently introduced allowing to measure bone density at implant placement site and to record implant insertion-related parameters, such as the instantaneous, average and peak insertion torque values, and the insertion torque/depth integral. The aim of this study was to investigate in vivo if any correlation existed between initial bone-to-implant contact (BIC) and bone density and integral values recorded with the instrument. Twenty-five patients seeking for implant-supported rehabilitation of edentulous areas were consecutively treated. Before implant placement, bone density at the insertion site was measured. For each patient, an undersized 3.3 × 8-mm implant was placed, recording the insertion torque/depth integral values. After 15 minutes, the undersized implant was retrieved with a 0.5 mm-thick layer of bone surrounding it. Standard implants were consequently placed. Retrieved implants were analyzed for initial BIC quantification after fixation, dehydration, acrylic resin embedment, sections cutting and grinding, and toluidine-blue and acid fuchsine staining. Correlation between initial BIC values, bone density at the insertion site, and the torque/depth integral values was investigated by linear regression analysis. A significant linear correlation was found to exist between initial BIC and (a) bone density at the insertion site (R = 0.96, explained variance R(2)  = 0.92) and (b) torque/depth integral at placement (R = 0.81, explained variance R(2)  = 0.66). The system provided quantitative, reliable data correlating significantly with immediate postinsertion initial BIC, and could therefore represent a valuable tool both for clinical research and for the oral implantologist in his/her daily clinical

Impact of cone-beam computed tomography on implant planning and on prediction of implant size

Energy Technology Data Exchange (ETDEWEB)

Pedroso, Ludmila Assuncao de Mello; Silva, Maria Alves Garcia Santos, E-mail: ludmilapedroso@hotmail.com [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia; Garcia, Robson Rodrigues [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Medicina Oral; Leles, Jose Luiz Rodrigues [Universidade Paulista (UNIP), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Cirurgia; Leles, Claudio Rodrigues [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Fac. de Odontologia. Dept. de Prevencao e Reabilitacao Oral

2013-11-15

The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning. (author)

Measurement of Primary and Secondary Stability of Dental Implants by Resonance Frequency Analysis Method in Mandible

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Shokri, Mehran; Daraeighadikolaei, Arash

2013-01-01

Background. There is no doubt that the success of the dental implants depends on the stability. The aim of this work was to measure the stability of dental implants prior to loading the implants, using a resonance frequency analysis (RFA) by Osstell mentor device. Methods. Ten healthy and nonsmoker patients over 40 years of age with at least six months of complete or partial edentulous mouth received screw-type dental implants by a 1-stage procedure. RFA measurements were obtained at surgery and 1, 2, 3, 4, 5, 7, and 11 weeks after the implant surgery. Results. Among fifteen implants, the lowest mean stability measurement was for the 4th week after surgery in all bone types. At placement, the mean ISQ obtained with the magnetic device was 77.2 with 95% confidence interval (CI) = 2.49, and then it decreased until the 4th week to 72.13 (95% CI = 2.88), and at the last measurement, the mean implant stability significantly (P value implant placement. These suggestions need to be further assessed through future studies. PMID:23737790

Systemic assessment of patients undergoing dental implant surgeries: A trans- and post-operative analysis

OpenAIRE

Sanjay Byakodi; Sachin Kumar; Rajesh Kumar Reddy; Vipin Kumar; Shipra Sepolia; Shivangi Gupta; Harkanwal Preet Singh

2017-01-01

Background: Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental i...

Standard Enucleation with Aluminium Oxide Implant (Bioceramic Covered with Patient's Sclera