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Parvizi S, Cameron A, Tadakamadla S, Figueredo CMS, Reher P. A Novel Irrigation System to Reduce Heat Generation during Guided Implantology: An In Vitro Study. J Clin Med 2023; 12:3944. [PMID: 37373638 DOI: 10.3390/jcm12123944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; and Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1 °C at 2 mm and 21.4 °C at 6 mm), which was statistically significant when compared with Groups C and D (p < 0.001). Group A showed a lower mean temperature compared with Group B as well; however, it was statistically significant only at 6 mm depth (p < 0.05). In conclusion, the proposed surgical guide has significantly reduced heat generation during implant osteotomy compared to conventional external irrigation. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides such as debris blockage and can be easily incorporated into computer designing and 3D printing software.
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Affiliation(s)
- Somayeh Parvizi
- School of Medicine & Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Andrew Cameron
- School of Medicine & Dentistry, Griffith University, Brisbane, QLD 4111, Australia
| | - Santosh Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, Bendigo, VIC 3552, Australia
| | - Carlos Marcelo S Figueredo
- School of Medicine & Dentistry, Griffith University, Brisbane, QLD 4111, Australia
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, OF Odontologi, OF Orala sjukdomar, 171 77 Stockholm, Sweden
| | - Peter Reher
- School of Medicine & Dentistry, Griffith University, Brisbane, QLD 4111, Australia
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Li S, Tanner A, Romanos G, Delgado-Ruiz R. Heat Accumulation in Implant Inter-Osteotomy Areas-An Experimental In Vitro Study. Biomedicines 2022; 11:biomedicines11010009. [PMID: 36672516 PMCID: PMC9855973 DOI: 10.3390/biomedicines11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/26/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
To examine the influence of the distance between adjacent implant osteotomies on heat accumulation in the inter-osteotomy area, two experimental groups with 15 pairs of osteotomies in Type II polyurethane blocks were compared: 7 mm inter-osteotomy separations (Group A, n = 15) and 14 mm inter-osteotomy separations (Group B, n = 15). An infrared thermographic analysis of thermal changes in the inter-osteotomy area was completed. A one-way analysis of variance (ANOVA) and Fisher post-test were used to determine group differences. Higher temperatures were recorded in Group A at the coronal and middle levels compared to the apical level in both groups. The temperature reached max temperatures at T80s and T100s. In Group A, the threshold for thermal necrosis was exceeded. Meanwhile, Group B did not reach the threshold for thermal necrosis. Preparing adjacent implant osteotomies in dense bone with a 7 mm separation between their centers increases the temperature in the inter-osteotomy area, exceeding the threshold for bone thermal necrosis; meanwhile, increasing the distance between osteotomies reduces the thermal accumulation and the risk for thermal necrosis.
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Affiliation(s)
- Shanlin Li
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Adam Tanner
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
- Correspondence:
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Wills DJ, Prasad A, Gilmer BB, Walsh WR. The thermal profile of self-tapping screws: The effect of insertion speed, power insertion, and screw geometry on heat production at the bone-screw interface. Med Eng Phys 2022; 100:103754. [DOI: 10.1016/j.medengphy.2022.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/24/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
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Dhein J, Haller C, Reichl FX, Milz S, Hickel R, Kollmuss M, Högg C. Intranuclear cell uptake and toxicity of titanium dioxide and zirconia particles as well as bacterial adhesion on dental titanium- and zirconia-implants. Dent Mater 2022; 38:517-528. [PMID: 34991888 DOI: 10.1016/j.dental.2021.12.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Previous studies have shown that particles can be released from dental titanium (Ti)- and zirconia (ZrO2)-implants. Titanium dioxide (TiO2)- and ZrO2-particles were compared regarding their toxicity and intranuclear cell uptake as well as the adhesion of various anaerobic bacteria on Ti- and ZrO2-implants. METHODS Cyto- and genotoxicity of TiO2-microparticles (TiO2-MPs) and TiO2-nanoparticles (TiO2-NPs) in periodontal ligament (PDL)-hTERT cells were determined with XTT test and DNA damage with comet assay. Particle sizes of TiO2- and ZrO2-particles were measured with scanning electron microscope. Intranuclear uptake in PDL-hTERT cells was determined with laser scanning confocal microscopy. Adhesions of relevant anaerobic mouth bacteria Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans on Ti- and ZrO2-implants were investigated by cultivation and counting bacterial colonies. RESULTS Particle size measurements revealed that 99% of the TiO2-NPs had a size below 100 nm and 88% of the TiO2-MPs sizes were between 50 and 200 nm. Following EC50 values were found for particles (mg/l): 92 (TiO2-MPs) and 15 (TiO2-NPs). A significant increase in olive tail moment (OTM) was found for TiO2-NPs at a concentration of 1/10 EC50. TiO2- and ZrO2-NPs had a higher intranuclear cell uptake efficiency, compared to corresponding TiO2- and ZrO2-MPs. All investigated particles could be detected in cell nucleus. Adhesion of all investigated bacterial species was significantly higher on Ti-implants, compared to ZrO2-implants. CONCLUSION Ti usually develops an oxide layer (TiO2). Particles released from Ti-implants should be TiO2-particles or Ti-particles coated with a TiO2-layer. Toxicity of released Ti-particles depends on their oxidation state and on their size (NP or MP). Particularly, NPs were more cyto- and genotoxic compared to the corresponding MPs. TiO2- and ZrO2-NPs showed a significant increase in the intranuclear cell uptake ratio at higher exposure concentration, compared to lower concentrations and consequently might lead to a higher potential of DNA damage. Adhesion of bacteria to ZrO2-implants is reduced, compared to Ti-implants. Therefore, ZrO2-implants might contribute to reduced biological complications (e.g. periimplantitis).
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Affiliation(s)
- Julia Dhein
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Germany
| | - Cornelia Haller
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Germany
| | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Germany
| | - Stefan Milz
- Institute of Anatomy, Neuroanatomy, Faculty of Medicine, LMU Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany
| | - Christof Högg
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany; Walther Straub Institute of Pharmacology and Toxicology, Faculty of Medicine, LMU Munich, Germany.
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Low-speed drilling without irrigation versus conventional drilling for dental implant osteotomy preparation: a systematic review. Clin Oral Investig 2021; 25:4251-4267. [PMID: 33893557 DOI: 10.1007/s00784-021-03939-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE This paper aims to review the evidence comparing low-speed drilling without irrigation versus conventional drilling for dental implant osteotomy preparation. MATERIALS AND METHODS A systematic review was carried out based on the PRISMA statement. Four databases and gray literature were searched up to November 2020. In vitro, animal, and clinical studies were included. The variables were temperature change, drilling time, quantity of harvested bone, osteotomy precision, marginal bone loss, implant success rate, osseointegration, and the histomorphologic characteristics and cellularity of the osteotomy and of the harvested bone. Different tools for the assessment of bias were applied for each study design. RESULTS A total of 626 articles were identified, of which 13 were included. Both low-speed drilling without irrigation (test group) and conventional drilling (control group) maintained temperatures below the critical temperature of 47 °C. The test group yielded a greater quantity and more beneficial cellular and histomorphologic properties of harvested bone, with a longer drilling time and greater osteotomy precision (p < 0.05). No significant results were obtained regarding drill wear, osseointegration, marginal bone loss, implant success rate, and histomorphology of the dental implant osteotomy (p > 0.05). The results, in particular on the osteotomy precision and quantity of harvested bone chips, should be interpreted with caution because outcomes are based in only one in vitro study. CONCLUSIONS Low-speed drilling without irrigation seems to be comparable to conventional drilling in preparing dental implant osteotomies. In some situations, low-speed drilling without irrigation might offer advantages over conventional drilling. The results should be interpreted with caution due to the low percentage of clinical human studies. Accordingly, more clinical studies are needed to improve the scientific evidence on this topic. CLINICAL RELEVANCE The low-speed drilling without irrigation is a valid technique for dental implant osteotomy preparation. Its higher quantity and quality of harvested autologous bone might be particularly beneficial in cases of dental implant placement with minor simultaneous bone regeneration.
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Heuzeroth R, Pippenger BE, Sandgren R, Bellón B, Kühl S. Thermal exposure of implant osteotomies and its impact on osseointegration-A preclinical in vivo study. Clin Oral Implants Res 2021; 32:672-683. [PMID: 33629437 DOI: 10.1111/clr.13729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear. MATERIALS AND METHODS 36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a temperature probe. BIC, fBIC, and tissue reactions were histomorphometrically derived after 2 and 8 weeks of healing. RESULTS Compared to control drills (1) or (2), test drills (3) resulted in significantly lower maximum temperatures ((35.4 (CI 30.2-40.5)°C vs. (46.5 (CI 41.0-52.0)°C, p = .0021)) and shorter drill times ((4.5 (CI 1.6-7.3)sec vs. 10.3 (7.3-13.4)sec). Lower osteotomy temperature values and shorter drill times corroborated with significantly higher BIC after 2 and 8 weeks healing for the test (3) compared to control groups (2) (2 weeks: (44.9 (CI 34.1-55. 7)% vs. (31.3 (CI 20.5-42.2)%, p = <.0001 and 8 weeks: (73.7 ( CI 64.2-83.2)% vs. (66.2 (CI 57.0-75.4)%, p = <.0455). CONCLUSION The improved osseointegration of implants placed after osteotomy preparation with novel test drills using a shortened drill sequence compared to standard drills and conventional drill protocols might be attributed to more favorable thermal profiles and less mechanical stress exerted on the bone surrounding the implant osteotomy.
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Affiliation(s)
- Raphael Heuzeroth
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Benjamin E Pippenger
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Rebecca Sandgren
- Biomedical Center, Faculty of Medicine, Lund University, Lund, Sweden
| | - Benjamin Bellón
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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Kämmerer T, Lesmeister T, Palarie V, Schiegnitz E, Schröter A, Al-Nawas B, Kämmerer PW. Calcium Phosphate-Coated Titanium Implants in the Mandible: Limitations of the in vivo Minipig Model. Eur Surg Res 2021; 61:177-187. [PMID: 33601367 DOI: 10.1159/000513846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to compare implant osseointegration with calcium phosphate (CaP) surfaces and rough subtractive-treated sandblasted/acid etched surfaces (SA) in an in vivo minipig mandible model. MATERIALS AND METHODS A total of 36 cylindrical press-fit implants with two different surfaces (CaP, n = 18; SA, n = 18) were inserted bilaterally into the mandible of 9 adult female minipigs. After 2, 4, and 8 weeks, we analyzed the cortical bone-to-implant contact (cBIC; %) and area coverage of bone-to-implant contact within representative bone chambers (aBIC; %). RESULTS After 2 weeks, CaP implants showed no significant increase in cBIC and aBIC compared to SA (cBIC: mean 38 ± 5 vs. 16 ± 11%; aBIC: mean 21 ± 1 vs. 6 ± 9%). Two CaP implants failed to achieve osseointegration. After 4 weeks, no statistical difference between CaP and SA was seen for cBIC (mean 54 ± 15 vs. 43 ± 16%) and aBIC (mean 43 ± 28 vs. 32 ± 6). However, we excluded two implants in each group due to failure of osseointegration. After 8 weeks, we observed no significant intergroup differences (cBIC: 18 ± 9 vs. 18 ± 20%; aBIC: 13 ± 8 vs. 16 ± 9%). Again, three CaP implants and two SA implants had to be excluded due to failure of osseointegration. CONCLUSION Due to multiple implant losses, we cannot recommend the oral mandibular minipig in vivo model for future endosseous implant research. Considering the higher rate of osseointegration failure, CaP coatings may provide an alternative to common subtractive implant surface modifications in the early phase post-insertion.
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Affiliation(s)
- Till Kämmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany, .,Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany,
| | - Tony Lesmeister
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Victor Palarie
- Clinic for Oral and Maxillofacial Surgery, University Nicolae Testemitanu, Chisinau, Moldova
| | - Eik Schiegnitz
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | | | - Bilal Al-Nawas
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
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Tur D, Giannis K, Unger E, Mittlböck M, Rausch-Fan X, Strbac GD. Thermal effects of various drill materials during implant site preparation-Ceramic vs. stainless steel drills: A comparative in vitro study in a standardised bovine bone model. Clin Oral Implants Res 2020; 32:154-166. [PMID: 33220104 PMCID: PMC7898889 DOI: 10.1111/clr.13685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/19/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate thermal effects of ceramic and metal implant drills during implant site preparation using a standardised bovine model. MATERIAL AND METHODS A total of 320 automated intermittent osteotomies of 10- and 16-mm drilling depths were performed using zirconium dioxide-based and stainless steel drills. Various drill diameters (2.0/ 2.2, 2.8, 3.5, 4.2 mm ∅) and different cooling methods (without/ with external saline irrigation) were investigated at room temperature (21 ± 1°C). Temperature changes were recorded in real time using two custom-built multichannel thermoprobes in 1- and 2-mm distance to the osteotomy site. For comparisons, a linear mixed model was estimated. RESULTS Comparing thermal effects, significantly lower temperatures could be detected with steel-based drills in various drill diameters, regardless of drilling depth or irrigation method. Recorded temperatures for metal drills of all diameters and drilling depths using external irrigation were below the defined critical temperature threshold of 47°C, whereas ceramic drills of smaller diameters reached or exceeded the harmful temperature threshold at 16-mm drilling depths, regardless of whether irrigation was applied or not. The results of this study suggest that the highest temperature changes were not found at the deepest point of the osteotomy site but were observed at subcortical and deeper layers of bone, depending on drill material, drill diameter, drilling depth and irrigation method. CONCLUSIONS This standardised investigation revealed drill material and geometry to have a substantial impact on heat generation, as well as external irrigation, drilling depth and drill diameter.
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Affiliation(s)
- Dino Tur
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Katharina Giannis
- Clinical Division Unit-Dentistry Training, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, AKH Vienna, Vienna, Austria
| | - Martina Mittlböck
- Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Georg D Strbac
- Clinical Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Tumedei M, Piattelli A, Falco A, De Angelis F, Lorusso F, Di Carmine M, Iezzi G. An in vitro evaluation on polyurethane foam sheets of the insertion torque, removal torque values, and resonance frequency analysis (RFA) of a self-tapping threads and round apex implant. CELLULAR POLYMERS 2020. [DOI: 10.1177/0262489320971796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The dental implant primary stability and micromovement absence represent critical factor for dental implant osseointegration. The aim of the present in vitro investigation was to simulate the bone response on different polyurethane densities the effect of self-tapping threads and round apex implant geometry. A total of 40 implants were positioned in D1, D2, D3 and D4 polyurethane block densities following a calibrated drilling protocol. The Insertion, removal Torque and resonance frequency analysis (RFA) means were calculated. All experimental conditions showed insertion torque values >30 Ncm. A significant higher insertion torque, removal and RFA was present in D1 polyurethane. Similar evidences were evidenced for D3 and D4. The effectiveness of the present study suggested a valuable clinical advantage for self-tapping threads and round apex implant using, such as in case of reduced bone density in the posterior maxilla
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Affiliation(s)
- Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
- Chair of Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Av. de los Jerónimos, Guadalupe, Murcia, Spain
- Fondazione Villa Serena per la Ricerca, Città Sant’Angelo (PE), Italy
| | | | - Francesco De Angelis
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
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Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants-A Systematic Review on Preclinical In Vivo Research. MATERIALS 2020; 13:ma13163461. [PMID: 32781597 PMCID: PMC7476012 DOI: 10.3390/ma13163461] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. METHODS Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in English and German language journals until 1 November 2019. The outcome measures were temperature-exposure intervals and laser settings effecting bone damage. Furthermore, investigated parameters were the bone-to-implant contact ratios (BIC) and infrabony pockets around dental implants after thermal treatment. For quality assessment of studies, the CAMARADES study quality checklist was applied. RESULTS A total of 455 animals in 25 animal studies were included for data extraction after screening of 45 titles from 957 selected titles of the MEDLINE (PubMed), The Cochrane Library, Embase and Web of Science search. The threshold values for bone necrosis ranged between 47 °C and 55 °C for 1 min. A threshold value for cryoinsult and laser treatment has not yet been defined. However, temperatures in the vicinity of 3.5 °C produce a histologically proven effect on the bone and in the surrounding tissue. At 50 °C for 1 min, BIC values significantly decreased and infrabony pockets increased. Bone quality had an influence on the outcome, as cancellous bone suffered higher bone damage from thermal treatment compared to cortical bone. CONCLUSION No clear threshold value for bone necrosis is available according to the current literature for warm and cold stimuli. More in-depth and clinical studies are required to provide further insights in assessing the potential of thermal necrosis for implant removal.
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In Vitro Study on Bone Heating during Drilling of the Implant Site: Material, Design and Wear of the Surgical Drill. MATERIALS 2020; 13:ma13081921. [PMID: 32325829 PMCID: PMC7216160 DOI: 10.3390/ma13081921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation. MATERIAL AND METHODS Three study groups (stainless steel drills with straight blades; diamond-like carbon-coated drills with straight blades; and diamond-like carbon-coated drills with twisted blades) were tested to compare material, design and wear of the surgical drill in terms of overall mean values (complete sequence of drills) and specific mean values (each drill separately). The groups comprised four drills: initial, pilot, progressive and final drill. Implant site configuration was performed through an intermittent and gradual drilling technique without irrigation at 800 rpm in standardized synthetic blocks. Maximum axial loading of two kilograms was controlled by an automatic press. Each surgical drill was submitted to 50 drillings and was sterilized every five uses. A thermographic camera analyzed the mean thermal changes. The software-controlled automatic press kept systematic drilling, axial loading and operational speed constant without any human intervention. Student's t-test, ANOVA and multiple linear regression models were performed. The level of significance was 5% (p = 0.05). RESULTS The overall mean comparison between the stainless steel and diamond-like carbon-coated materials showed no statistically significant differences (p > 0.05), though specific mean comparison showed statistically significant differences between the drills of the different groups (p < 0.05). The twisted blades exhibited less overall and specific mean thermal variation than straight blades for the progressive and final drills (p < 0.01). In addition, the initial and pilot drills showed a greater mean thermal change than the progressive and final drills. The mean thermal variation was seen to increase during the 50 drillings. CONCLUSIONS Within the limitations of this study, it can be concluded that the drill material did not significantly influence the overall mean thermal variation except for the pilot drill. The drill design affected overall and specific mean thermal variation since the twisted blades heated less than the straight blades. The initial and pilot drills increased the specific mean thermal variation with respect to the progressive and final drills. In addition, all drills in each group produced a gradual increase in mean temperature during the 50 drillings.
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He X, Reichl FX, Milz S, Michalke B, Wu X, Sprecher CM, Yang Y, Gahlert M, Röhling S, Kniha H, Hickel R, Högg C. Titanium and zirconium release from titanium- and zirconia implants in mini pig maxillae and their toxicity in vitro. Dent Mater 2020; 36:402-412. [DOI: 10.1016/j.dental.2020.01.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/02/2019] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
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Scarano A, Lorusso F, Noumbissi S. Infrared Thermographic Evaluation of Temperature Modifications Induced during Implant Site Preparation with Steel vs. Zirconia Implant Drill. J Clin Med 2020; 9:jcm9010148. [PMID: 31948130 PMCID: PMC7019482 DOI: 10.3390/jcm9010148] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 12/21/2019] [Accepted: 12/31/2019] [Indexed: 12/12/2022] Open
Abstract
Background: The heat produced during implant site osteotomy can potentially interfere with and influence the osseointegration process of a dental implant. The objective of this in vitro investigation was to measure the temperature changes during simulated osteotomies in bovine rib bone. The measurements were made at the apical area of the osteotomies with steel implant drills compared to zirconia implant drills. Methods: Steel cylindrical drills (2 mm) and zirconia cylindrical drills (2 mm) were evaluated in vitro using bovine rib bone for a total of five groups based on the number of osteotomies performed with each drill: 10, 20, 40, 90, or 120 osteotomies. Bone and apical drill temperatures were measured by means of infrared thermography. The drilling time for each osteotomy was measured for each preparation. Results: Statistically significant differences were found in the temperature measurements in the bone and apical portion of the drills between the study groups (p < 0.05). A statistically significant difference was observed for drilling time preparation between steel cylindrical drill (2 mm) and zirconia cylindrical drills (2 mm) (p < 0.01). Conclusions: The drill material has an impact on the temperature changes that occur at its apical portion during bone preparation for implant placement.
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Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences and CeSI-Met, University of Chieti-Pescara, Via Dei Vestini, 31, 66100 Chieti, Italy
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA;
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Brazil
- Correspondence: ; Tel.: +39-08713664099
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy;
| | - Sammy Noumbissi
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA;
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy;
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Camps-Font O, Martín-Fatás P, Clé-Ovejero A, Figueiredo R, Gay-Escoda C, Valmaseda-Castellón E. Postoperative infections after dental implant placement: Variables associated with increased risk of failure. J Periodontol 2018; 89:1165-1173. [DOI: 10.1002/jper.18-0024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Octavi Camps-Font
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Pablo Martín-Fatás
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Adrià Clé-Ovejero
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Rui Figueiredo
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Cosme Gay-Escoda
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- Oral Surgery and Implantology; Faculty of Medicine; Efhre International University; Belize City Belize
| | - Eduard Valmaseda-Castellón
- Oral Surgery and Implantology; Faculty of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
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Schmalz G, Hickel R, van Landuyt KL, Reichl FX. Nanoparticles in dentistry. Dent Mater 2017; 33:1298-1314. [PMID: 28951037 DOI: 10.1016/j.dental.2017.08.193] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Nanoparticles having a size from 1 to 100nm are present in nature and are successfully used in many products of daily life. Nanoparticles are also embedded per se or as byproducts from milling processes of larger filler particles in many dental materials. METHODS AND RESULTS Recently, possible adverse effects of nanoparticles have gained increased interest with the lungs being a main target organ. Exposure to nanoparticles in dentistry may occur in the dental laboratory, by processing gypsum type products or by grinding and polishing materials. In the dental practice virtually no exposure to nanoparticles occurs when handling unset materials. However, nanoparticles are produced by intraoral adjustment of set restorative materials through grinding/polishing regardless whether they contain nanoparticles or not. Nanoparticles may also be produced through wear of restorations or released from dental implants and they enter the environment when removing restorations. The risk for dental technicians is taken care of by legal regulations. Based on model worst case mass-based calculations, the exposure of dental practice personnel and patients to nanoparticles through intraoral grinding/polishing and wear is low to negligible. Accordingly, the additional risk due to nanoparticles exposure from present materials is considered to be low. However, more research is needed, especially on vulnerable groups (asthma or COPD). An assessment of risks for the environment is not possible due to the lack of data. SIGNIFICANCE Measures to reduce exposure to nanoparticles include intraorally grinding/polishing using water coolants, proper sculpturing to reduce the need for grinding and sufficient ventilation of treatment areas.
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Affiliation(s)
- Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital, Regensburg, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany
| | | | - Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Germany.
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16
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Silva RDO, Passador F, Caria PHF. Twist removal of healed vs. nonhealed implants-a mechanical and histological study in mini pigs. Int J Implant Dent 2016; 2:23. [PMID: 27888491 PMCID: PMC5124023 DOI: 10.1186/s40729-016-0059-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/18/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The objective of this study was to evaluate the effect of removal torque (reverse torque) of titanium implants in peri-implant bone. METHODS The P1-M1 teeth were extracted bilaterally of 6 mini pigs (BR-1). Each animal received 6 titanium implants, three for each side of mandible. On the right side of mandible, 3 implants reminded 9 months (9M) under masticatory activity and on the left side, other 3 implants were placed and immediately removed (IR). All 36 implants were removed by removal torque, and the recorded values were statistically analyzed. Animals were euthanized right after the removal torque and recording. Each third (cervical, medium, and apical) of peri-implant bone was extracted and analyzed histological and immunohistochemically. Student's t test was used to determine statistical differences in the values between the 9M and IR samples. Data were presented as means with standard deviations. The level of significance was set at 5% (P < 0.05). RESULTS Removal torque was higher in 9M experimental situation than in IR. Histological characteristics of mature bone were presented in the 9M experimental condition, and immature bone characteristics were presented in the IR experimental condition. Removal torque caused small fractures and rounding in the bone grooving. Immunohistochemical analysis reinforced the histological results; Student's t test provided statistically significant differences to osteocalcin expression in 9M samples and no statistically significant differences expression to collagen I in both experimental conditions (P < 0.05). CONCLUSIONS Removal torque caused microscopical fractures and smoothing in the peri-implant bone grooves, but it does not compromise the bone healing.
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He X, Reichl FX, Wang Y, Michalke B, Milz S, Yang Y, Stolper P, Lindemaier G, Graw M, Hickel R, Högg C. Analysis of titanium and other metals in human jawbones with dental implants - A case series study. Dent Mater 2016; 32:1042-51. [PMID: 27298240 DOI: 10.1016/j.dental.2016.05.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/23/2015] [Accepted: 05/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to measure titanium (Ti) content in human jawbones and to show that Ti was released from dental implants inserted into these jawbones. METHODS Seven samples from four human subjects with dental implants were analysed as test group and six bone samples of similar topographical regions from six human subjects without implants served as control. The contents of various elements in human jawbones were detected by inductively coupled plasma optical emission spectrometry. The distributions of various isotopes in human mandibular bone were measured with laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Histological analyses of undecalcified, Giemsa-Eosin stained mandible sections were performed by light microscopy and particles were identified in human bone marrow by scanning electron microscope-energy dispersive X-ray analysis. RESULTS In test group only Ti content was significantly higher compared to control group. The mean contents of Ti were 1940μg/kg in test group and 634μg/kg in control group. The highest Ti content detected in human mandibular bone was 37,700μg/kg-bone weight. In samples 4-7 (human subjects II-IV), increased Ti intensity was also detected by LA-ICP-MS in human mandibular tissues at a distance of 556-1587μm from implants, and the intensity increased with decreasing distance from implants. Particles with sizes of 0.5-40μm were found in human jawbone marrow tissues at distances of 60-700μm from implants in samples 4-7. SIGNIFICANCE Ti released from dental implants can be detected in human mandibular bone and bone marrow tissues, and the distribution of Ti in human bone was related to the distance to the implant.
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Affiliation(s)
- Xiuli He
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Franz-Xaver Reichl
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Yan Wang
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Bernhard Michalke
- Research Unit Analytical Biogeochemistry, Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Ingolstaedter Landstraße 1, 85764 Neuherberg, Germany
| | - Stefan Milz
- Department of Anatomy II - Neuroanatomy, Ludwig-Maximilians-University of Munich, Pettenkoferstr. 11, 80336 Munich, Germany
| | - Yang Yang
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Philipp Stolper
- Fogra Forschungsgesellschaft Druck e.V., Streitfeldstr 1, 81673 Munich, Germany
| | - Gabriele Lindemaier
- Institute of Forensic Medicine, Ludwig-Maximilian-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Matthias Graw
- Institute of Forensic Medicine, Ludwig-Maximilian-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Reinhard Hickel
- Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Christof Högg
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany.
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Cubela M, Soljic V, Kero D, Vukojevic K, Govorko DK, Saraga-Babic M. Comparison of proliferation, apoptosis and expression of syndecan-1 and α-SMA in edentulous ridge oral mucosa of successful and early failed submerged dental implants—An immunohistochemical study. Arch Oral Biol 2016; 66:155-64. [DOI: 10.1016/j.archoralbio.2016.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/18/2016] [Accepted: 02/26/2016] [Indexed: 11/30/2022]
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Calvo-Guirado JL, Delgado-Peña J, Maté-Sánchez JE, Mareque Bueno J, Delgado-Ruiz RA, Romanos GE. Novel hybrid drilling protocol: evaluation for the implant healing--thermal changes, crestal bone loss, and bone-to-implant contact. Clin Oral Implants Res 2014; 26:753-60. [PMID: 24502654 DOI: 10.1111/clr.12341] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate a new hybrid drilling protocol, by the analysis of thermal changes in vitro, and their effects in the crestal bone loss and bone-to-implant contact in vivo. MATERIALS AND METHODS Temperature changes during simulated osteotomies with a hybrid drilling technique (biologic plus simplified) (test) versus an incremental drilling technique (control) were investigated. One hundred and twenty random osteotomies were performed (60 by group) in pig ribs up to 3.75-mm-diameter drill to a depth of 10 mm. Thermal changes and time were recorded by paired thermocouples. In a parallel experiment, bilateral mandibular premolars P2, P3, P4, and first molar M1 were extracted from six dogs. After 2-month healing, implant sites were randomly prepared using either of the drilling techniques. Forty eight implants of 3.75 mm diameter and 10 mm length were inserted. The dogs were euthanized at 30 and 90 days, and crestal bone loss (CBL) and bone-to-implant contact (BIC) were evaluated. RESULTS The control group showed maximum temperatures of 35.3 °C ± 1.8 °C, ΔT of 10.4 °C, and a mean time of 100 s/procedure; meanwhile, the test group showed maximum temperatures of 36.7 °C ± 1.2 °C, ΔT of 8.1 °C, and a mean time of 240 s/procedure. After 30 days, CBL values for both groups (test: 1.168 ± 0.194 mm; control: 1.181 ± 0.113 mm) and BIC values (test: 43 ± 2.8%; control: 45 ± 1.3%) were similar, without significant differences (P > 0.05). After 90 days, CBL (test: 1.173 ± 0.187 mm; control: 1.205 ± 0.122 mm) and BIC (test: 64 ± 3.3%; control: 64 ± 2.4%) values were similar, without significant differences (P > 0.05). The BIC values were increased at 90 days in both groups compared with the 30-day period (P < 0.05). CONCLUSIONS Within the limitations of this study, the new hybrid protocol for the preparation of the implant bed without irrigation, increase the temperature similarly to the incremental conventional protocol, and requires twice the time for the completion of the drilling procedure in vitro. Crestal bone loss and bone-to-implant contact in the hybrid drilling protocol are comparable with the conventional drilling protocol and do not affect the osseointegration process in vivo.
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20
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Marković A, Mišić T, Mančić D, Jovanović I, Šćepanović M, Jezdić Z. Real-time thermographic analysis of low-density bone during implant placement: a randomized parallel-group clinical study comparing lateral condensation with bone drilling surgical technique. Clin Oral Implants Res 2013; 25:910-8. [PMID: 23710900 DOI: 10.1111/clr.12191] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare the effect of two surgical techniques, lateral condensation and bone drilling, on changes in temperature of the adjacent low-density bone during implant placement into posterior maxilla and to investigate the influence of the host factors - age, gender, region of implantation, bone density, and thickness of the cortical bone at the recipient sites. MATERIAL AND METHODS Local bone temperature was measured thermographically during implant placement into posterior maxilla following lateral bone condensing (test group) or bone drilling (controls). The main study outcomes were baseline bone temperature prior to implantation and maximum bone temperature recorded during implantation. Early implant success was evaluated after 6 months of healing. RESULTS A total of 40 implants were randomly allocated to test and control groups and placed into maxillary premolar and/or molar region of 18 participants of both genders and average age of 51.74 years. All recorded bone temperatures were below the threshold for thermal necrosis. Although both groups showed significant increase in bone temperature during implant placement procedure (P ≤ 0.0005), it was significantly higher for bone condensing compared with drilling (P ≤ 0.0005; 3.79 ± 1.54°C; 1.91 ± 0.70°C respectively). No host factor was singled out as a significant predictor of bone temperature changes, although trend of higher increase was observed in young patients, regardless of gender, during implant placement procedure into maxillary first premolar region with bone density type 3 and cortical layer thicker than 1 mm. Early implant success rate after 6 months follow-up was 100%. CONCLUSION Although both surgical techniques, bone condensing and bone drilling, can be considered safe regarding their thermal effect on the bone of posterior maxilla, bone drilling is associated with fewer local bone heating during implantation. Host factors do not affect the bone thermal changes significantly.
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Affiliation(s)
- Aleksa Marković
- Clinic of Oral Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
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Aboushelib MN, Osman E, Jansen I, Everts V, Feilzer AJ. Influence of a Nanoporous Zirconia Implant Surface of on Cell Viability of Human Osteoblasts. J Prosthodont 2013; 22:190-5. [DOI: 10.1111/j.1532-849x.2012.00920.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Streckbein P, Streckbein RG, Wilbrand JF, Malik CY, Schaaf H, Howaldt HP, Flach M. Non-linear 3D evaluation of different oral implant-abutment connections. J Dent Res 2012; 91:1184-9. [PMID: 23045362 DOI: 10.1177/0022034512463396] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Micro-gaps and osseous overload in the implant-abutment connection are the most common causes of peri-implant bone resorption and implant failure. These undesirable events can be visualized on standardized three-dimensional finite element models and by radiographic methods. The present study investigated the influence of 7 available implant systems (Ankylos, Astra, Bego, Brånemark, Camlog, Straumann, and Xive) with different implant-abutment connections on bone overload and the appearance of micro-gaps in vitro. The individual geometries of the implants were transferred to three-dimensional finite element models. In a non-linear analysis considering the pre-loading of the occlusion screw, friction between the implant and abutment, the influence of the cone angle on bone strain, and the appearance of micro-gaps were determined. Increased bone strains were correlated with small (< 15°) cone angles. Conical implant-abutment connections efficiently avoided micro-gaps but had a negative effect on peri-implant bone strain. Bone strain was reduced in implants with greater wall thickness (Ankylos) or a smaller cone angle (Bego). The results of our in silico study provide a solid basis for the reduction of peri-implant bone strain and micro-gaps in the implant-abutment connection to improve long-term stability.
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Affiliation(s)
- P Streckbein
- Department for Cranio-Maxillo-Facial and Plastic Surgery, University Hospital Giessen, Klinikstr. 33, 35385 Giessen, Germany.
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23
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Marković A, Mišić T, Miličić B, Calvo-Guirado JL, Aleksić Z, Đinić A. Heat generation during implant placement in low-density bone:effect of surgical technique, insertion torque and implant macro design. Clin Oral Implants Res 2012; 24:798-805. [DOI: 10.1111/j.1600-0501.2012.02460.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Aleksa Marković
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Tijana Mišić
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Biljana Miličić
- Department of Medical Statistics and Informatics, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Jose Luis Calvo-Guirado
- Department of Dental Implantology, Faculty of Medicine and Dentistry; University of Murcia; Murcia, Spain
| | - Zoran Aleksić
- Department of Periodontics, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
| | - Ana Đinić
- Clinic of Oral Surgery, Faculty of Dentistry; University of Belgrade; Belgrade; Serbia
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Jo KH, Yoon KH, Park KS, Bae JH, You KH, Han JH, Shin JM, Baik JS, Jeon IS, Cheong JK. Thermally induced bone necrosis during implant surgery: 3 case reports. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.5.406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Kyu-Hong Jo
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Kyh-Ho Yoon
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Kwan-Soo Park
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Jung-Ho Bae
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Kyung-Ha You
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Ji-Hoon Han
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Jae-Myung Shin
- Department of Oral and Maxillofacial Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea
| | - Jee-Seon Baik
- Department of Oral and Maxillofacial Surgery, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea
| | | | - Jeong-Kwon Cheong
- Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
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25
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AlGhamdi AST. Successful Treatment of Early Implant Failure: A Case Series. Clin Implant Dent Relat Res 2010; 14:380-7. [DOI: 10.1111/j.1708-8208.2009.00267.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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27
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El-Beialy AR, Abou-El-Ezz AM, Attia KH, El-Bialy AM, Mostafa YA. Loss of anchorage of miniscrews: A 3-dimensional assessment. Am J Orthod Dentofacial Orthop 2009; 136:700-7. [DOI: 10.1016/j.ajodo.2007.10.059] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2007] [Revised: 10/01/2007] [Accepted: 10/01/2007] [Indexed: 12/11/2022]
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Scarano A, Piattelli A, Assenza B, Carinci F, Donato LD, Romani GL, Merla A. Infrared Thermographic Evaluation of Temperature Modifications Induced during Implant Site Preparation with Cylindrical versus Conical Drills. Clin Implant Dent Relat Res 2009; 13:319-23. [DOI: 10.1111/j.1708-8208.2009.00209.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Scarano A, Carinci F, Quaranta A, Di Iorio D, Assenza B, Piattelli A. Effects of bur wear during implant site preparation: an in vitro study. Int J Immunopathol Pharmacol 2008; 20:23-6. [PMID: 17897497 DOI: 10.1177/039463200702001s06] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Few studies have investigated the influence of drilling on bone healing. After the drilling of bone and placement of dental implants a sequence begins of cellular and molecular events which represents a combined response of wound healing. The bone healing around dental implants is a complex phenomenon and influences the proliferation and differentiation of pre-osteoblasts into osteoblasts, together with the activation of periosteal and endosteal lining cells, and initiates the production and mineralization of osteoid matrix followed by the organization of the bone-implant interface. The objective of this study is to quantify the temperature changes in cortical bone and marrow spaces during implant site preparation in bovine rib bone. A total 10 harvested bovine ribs and 6 10.5 x 3.5 new drills for implant insertion with external irrigation (Bone System, Milano, Italy) were used in this study. The implant sites were prepared with 10 mm long drills at 500 rpm under abundant external irrigation with saline solution at 37 degrees C. Each drill was used for 10, 30, 60, 90 and 120 implant site preparations; each drill was then observed under SEM for evaluation of the damage of the cutting edge after 10, 30, 60, 90 and 120 preparations. There was an higher and statistically significant increase in the temperature in the cortical bone; this increase in temperature increases with the number of the times of drill use. The drill wear seemed to play a major role in heat production and could explain the observed increased temperature of the bone.
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31
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Liou EJW, Pai BCJ, Lin JCY. Do miniscrews remain stationary under orthodontic forces? Am J Orthod Dentofacial Orthop 2004; 126:42-7. [PMID: 15224057 DOI: 10.1016/j.ajodo.2003.06.018] [Citation(s) in RCA: 230] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. Sixteen adult patients with miniscrews (diameter = 2 mm, length = 17 mm) as the maxillary anchorage were included in this study. Miniscrews were inserted on the maxillary zygomatic buttress as a direct anchorage for en masse anterior retraction. Nickel-titanium closed-coil springs were placed for the retraction 2 weeks after insertion of the miniscrews. Cephalometric radiographs were taken immediately before force application (T1) and 9 months later (T2). The cephalometric tracings at T1 and T2 were superimposed for the overall best fit on the structures of the maxilla, cranial base, and cranial vault to determine any movement of the miniscrews. The miniscrews were also evaluated clinically for their mobility (0: no movement, 1: < or =0.5 mm, 2: 0.5-1.0 mm, 3: >1.0 mm). The mobility of all miniscrews was 0 at T1 and T2. On average, the miniscrews tipped forward significantly, by 0.4 mm at the screw head. The miniscrews were extruded and tipped forward (-1.0 to 1.5 mm) in 7 of the 16 patients. Miniscrews are a stable anchorage but do not remain absolutely stationary throughout orthodontic loading. They might move according to the orthodontic loading in some patients. To prevent miniscrews hitting any vital organs because of displacement, it is recommended that they be placed in a non-tooth-bearing area that has no foramen, major nerves, or blood vessel pathways, or in a tooth-bearing area allowing 2 mm of safety clearance between the miniscrew and dental root.
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Affiliation(s)
- Eric J W Liou
- Department of Orthodontics and Craniofacial Dentistry, Chang Gung Memorial Hospital and Graduate School of Craniofacial Medicine, Chang Gung University, 199 Tung-Hwa North Road, Taipei 105, Taiwan.
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Piattelli A, Scarano A, Favero L, Iezzi G, Petrone G, Favero GA. Clinical and histologic aspects of dental implants removed due to mobility. J Periodontol 2003; 74:385-90. [PMID: 12710760 DOI: 10.1902/jop.2003.74.3.385] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Implant failures are rare but do occur. Mechanical factors are certainly important in implant failures; so are biologic, iatrogenic, and functional factors. Mobility is the cardinal sign of implant failure. Three major etiologic factors have been suggested for implant failures: infection, impaired healing, and overload. The aim of the present study was to histologically and histochemically evaluate the fibrous connective tissue found around failed dental implants removed due to mobility. METHODS In a 5-year period, 51 root-form implants were retrieved because of mobility and underwent histological examination. Thin ground sections were obtained from each implant. RESULTS Almost all implants had been inserted in posterior (premolar-molar) regions of both jaws. In all specimens, there was the presence of a 600 to 1,100 microm thick connective tissue between implants and surrounding bone. In every case, the surrounding bone was compact and highly mineralized, with well-structured Haversian canals and few areas of remodeling. No bacteria were found in the most coronal portion of the implants. A scarce inflammatory cell infiltrate was present in the connective tissue of some specimens. In about 10% of specimens, the epithelium tended to surround the perimeter of the implant. CONCLUSION Our histological results are consistent with the hypothesis that late failures of osseointegrated implants can be caused by a combination of poor bone quality, mechanical trauma to bone, and overloading forces.
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Allen EP, Bayne SC, Becker IM, Donovan TE, Hume WR, Kois JC. Annual review of selected dental literature: report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 1999; 82:27-66. [PMID: 10384164 DOI: 10.1016/s0022-3913(99)70128-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- E P Allen
- Department of Periodontics, Baylor College of Dentistry, The Texas A&M University System, Dallas, USA.
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